High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.

<h4>Introduction</h4>In high multidrug resistant (MDR) tuberculosis (TB) prevalence areas, drug susceptibility testing (DST) at diagnosis is recommended for patients with risk factors for MDR. However, this approach might miss a substantial proportion of MDR-TB in the general population....

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Autores principales:	Larissa Otero, Fiorella Krapp, Cristina Tomatis, Carlos Zamudio, Francine Matthys, Eduardo Gotuzzo, Patrick Van der Stuyft, Carlos Seas
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/760ef6b9e93b47e3bbb971def0c93c94
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spelling	oai:doaj.org-article:760ef6b9e93b47e3bbb971def0c93c942021-11-18T07:35:37ZHigh prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.1932-620310.1371/journal.pone.0026276https://doaj.org/article/760ef6b9e93b47e3bbb971def0c93c942011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22046266/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>In high multidrug resistant (MDR) tuberculosis (TB) prevalence areas, drug susceptibility testing (DST) at diagnosis is recommended for patients with risk factors for MDR. However, this approach might miss a substantial proportion of MDR-TB in the general population. We studied primary MDR in patients considered to be at low risk of MDR-TB in Lima, Peru.<h4>Methods</h4>We enrolled new sputum smear-positive TB patients who did not report any MDR-TB risk factor: known exposure to a TB patient whose treatment failed or who died or who was known to have MDR-TB; immunosuppressive co-morbidities, ex prison inmates; prison and health care workers; and alcohol or drug abuse. A structured questionnaire was applied to all enrolled participants to confirm the absence of these factors and thus minimize underreporting. Sputum from all participants was cultured on Löwenstein-Jensen media and DST for first line drugs was performed using the 7H10 agar method.<h4>Results</h4>Of 875 participants with complete data, 23.2% (203) had risk factors for MDR-TB elicited after enrolment. Among the group with no reported risk factors who had a positive culture, we found a 6.3% (95%CI 4.4-8.3) (37/584) rate of MDR-TB. In this group no epidemiological characteristics were associated with MDR-TB. Thus, in this group, multidrug resistance occurred in patients with no identifiable risk factors.<h4>Conclusions</h4>We found a high rate of primary MDR-TB in a general population with no identifiable risk factors for MDR-TB. This suggests that in a high endemic area targeting patients for MDR-TB based on the presence of risk factors is an insufficient intervention.Larissa OteroFiorella KrappCristina TomatisCarlos ZamudioFrancine MatthysEduardo GotuzzoPatrick Van der StuyftCarlos SeasPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 10, p e26276 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Larissa Otero Fiorella Krapp Cristina Tomatis Carlos Zamudio Francine Matthys Eduardo Gotuzzo Patrick Van der Stuyft Carlos Seas High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.
description	<h4>Introduction</h4>In high multidrug resistant (MDR) tuberculosis (TB) prevalence areas, drug susceptibility testing (DST) at diagnosis is recommended for patients with risk factors for MDR. However, this approach might miss a substantial proportion of MDR-TB in the general population. We studied primary MDR in patients considered to be at low risk of MDR-TB in Lima, Peru.<h4>Methods</h4>We enrolled new sputum smear-positive TB patients who did not report any MDR-TB risk factor: known exposure to a TB patient whose treatment failed or who died or who was known to have MDR-TB; immunosuppressive co-morbidities, ex prison inmates; prison and health care workers; and alcohol or drug abuse. A structured questionnaire was applied to all enrolled participants to confirm the absence of these factors and thus minimize underreporting. Sputum from all participants was cultured on Löwenstein-Jensen media and DST for first line drugs was performed using the 7H10 agar method.<h4>Results</h4>Of 875 participants with complete data, 23.2% (203) had risk factors for MDR-TB elicited after enrolment. Among the group with no reported risk factors who had a positive culture, we found a 6.3% (95%CI 4.4-8.3) (37/584) rate of MDR-TB. In this group no epidemiological characteristics were associated with MDR-TB. Thus, in this group, multidrug resistance occurred in patients with no identifiable risk factors.<h4>Conclusions</h4>We found a high rate of primary MDR-TB in a general population with no identifiable risk factors for MDR-TB. This suggests that in a high endemic area targeting patients for MDR-TB based on the presence of risk factors is an insufficient intervention.
format	article
author	Larissa Otero Fiorella Krapp Cristina Tomatis Carlos Zamudio Francine Matthys Eduardo Gotuzzo Patrick Van der Stuyft Carlos Seas
author_facet	Larissa Otero Fiorella Krapp Cristina Tomatis Carlos Zamudio Francine Matthys Eduardo Gotuzzo Patrick Van der Stuyft Carlos Seas
author_sort	Larissa Otero
title	High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.
title_short	High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.
title_full	High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.
title_fullStr	High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.
title_full_unstemmed	High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.
title_sort	high prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/760ef6b9e93b47e3bbb971def0c93c94
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High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.

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