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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
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Clasificación de la tuberculosis resistente a los medicamentos en una zona de epidemia
A Van Rie1, R Warren, M Richardson
1Department of Paediatrics and Child Health, University of Stellenbosch, South Africa.
Lancet (London, England)
|July 13, 2000
Resumen
La clasificación tradicional de la tuberculosis resistente a los medicamentos es engañosa. El polimorfismo de longitud de fragmento de restricción (RFLP) reveló la transmisión de cepas resistentes a los medicamentos en más de la mitad de los casos, lo que pone de relieve la necesidad de revisar la terminología.
Área de la Ciencia:
- Epidemiología molecular epidemiología molecular.
- Transmisión de enfermedades infecciosas por transmisión.
- La vigilancia de la salud pública.
Sus antecedentes:
- La clasificación tradicional de la tuberculosis resistente a los medicamentos se basa en el historial de tratamiento.
- La resistencia primaria a los medicamentos se ha atribuido históricamente únicamente a la transmisión de cepas resistentes a los medicamentos.
Objetivo del estudio:
- Evaluar la contribución de la transmisión de cepas resistentes a los medicamentos en la tuberculosis resistente a los medicamentos.
- Para comparar los resultados de la tipificación molecular con las clasificaciones clínicas tradicionales.
Principales métodos:
- Estudio descriptivo de 63 pacientes con tuberculosis resistente a los medicamentos en Ciudad del Cabo, Sudáfrica.
- Utilizó el polimorfismo de longitud de fragmento de restricción (RFLP, por sus siglas en inglés) para el tipo de cepa.
- Comparó los hallazgos de RFLP con la clasificación tradicional de pacientes.
Principales resultados:
- El polimorfismo de longitud de fragmento de restricción (RFLP) identificó la transmisión como la causa en el 52% de los casos de tuberculosis resistente a los medicamentos.
- La proporción de transmisión fue mayor para la tuberculosis multirresistente (64%) que para la resistente a un solo fármaco.
- La clasificación tradicional identificó erróneamente la transmisión en 25 pacientes.
Conclusiones:
- El término "resistencia adquirida a los medicamentos" abarca inexactamente tanto la verdadera adquisición como la transmisión.
- La clasificación errónea puede conducir a una supervisión defectuosa, la evaluación del programa y el retraso en el tratamiento.
- Recomendar la sustitución de "resistencia adquirida a los medicamentos" por "resistencia a los medicamentos en casos tratados previamente".
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