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Resistant Mycobacterium tuberculosis Strains From Immigrants in the Community of Madrid: Current Assessment
Belén Sanz Barbero
, Teresa Blasco Hernández, on behalf of the working group on Adherence to Tuberculosis Treatment in the Immigrant Population of the Community of Madrid (ATBIM) 1
Corresponding author
bsanz@isciii.es
Correspondence: Dra. B. Sanz Barbero. Centro Nacional de Medicina Tropical. Instituto de Salud Carlos III. Sinesio Delgado, 4-8, pabellón 13. 28029 Madrid. España
Correspondence: Dra. B. Sanz Barbero. Centro Nacional de Medicina Tropical. Instituto de Salud Carlos III. Sinesio Delgado, 4-8, pabellón 13. 28029 Madrid. España
Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain
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"España" ] 4 => array:2 [ "nombre" => "Rosa" "apellidos" => "Díez" ] 5 => array:2 [ "nombre" => "Mikel" "apellidos" => "Oribe" ] 6 => array:2 [ "nombre" => "Isabel" "apellidos" => "Urrutia" ] 7 => array:2 [ "nombre" => "Urko" "apellidos" => "Aguirre" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212907600779?idApp=UINPBA00003Z" "url" => "/15792129/0000004300000006/v1_201305150319/S1579212907600779/v1_201305150319/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Resistant <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> Strains From Immigrants in the Community of Madrid: Current Assessment" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "324" "paginaFinal" => "333" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Belén Sanz Barbero, Teresa Blasco Hernández" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Belén Sanz" "apellidos" => "Barbero" "email" => array:1 [ 0 => "bsanz@isciii.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "Teresa Blasco" "apellidos" => "Hernández" ] 2 => array:2 [ "colaborador" => "on behalf of the working group on Adherence to Tuberculosis Treatment in the Immigrant Population of the Community of Madrid (ATBIM)" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn1" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra. B. Sanz Barbero. Centro Nacional de Medicina Tropical. Instituto de Salud Carlos III. Sinesio Delgado, 4-8, pabellón 13. 28029 Madrid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-07-04" "fechaAceptado" => "2006-10-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154899" "palabras" => array:4 [ 0 => "Immigration" 1 => "Tuberculosis" 2 => "Resistance" 3 => "Community of Madrid" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154898" "palabras" => array:4 [ 0 => "Inmigración" 1 => "Tuberculosis" 2 => "Resistencias" 3 => "Comunidad de Madrid" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">OBJECTIVE</span><p class="elsevierStyleSimplePara elsevierViewall">Immigration to Spain from countries with high rates of tuberculosis infection is increasing. The aim of this study was to describe and analyze resistance to antituberculosis drugs in strains isolated from foreign-born patients in the Community of Madrid.</p> <span class="elsevierStyleSectionTitle">PATIENTS AND METHODS</span><p class="elsevierStyleSimplePara elsevierViewall">A cohort of immigrants was identified at 14 hospitals in the Community of Madrid. To assess the sensitivity of isolated strains, we used the MGIT 960 system and/or the proportion method of Canetti. Clinical and sociodemographic information was recorded for each patient. We compiled descriptive statistics and performed univariate analysis, followed by multiple logistic regression analysis.</p> <span class="elsevierStyleSectionTitle">RESULTS</span><p class="elsevierStyleSimplePara elsevierViewall">From a total of 312 cases, 268 strains were isolated. Sensitivity was tested in 221 strains. The proportion of immigrants with no health care coverage was 19.9%. Thirty-one strains (14.0%) were resistant; 24 (12.6%) were in newly diagnosed cases and 6 (27.3%) were in patients who had been treated previously. Ten strains (4.5%) were multidrug resistant. Resistance to isoniazid was detected in 18 strains (9.5%). Multidrug resistance was associated with a history of prior antituberculosis treatment (odds ratio, 5.94; 95% confidence interval, 1.46-24.18).</p> <span class="elsevierStyleSectionTitle">CONCLUSIONS</span><p class="elsevierStyleSimplePara elsevierViewall">Barriers to health care faced by immigrants with tuberculosis should be removed. Treatment should begin with 4 drugs while the results of sensitivity tests are pending. A history of prior antituberculosis treatment should raise a suspicion of multidrug resistance.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">OBJETIVO</span><p class="elsevierStyleSimplePara elsevierViewall">Actualmente en España se está produciendo un incremento de la población de inmigrantes que proceden de países con altas tasas de incidencia de enfermedad tuberculosa. El objetivo de este trabajo ha sido describir y analizar las resistencias a fármacos antituberculosos entre la población inmigrante de la Comunidad de Madrid.</p> <span class="elsevierStyleSectionTitle">PACIENTES Y MÉTODOS</span><p class="elsevierStyleSimplePara elsevierViewall">La cohorte de inmigrantes fue identificada a través de 14 hospitales de la Comunidad de Madrid. Para evaluar la susceptibilidad de las cepas aisladas se utilizó el sistema MGIT 960 y/o el método de las proporciones de Canetti. De cada paciente se recogió información clínica y sociodemográfica. En primer lugar se realizó un estudio descriptivo y, posteriormente, un análisis univariante y multivariante por medio de regresiones logísticas.</p> <span class="elsevierStyleSectionTitle">RESULTADOS</span><p class="elsevierStyleSimplePara elsevierViewall">Se identificaron 312 casos, en los que se aislaron 268 cepas. Se obtuvo información de sensibilidad de 221 cepas. El 19,9% de la muestra no tenía cobertura sanitaria. Fueron resistentes 31 cepas (14,0%), de las que 24 (12,6%) correspondían a casos nuevos y 6 (27,3%) a casos previamente tratados. Diez cepas (4,5%) fueron multirresistentes. La resistencia a isoniacida en casos nuevos fue del 9,5% (18 cepas). La multirresistencia se asoció a historia previa de tratamiento antituberculoso (<span class="elsevierStyleItalic">odds ratio</span> = 5,94; intervalo de confianza del 95%, 1,46-24,18).</p> <span class="elsevierStyleSectionTitle">CONCLUSIONES</span><p class="elsevierStyleSimplePara elsevierViewall">Es necesario eliminar los problemas de acceso al sistema sanitario entre los inmigrantes afectados de tuberculosis. Las pautas de tratamiento deberían comenzar con 4 fármacos hasta conocer los resultados de sensibilidad. La historia previa de tratamiento antituberculoso debe incrementar la sospecha de multirresistencia.</p>" ] ] "NotaPie" => array:2 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was partially funded by a grant from the Instituto de Salud Carlos III (project SBPY 1254/02-02).</p>" ] 1 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara">Members of the working group on Adherence to Tuberculosis Treatment in the Immigrant Population of the Community of Madrid (ATBIM) are listed at the end of the article.</p>" "identificador" => "fn1" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Tuberculosis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "A global emergency. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 2 | 6 |
| 2024 October | 28 | 13 | 41 |
| 2024 September | 21 | 13 | 34 |
| 2024 August | 37 | 32 | 69 |
| 2024 July | 21 | 26 | 47 |
| 2024 June | 23 | 22 | 45 |
| 2024 May | 34 | 23 | 57 |
| 2024 April | 21 | 23 | 44 |
| 2024 March | 20 | 15 | 35 |
| 2024 February | 28 | 18 | 46 |
| 2024 January | 1 | 0 | 1 |
| 2023 March | 3 | 3 | 6 |
| 2023 February | 12 | 13 | 25 |
| 2023 January | 15 | 35 | 50 |
| 2022 December | 19 | 26 | 45 |
| 2022 November | 16 | 16 | 32 |
| 2022 October | 19 | 28 | 47 |
| 2022 September | 14 | 18 | 32 |
| 2022 August | 18 | 36 | 54 |
| 2022 July | 16 | 44 | 60 |
| 2022 June | 15 | 26 | 41 |
| 2022 May | 13 | 26 | 39 |
| 2022 April | 23 | 29 | 52 |
| 2022 March | 14 | 37 | 51 |
| 2022 February | 17 | 31 | 48 |
| 2022 January | 17 | 28 | 45 |
| 2021 December | 15 | 42 | 57 |
| 2021 November | 10 | 46 | 56 |
| 2021 October | 16 | 42 | 58 |
| 2021 September | 15 | 59 | 74 |
| 2021 August | 9 | 24 | 33 |
| 2021 July | 14 | 20 | 34 |
| 2021 June | 11 | 38 | 49 |
| 2021 May | 12 | 25 | 37 |
| 2021 April | 26 | 28 | 54 |
| 2021 March | 13 | 22 | 35 |
| 2021 February | 11 | 13 | 24 |
| 2021 January | 6 | 14 | 20 |
| 2020 December | 10 | 18 | 28 |
| 2020 November | 9 | 7 | 16 |
| 2020 October | 3 | 3 | 6 |
| 2020 September | 4 | 2 | 6 |
| 2020 August | 9 | 7 | 16 |
| 2020 July | 5 | 13 | 18 |
| 2020 June | 10 | 4 | 14 |
| 2020 May | 13 | 6 | 19 |
| 2020 April | 15 | 15 | 30 |
| 2020 March | 9 | 7 | 16 |
| 2020 February | 12 | 10 | 22 |
| 2020 January | 9 | 9 | 18 |
| 2019 December | 16 | 12 | 28 |
| 2019 November | 6 | 9 | 15 |
| 2019 October | 14 | 3 | 17 |
| 2019 September | 14 | 11 | 25 |
| 2019 August | 10 | 7 | 17 |
| 2019 July | 10 | 12 | 22 |
| 2019 June | 6 | 5 | 11 |
| 2019 May | 9 | 9 | 18 |
| 2019 April | 12 | 14 | 26 |
| 2019 March | 6 | 8 | 14 |
| 2019 February | 8 | 10 | 18 |
| 2019 January | 0 | 3 | 3 |
| 2018 December | 3 | 8 | 11 |
| 2018 November | 8 | 6 | 14 |
| 2018 October | 14 | 15 | 29 |
| 2018 September | 10 | 10 | 20 |
| 2018 May | 8 | 1 | 9 |
| 2018 April | 6 | 6 | 12 |
| 2018 March | 9 | 4 | 13 |
| 2018 February | 5 | 6 | 11 |
| 2018 January | 1 | 6 | 7 |
| 2017 December | 7 | 8 | 15 |
| 2017 November | 4 | 3 | 7 |
| 2017 October | 7 | 7 | 14 |
| 2017 September | 5 | 16 | 21 |
| 2017 August | 3 | 14 | 17 |
| 2017 July | 4 | 7 | 11 |
| 2017 June | 5 | 8 | 13 |
| 2017 May | 8 | 4 | 12 |
| 2017 April | 1 | 5 | 6 |
| 2017 March | 3 | 3 | 6 |
| 2017 February | 1 | 3 | 4 |
| 2017 January | 2 | 3 | 5 |
| 2016 December | 6 | 6 | 12 |
| 2016 November | 11 | 5 | 16 |
| 2016 October | 11 | 12 | 23 |
| 2016 September | 10 | 3 | 13 |
| 2016 August | 13 | 3 | 16 |
| 2016 July | 6 | 4 | 10 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 50 | 6 | 56 |
| 2015 September | 45 | 6 | 51 |
| 2015 August | 45 | 10 | 55 |
| 2015 July | 59 | 5 | 64 |
| 2015 June | 25 | 5 | 30 |
| 2015 May | 53 | 11 | 64 |
| 2015 April | 44 | 7 | 51 |
| 2015 March | 48 | 8 | 56 |
| 2015 February | 43 | 4 | 47 |
| 2015 January | 42 | 6 | 48 |
| 2014 December | 33 | 5 | 38 |
| 2014 November | 44 | 9 | 53 |
| 2014 October | 73 | 13 | 86 |
| 2014 September | 49 | 11 | 60 |
| 2014 August | 36 | 11 | 47 |
| 2014 July | 30 | 11 | 41 |
| 2014 June | 58 | 12 | 70 |
| 2014 May | 57 | 17 | 74 |
| 2014 April | 54 | 11 | 65 |
| 2014 March | 71 | 8 | 79 |
| 2014 February | 62 | 12 | 74 |
| 2014 January | 47 | 10 | 57 |
| 2013 December | 49 | 12 | 61 |
| 2013 November | 33 | 7 | 40 |
| 2013 October | 29 | 12 | 41 |
| 2013 September | 45 | 7 | 52 |
| 2013 August | 41 | 14 | 55 |
| 2013 July | 51 | 15 | 66 |
| 2013 June | 40 | 7 | 47 |
| 2013 May | 34 | 7 | 41 |
| 2013 April | 31 | 10 | 41 |
| 2013 March | 8 | 3 | 11 |
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