Abstract
Aim: To study the evolution of Mycobacterium tuberculosis (MT) over a period of 21 years in our area and to know the resistance rates to first-line antituberculostatic drugs.
Material and methods: We studied all cases of MT infection diagnosed between 1989 and 2009 in our hospital, attending a population of 420.000.
Results: In this period, 2.164 cases of MT infection have been diagnosed. The mean incidence rate was 24.5 per 100,000 inhabitants per year (maximum 42.6 in 1992 and minimum 11.9 in 2008). The mean age was 46.8, with a higher incidence in the group of 30-49 years.The gender distribution was 1.8 men/women. In 262 cases there was coinfection with HIV (12.1%), with a maximum of 23.6% (n = 35) in 1993 and minimum of 2.5% (n = 2) in 2004.
The location was pulmonary in 74.2%, extrapulmonary in 20.1% and disseminated in 5.7%. In patients co-infected with HIV, the presentation was pulmonary in 61.4%, extrapulmonary in 13.4% and disseminated in 25.2%. 61 strains have been detected with some resistance (2.8% of general population, which corresponds to 3% in non-HIV and 1.5% of coinfected). There were 36 strains resistant to isoniazid (1.7%), 11 to rifampicin (0.5%), 3 to ethambutol (0.14%) and 25 to streptomycin (1.2%). 17 strains were resistant to more than one drug. Of these, 6 were resistant to at least isoniazid and rifampicin (MDR-TB).
Conclusions: 1.The incidence of MT has clearly diminished over the study period. 2. There has been no change over the years in terms of gender distribution, age groups and location of MT. 3. HIV co-infection has less importance as a risk factor associated. 4. Resistance to first-line drugs is rare in our area and maintains stable levels. 5. We have found some MDR-TB in the study period.
- © 2011 ERS
