Investigation and Control of a Large Outbreak of Multi-Drug Resistant Tuberculo...

• Autor(es): Hannan, MM ; Peres, H ; Maltez, F ; Hayward, AC ; Machado, J ; Morgado, A ; Proença, R ; Nelson, MR ; Bico, J ; Young, DB ; Gazzard, BS
• Data: 2001
• Identificador Persistente: http://hdl.handle.net/10400.17/1782
• Origem: Repositório do Centro Hospitalar de Lisboa Central, EPE
• Assunto(s): HCC INF; Infecções Oportunistas Relacionadas com a SIDA; Análise por Conglomerados; Infecção Hospitalar; DNA Bacteriano; Surtos de Doenças; Unidades Hospitalares; Hospital Urbano; Controlo de Infecção; Mycobacterium Tuberculosis; Portugal; Estudos Retrospectivos; Abuso de Substâncias por Via Intravenosa; Tuberculose Resistente a Múltiplos Medicamentos
• Tipo de Documento: Artigo
• Idioma: Inglês

Descrição

An increase in the number of new cases of tuberculosis (TB) combined with poor clinical outcome was identified among HIV-infected injecting drug users attending a large HIV unit in central Lisbon. A retrospective epidemiological and laboratory study was conducted to review all newly diagnosed cases of TB from 1995 to 1996 in the HIV unit. Results showed that from 1995 to 1996, 63% (109/173) of the Mycobacterium tuberculosis isolates from HIV-infected patients were resistant to one or more anti-tuberculosis drugs; 89% (95) of these were multidrug-resistant, i.e., resistant to at least isoniazid and rifampicin. Eighty percent of the multidrug-resistant strains (MDR) available for restriction fragment length polymorphism (RFLP) DNA fingerprinting clustered into one of two large clusters. Epidemiological data support the conclusion that the transmission of MDR-TB occurred among HIV-infected injecting drug users exposed to infectious TB cases on open wards in the HIV unit. Improved infection control measures on the HIV unit and the use of empirical therapy with six drugs once patients were suspected to have TB, reduced the incidence of MDR-TB from 42% of TB cases in 1996 to 11% in 1999.