Evaluación de las medidas de control adoptadas frente a la epidemia de tuberculosis multirresistente asociada al sida en un hospital hispanoamericano

HIV Infection and Geographically Bound Transmission of Drug-Resistant Tuberculosis, Argentina

“…HIV infection was associated with almost one third of MDR TB cases; this proportion is 2–4× higher than that attributed by different studies to all forms of TB in the country ( 16 , 17 ). As previously observed ( 18 ), annual fluctuations in the numbers of total MDR/XDR TB cases during the study period paralleled closely annual fluctuations in the numbers of HIV-infected patients.…”

“…After genotyping confirmed outbreaks of MDR TB among the patients with AIDS ( 4 ), hospital infection control interventions were adopted, microbiologic diagnosis and drug-resistance detection were expedited, and second-line TB drugs and highly active antiretroviral therapy became available. As a result of those interventions, hospital transmission was substantially reduced but not completely controlled ( 18 ). At the time of our study, however, the M strain had long expanded beyond the hospital environment ( 6 ).…”

Impact of Infection Control Measures to Control an Outbreak of Multidrug-Resistant Tuberculosis in a Human Immunodeficiency Virus Ward, Peru

“…The striking and statisitically significant decrease in the proportion of MDRTB among HIV-positive patients with TB seen in this study is consistent with reports from Hospital Muñiz in Buenos Aires, Argentina, where the proportion of MDRTB cases among HIV-coinfected patients reduced from 16% in 1995 to 7% in 2001 37. In both hospitals, infection control measures included measures to improve detection of TB before and during admission, and isolation of patients with MDRTB 6.…”

Molecular Epidemiology of Mycobacterium tuberculosis, Buenos Aires, Argentina

“…This phenomenon could be associated with a bias in the sample resulting from the specialized nature of the hospital or it could be that the MDR TB version has become predominant in the population because of the low fitness cost of its 2 mutations, kat G315 and S531L ( 10 , 11 ) )). In addition, the presence of clusters suggests that even though new technologies have reduced the time taken to diagnose drug resistance, more rapid initial diagnosis of MDR TB to reduce transmission still is needed ( 12 ). …”