Estudo da prevalência da resistência aos antibacilares

ABSTRACTIn Portugal the incidence of tuberculosis remains rather high. Morever, the tuberculosis co-infected patients With HIV, especcialy drug addicts as well as Mycobacterium tuberculosis have increased·in frequency. The increase in probability of drug-resistant tuberculosis in these patients along with the frequent ocurrence of non-compliance with antituberculosis chemotherapy prompted us to make this study. Objective: To determine resistence patterns to anti-tuberculosis drugs in new and previously treted patients. Design: We evaluated clinical and epidemilogical data. The results of susceptibility tests were obtained (critical proportions method), for all the five major antimy-cobactcrial drug, from hospitalized between April 1993 and July 1995. Documentation about HIV infeccion was also obtained. Results and conclusion; Resistance to one or more drugs was high in 17.7% of new cases and higher in 37.5% of Previously treated patients. Resistance to both Isoniazid and Rifampin was of 4.3%. higher and 23.2 %. respectively. In terms of epidemiological significancee there is an outstandingly high level of resistance to Isoniazid, chiefly in new eases (8.5%). An higher frequency of general resisance was found associated with HIV infection (28%). alcoholism (26.7%), and drug abuse (19.5%). We conclude that there is a considerable increase in drug-resistant tuberculosis affecting previously treated patients at of contracting or already being infected with HIV, which probably results from a noncompliance with chemotherapy. Finally, the high level (8.5%.) of resistance to Isoniazid in new cases, recommends the initial four drug regimen as an Initial therapy in our Department