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Vol. 27. Issue 1.
Pages 17-22 (January - February 1991)
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Vol. 27. Issue 1.
Pages 17-22 (January - February 1991)
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Epidemiología de las resistencias bacilares en la isla de Gran Canaria
Epidemiology of bacilar resistances in Gran Canaria island
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J.A. Caminero Luna, F. Rodríguez de Castro, G. Juliá Sardá, J.M. Fernández Sánchez, P. Cabrera Navarro
Sección de Neumología, Hospital Nuestra Señora del Pino. Las Palmas de Gran Canaria
A. González García*
* Sección de Microbiología. Hospital Nuestra Señora del Pino. Las Palmas de Gran Canaria
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Durante 1988 se estudiaron 102 pacientes con tuberculosis confirmada bacteriológicamente a los que se realizó una detallada recogida de datos y un seguimiento bacteriológico a lo largo del tratamiento. Todos los enfermos tenían cultivo positivo de las distintas muestras estudiadas, realizándole a todos ellos estudio de sensibilidad in vitro. Se encontraron cepas resistentes a uno o más fármacos en el 14,7% de los enfermos, siendo este porcentaje superior en los 13 que habían recibido previamente tratamiento antituberculoso (38,4%) que en los 89 que no referían este dato (11,2%). La resistencia fue más elevada en las 80 cepas aisladas a partir de muestras respiratorias (16,2%) que en las 22 aisladas de muestras de otras localizaciones (9%). Los fármacos que aportaron mayor resistencia primaria fueron la estreptomicina (6,7%) e isoniacida (5,6%), siendo este último fármaco el que presentó la tasa más elevada de resistencia secundaria (30,7%), seguido de rifampicina (23%) y estreptomicina (23%). De todos los factores analizados en los pacientes, tan sólo dieron tasas de resistencia más elevada que fueran estadísticamente significativas, el grupo de enfermos que habían recibido tratamiento previo (p<0,01). Los pacientes que eran portadores de enfermedad pulmonar cavitaria, los alcohólicos y los que referían contacto cercano con tuberculosos mal tratados aportaron mayores tasas de resistencia, aunque no tuvieron significación estadística. No se encontraron resistencias entre los 9 pacientes portadores de anticuerpos anti-VIH ni en los 4 afectos de SIDA (grupo no representativo). No se demostró influencia de la resistencia primaria a los distintos fármacos en el resultado final del tratamiento estándar de 9 meses empleado.

This study analyzed clinical data and bacteriologic response to treatment in a series of 102 patients with tuberculosis diagnosed by bacteriologic examination during 1988. Alt patients exhibited positive culture test in the studied samples and in all instances an in vitro sensitivity test was performed. Resistant strains to one or more antibiotic were found in 14.7% of patients. This percentage was higher in 13 patients who previously recieved antituberculous treatment (38.4%) than in 89 who did not recieve this treatment (11.2%). Resistance was higher in the 80 strains isolated from respiratory samples (16.2%) than in the 22 strains isolated from samples of other origin (9%). Antibiotic drugs with higher primary resistance were streptomycin (6.7%) and isoniazid (5.6%). Secondary resistance was 30.7% for isoniazid and 23% for rifampicin and streptomycin. Among all clinical variables analyzed the presence of previous antituberculous treatment was associated with a statistically significant increased resistance (p<0,01). Although not significantly patients with cavitary pulmonary tuberculosis, alcoholism, and those with close contact with insufficiently treated tuberculous patients had a tendency to show increased resistance values. There were no resistances in the 9 patients with anti-HIV antibodies nor in the 4 patients with AIDS (non representative group). Primary resistance to the different antibiotics appeared to not influence the final result of the conventional treatment stablished during a period of 9 months.

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