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Evolution of tuberculosis in an area of Vizcaya

Sandra Pedrero Tejada, Begoña Vilar Achabal, Maria Alfonso Imizcoz, Israel Lopez Mirones, Luis Miguel Soria Riendas, Nuria Marina Malanda, Ines Martinez Rienda, Esteban Ciruelos Ayuso, Rafael Zalacain Jorge, Elena Urra Zalbidegoitia
European Respiratory Journal 2011 38: p2629; DOI:
Sandra Pedrero Tejada
1Pneumology, Cruces Hospital, Barakaldo, Spain
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Begoña Vilar Achabal
2Microbiology, Cruces Hospital, Barakaldo, Spain
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Maria Alfonso Imizcoz
1Pneumology, Cruces Hospital, Barakaldo, Spain
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Israel Lopez Mirones
2Microbiology, Cruces Hospital, Barakaldo, Spain
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Luis Miguel Soria Riendas
2Microbiology, Cruces Hospital, Barakaldo, Spain
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Nuria Marina Malanda
1Pneumology, Cruces Hospital, Barakaldo, Spain
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Ines Martinez Rienda
2Microbiology, Cruces Hospital, Barakaldo, Spain
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Esteban Ciruelos Ayuso
1Pneumology, Cruces Hospital, Barakaldo, Spain
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Rafael Zalacain Jorge
1Pneumology, Cruces Hospital, Barakaldo, Spain
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Elena Urra Zalbidegoitia
2Microbiology, Cruces Hospital, Barakaldo, Spain
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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.

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Evolution of tuberculosis in an area of Vizcaya
Sandra Pedrero Tejada, Begoña Vilar Achabal, Maria Alfonso Imizcoz, Israel Lopez Mirones, Luis Miguel Soria Riendas, Nuria Marina Malanda, Ines Martinez Rienda, Esteban Ciruelos Ayuso, Rafael Zalacain Jorge, Elena Urra Zalbidegoitia
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2629;

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Evolution of tuberculosis in an area of Vizcaya
Sandra Pedrero Tejada, Begoña Vilar Achabal, Maria Alfonso Imizcoz, Israel Lopez Mirones, Luis Miguel Soria Riendas, Nuria Marina Malanda, Ines Martinez Rienda, Esteban Ciruelos Ayuso, Rafael Zalacain Jorge, Elena Urra Zalbidegoitia
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2629;
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