       Document 0069
 DOCN  M9630069
 TI    [Resistance of Mycobacterium tuberculosis in Mexican patients. I.
       Clinical features and risk factors]
 DT    9603
 AU    Sifuentes-Osornio J; Ponce-de-Leon LA; Camacho-Mezquita FE;
       Bobadilla-del-Valle JM; Infante-Suarez ML; Ramirez-Fernandez N;
       Hernandez-Gomez L; Nelson AM; Departamento de Infectologia, Instituto
       Nacional de la; Nutricion Salvador Zubiran.
 SO    Rev Invest Clin. 1995 Jul-Aug;47(4):273-81. Unique Identifier : AIDSLINE
       MED/96030316
 AB    OBJECTIVE. To determine the clinical manifestations associated with
       resistant M. tuberculosis infection and the antimicrobial resistance in
       isolates from Mexican patients. STUDY DESIGN. Epidemiological
       surveillance. PATIENTS. Tuberculosis confirmed cases. METHODS. Primary
       resistance: no history of treatment prior to diagnosis. The following
       critical concentrations (micrograms/mL) were used for susceptibility:
       isoniazid 0.2 and 1; rifampin 1 and 5; ethambutol 5 and 10; streptomycin
       2 and 10; ethionamide 5; kanamycin 6; and para-aminosalicylic acid (PAS)
       2 and 10. RESULTS. Eighty-four patients with a mean age of 44.7 years
       were included; 54 men (64%) and 30 women (36%); most patients were from
       the Mexico City metropolitan area. In 34 patients there was clinical
       information available, 26 presented fever and weight loss and 8
       respiratory symptoms. Fifty-nine patients (70%) were infected by
       pan-susceptible M. tuberculosis, and 25 (30%) by a resistant isolate; 17
       (68%) of them were resistant to at least two drugs, 16 (64%) to
       isoniazid and rifampin. The proportion of resistance was: isoniazid 24%,
       rifampin 19%, streptomycin 12%, ethambutol 10%, PAS 9%, etionamide 7%,
       and kanamycin 6%. Of 47 patients without previous treatment, eight had a
       resistant microorganism (17%): 9% resistant to isoniazid, 6% to
       rifampin, 2% to streptomycin, 6% to PAS and 6% multiresistant. Of 37
       patients with history of previous treatment for tuberculosis, 17 (46%)
       had a resistant isolate; 44% were resistant to isoniazid, 35% to
       rifampin, 24% to streptomycin, 19% to ethambutol, 12% to PAS and 35%
       multiresistant. Of the 84 patients, four were physicians infected by a
       resistant isolate, and seven HIV-infected patients, one with a
       multiresistant isolate, and another with isoniazid resistance.
       CONCLUSIONS. Antimicrobial resistance among M. tuberculosis is
       alarmingly high in Mexico City; these results emphasize the importance
       of case detection and early isolation of patients.
 DE    Adolescence  Adult  Aged  Aged, 80 and over  Antitubercular
       Agents/*PHARMACOLOGY  Child  Comorbidity  Drug Resistance, Microbial
       Drug Resistance, Multiple  English Abstract  Female  Human  HIV
       Infections/EPIDEMIOLOGY  Male  Microbial Sensitivity Tests  Middle Age
       Mycobacterium tuberculosis/*DRUG EFFECTS/ISOLATION & PURIF  Population
       Surveillance  Retrospective Studies  Risk Factors  Support, Non-U.S.
       Gov't  Support, U.S. Gov't, Non-P.H.S.  Support, U.S. Gov't, P.H.S.
       Tuberculosis/EPIDEMIOLOGY/*MICROBIOLOGY  Urban Population  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

