Estudo sobre o perfil de resistência do Mycobacterium tuberculosis aos fármacos antimicobacterianos no Ceará

Abstract

Mycobacterium tuberculosis, due to its high mutagenic capacity, can adapt to adverse conditions and persist as the causative pathogen of infectious disease with the highest mortality rate worldwide. The study aimed to identify the resistance profile of the strains of M. tuberculosis to antimycobacterial drugs diagnosed in the LACEN (Central Public Health Laboratory). The specific objectives were to identify the profile of most drugs occurring in monoresistance; determine the frequency of cases of Pulmonary Tuberculosis Extrapulmonary and resistant to anti-TB drugs; Identify characteristics of the population, according to demographics, such as gender, age, Regional Health (CRES); Classify the type of resistance: monoresistance, polirresistance, multidrug resistance and extensive; Classify the occurrence of monorresistance according drug. This is a cohort study restrospectivo history of individuals with M. tuberculosis isolates with resistance to antimycobacterial drugs at LACEN–CE, diagnosed in the period 2010-2013. Classification of resistance profile was based on WHO criteria in monoresistance, polirresistance, multidrug resistance (MDR) and extensively resistance (XDR). The results revealed more cases of TB-resistant in male patients, with 66 % of cases. The age group most affected was 26-59 years with 66% of cases. As for the municipality of occurrence, it is observed that the prevalence of Ceara - resistant TB occurs in the first Regional Health (CRES), with 58 % of cases. 3984 of Mycobacterium tuberculosis strains isolated by culture in the years 2010-2013, 12% correspond to patients with any type of TB -resistant. As to the site of infection, it is noted the prevalence of pulmonary TB- resistant with 98% of cases. As to the resistance profile, 53% had only a drug resistance, 38% are multidrug resistant and 9% polirresistent. Must remain alert to the emergence of two cases of XDR TB, which shows an evolution in the resistance profile of the microorganism. Therefore, preventive measures should be employed, such as early diagnosis, appropriate monitoring of diagnosed cases and an incentive to search for new effective drugs against TB.