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Rendimiento del cribado sistemático de tuberculosis en pacientes con enfermedad obstructiva de las vías respiratorias
Manju Rajaram1, Palanivel Chinnakali2, Vinayagamoorthy Venugopal3
1Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Lung India : official organ of Indian Chest Society
|September 2, 2025
Resumen
Los pacientes que usan altas dosis de corticosteroides inhalados y los que tienen diabetes tienen un mayor riesgo de tuberculosis. Se recomienda un cribado específico para estas personas para detectar la tuberculosis temprano.
Área de la Ciencia:
- Medicina de los pulmones
- Enfermedades infecciosas
- Farmacología
Sus antecedentes:
- Los corticosteroides inhalados (ICS) están relacionados con un mayor riesgo de tuberculosis (TB).
- Los factores de riesgo específicos para el desarrollo de la tuberculosis en los usuarios de ICS requieren una investigación adicional.
Objetivo del estudio:
- Para identificar los factores de riesgo de tuberculosis en pacientes que usan corticosteroides inhalados.
- Informar sobre las estrategias de detección de la tuberculosis en esta población.
Principales métodos:
- Estudio transversal realizado en Puducherry, India.
- Se incluyeron 1550 pacientes tratados con ICS durante más de un año con presuntos síntomas de tuberculosis.
- Los métodos de diagnóstico incluyeron frotis de esputo, radiografía de tórax, CBNAAT, broncoscopia y BAL para la confirmación microbiológica.
Principales resultados:
- La diabetes y las dosis más altas de ICS fueron factores de riesgo independientes para la TB (OR: 6,4 y 7, respectivamente).
- Otros factores de riesgo identificados incluyen el sexo masculino, la enfermedad arterial coronaria, el tabaquismo y el consumo de alcohol.
- Se necesitó examinar a 262 pacientes para identificar un caso de tuberculosis.
Conclusiones:
- Los pacientes diabéticos y los que reciben dosis altas de ICS requieren un cribado específico para la tuberculosis.
- La detección temprana a través del cribado es crucial para el manejo de la tuberculosis en poblaciones vulnerables.
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