Letter to the Editor
Data Collection and Microbiological Monitoring in Global Tuberculosis Intervention
Recogida de datos y control microbiológico para la intervención global de la tuberculosis
Miguel López-Gobernadoa,
, Alberto Pérez-Rubiob, Eva Lopez-Garcíac, Jose María Eirosd
Corresponding author
a Servicio de Estudios, Documentación y Estadística, Consejería de Sanidad de la Junta de Castilla y León, Valladolid, Spain
b Dirección Médica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
c Gerencia de Atención Primaria Valladolid-Oeste, Valladolid, Spain
d Departamento de Microbiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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"idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Data Collection and Microbiological Monitoring in Global Tuberculosis Intervention" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "395" "paginaFinal" => "396" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Miguel López-Gobernado, Alberto Pérez-Rubio, Eva Lopez-García, Jose María Eiros" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Miguel" "apellidos" => "López-Gobernado" "email" => array:1 [ 0 => "mlopezgob@saludcastillayleon.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Alberto" "apellidos" => "Pérez-Rubio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Eva" "apellidos" => "Lopez-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Jose María" "apellidos" => "Eiros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Estudios, Documentación y Estadística, Consejería de Sanidad de la Junta de Castilla y León, Valladolid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Dirección Médica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Gerencia de Atención Primaria Valladolid-Oeste, Valladolid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Microbiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Recogida de datos y control microbiológico para la intervención global de la tuberculosis" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the article published by Caylà and Caminero,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> and in line with their proposal to update and implement a national program for the control of tuberculosis (TB) for Spain, we would like to contribute to this effort from Castile-Leon and emphasize the importance of epidemiological surveillance, microbiological control, and diagnosis and treatment of this disease.</p><p id="par0010" class="elsevierStylePara elsevierViewall">TB generates a high burden of morbidity and mortality worldwide, and it is estimated that 1.7 billion (23%) of the world's population is infected with <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> The distribution of the disease burden varies significantly depending on the region, and it was estimated that in 2017, 44% of cases occurred in the World Health Organization (WHO) South-East Asia region, 25% in Africa, 18% in the Western Pacific region, and 7.7% in the Eastern Mediterranean region. Incidence is lower in the Americas (2.8%) and Europe (2.7%).<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In total, 1419 new cases of TB were reported to the Epidemiological Surveillance Network of Castile-Leon in the 5-year period between 2012 and 2016.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> Incidence rates have remained steady, ranging from 10.5 new cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants reported in 2012 to 10.1 TB cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants in 2016. The incidence of confirmed cases shows a declining trend, from 11.7 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants in 2012 to 8.6 cases per 100<span class="elsevierStyleHsp" style=""></span>000 in the year 2016. Median age in men is 58 years and 48 years in women, with a male/female ratio ranging between 1.54 in 2014 and 1.94 in 2016.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Etiology from bacteriological diagnosis identifies <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> as the most frequently isolated microorganism, detected in 71% of cases. Antibiotic sensitivity testing of the series found 83 resistance patterns, of which 32 (39%) involve pyrazinamide resistance and 21 (25%) isoniazid resistance. Analysis of the follow-up results shows that in 2015, 67% had received satisfactory treatment, defined as cure and completed treatment.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The increasing prevalence of resistance in Castile-Leon since the beginning of this decade (1.2% to streptomycin; 3.2% to isoniazid; 0.3% to rifampicin; 0.1% to ethambutol; and 0.5% to pyrazinamide)<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> underlines the need for maintaining active surveillance and performing sensitivity studies, particularly when in Europe it is estimated that 17% (95% CI: 16%–18%) are new cases and 53% (95% CI: 46%–61%) of previously treated cases have methicillin-resistant and/or multidrug-resistant TB.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Our view, reflected by other authors,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> is that the rational and sequential use of antituberculous drugs is of utmost importance when designing TB treatment, be it sensitive or resistant.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Follow-up indicators and compliance with the criteria of the Plan for the Prevention and Control of Tuberculosis, agreed by the autonomous communities and approved by the Public Health Commission in June 2013, have improved in the years under study. However, it is essential that registries also improve, including the recording of appropriate microbiological data, if we are to achieve the proposed objectives and accelerate progress toward the global goals and milestones set down by the WHO for reducing the burden of TB disease, scheduled for 2020, 2025, 2030 and 2035.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López-Gobernado M, Pérez-Rubio A, Lopez-García E, Eiros JM. Recogida de datos y control microbiológico para la intervención global de la tuberculosis. Arch Bronconeumol. 2019;55:395–396.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La necesidad histórica de un programa nacional de control de la tuberculosis para España" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.A. Caylà" 1 => "J.A. Caminero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2018.06.013" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2018" "volumen" => "54" "paginaInicial" => "603" "paginaFinal" => "604" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30049559" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The global burden of latent tuberculosis infection: a reestimation using mathematical modelling" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.M. Houben" 1 => "P.J. 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Años 2012, 2013, 2014, 2015 y 2016" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Servicio de Epidemiologia" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2018" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Drug-resistance in <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> in Castilla y León, Spain, 2001–2005: third collaborative study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Alberte-Castiñeiras" 1 => "A. Campos-Bueno" 2 => "L. López-Urrutia" 3 => "E. Alvarez-Alonso" 4 => "G. Megías" 5 => "E. Ojeda-Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eimc.2010.02.011" "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2010" "volumen" => "28" "paginaInicial" => "706" "paginaFinal" => "709" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20627375" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and treatment of drug-resistant tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.A. Caminero" 1 => "J.A. Cayla" 2 => "J.M. García-García" 3 => "F.J. García-Pérez" 4 => "J.J. Palacios" 5 => "J. Ruiz-Manzano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2017.02.006" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2017" "volumen" => "53" "paginaInicial" => "501" "paginaFinal" => "509" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28359606" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005500000007/v1_201907020952/S1579212919301314/v1_201907020952/en/main.assets" "Apartado" => array:4 [ "identificador" => "45358" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005500000007/v1_201907020952/S1579212919301314/v1_201907020952/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919301314?idApp=UINPBA00003Z" ]
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