Caracterização molecular de isolados de Mycobacterium tuberculosis multidroga resistente em unidade de referência no município de Fortaleza, Ceará

Abstract

Tuberculosis (TB) disease is highly infectious, caused by the bacillus Mycobacterium tuberculosis. It is estimated that a quarter of the world's population is infected. According to WHO, in 2014 it was estimated that there were 480,000 cases of MDR-TB. In 2017, 3,076 TB cases were reported in Ceará, of which 1,847 were reported in Fortaleza alone, representing an incidence rate of 63.8 new cases per 100,000 inhabitants, which is considered a high parameter in relation to the national average. Resistant multidrug TB (MDR) is defined as resistance to isoniazid (I) and rifampicin (R), two main drugs used to treat TB, thus constituting a serious problem for the control of the disease. The main objective was to determine and understand the variables of frequency and transmission of resistant TB (TB-R) related to the home and community environment, evaluating socioeconomic, environmental, behavioral and comorbidities aspects associated with R-TB. A prospective and observational study was conducted with 49 participants with TB-R in HIV-negative patients. The material was collected at the outpatient clinics of Dr. Carlos Alberto Studart Gomes Hospital from July 2017 to June 2018. Sputum samples were cultured and submitted to the BACTEC phenotypic test. In addition, a questionnaire with demographic, clinical and behavioral data was applied. The I and R resistance were found in 30.6% (15/49) of the analyzed cases. Regarding diabetes, 67.8% (33/49) of the patients did not present this comorbidity. Alcoholism increased the risk of resistance, where 73.7% (14/19) of the patients had resistant strains. Regarding gender, there was a predominance of men in the total of the participants of 53.1% (26/49). All the information in this study could be used to establish more adequate and effective measures for the prevention of this disease.