Manejo clínico de tuberculosis drogorresistente en pacientes inmunocomprometidos
Fecha
2023
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La tuberculosis (TB), enfermedad infecciosa crónica que existe hace millones de años y no ha podido ser erradicada, es de preocupación a nivel mundial debido a estadísticas preocupantes en el número de muertes provocadas por esta enfermedad y al momento siguen incrementando los casos confirmados con algún tipo de resistencia a los antibióticos, como resistencia a rifampicina (RR), a isoniacida y rifampicina (MDR), resistencia fluoroquinolonas e inyectables de 2da línea (XDR). Objetivo: Determinar el manejo clínico de tuberculosis drogoresistente en pacientes inmunocomprometidos en el hospital Dr. José Daniel Rodríguez Maridueña del año 2019 al 2022. Identificar los casos diagnósticados con Tuberculosis drogorresistente en inmunocomprometidos. Caracterizar el manejo clínico de los pacientes diagnósticados. Investigar las técnicas diagnósticas los casos de Tuberculosis drogorresistente en pacientes inmunocomprometidos. Correlacionar asociación entre los pacientes diagnósticados con Tuberculosis Drogorresistente inmunocomprometidos y el manejo clínico recibido.
Resultados: Se logró investigar 869 pacientes con tuberculosis el 66% en el año 2022, el 9% con TB DR, predomina el sexo masculino 84%, entre los 20 y 40 años con un 88%.
Se detectó que en el 62% de los casos se recomendó el tratamiento estandarizado con antibióticos inyectables y quinolonas, un 58% de los pacientes se encuentran inmunocomprometidos por causa del VIH. Los casos detectados de MDR por Gen Xpert fueron de 73% de casos y XDR diagnósticados por PSD con un 27%. La correlación entre el manejo clínico y los casos de TB el 9% de los pacientes drogorresistentes comenzaron su tratamiento durante los 4 años de estudio.
Tuberculosis (TB), a chronic infectious disease that has existed for millions of years and has not been eradicated, is of worldwide concern due to worrying statistics in the number of deaths caused by this disease and at the moment confirmed cases continue to increase with some type of resistance to antibiotics, such as resistance to rifampicin (RR), to isoniazid and rifampicin (MDR), resistance to fluoroquinolones and second-line injectables (XDR). Objective: To determine the clinical management of drug-resistant tuberculosis in immunocompromised patients at the Dr. José Daniel Rodríguez Maridueña hospital from 2019 to 2022. To identify the cases diagnosed with drug- resistant tuberculosis in immunocompromised patients. Characterize the clinical management of diagnosed patients. Investigate diagnostic techniques for cases of drug- resistant tuberculosis in immunocompromised patients. To correlate the association between immunocompromised patients diagnosed with drug-resistant tuberculosis and the clinical management received. Results: It was possible to investigate 869 patients with tuberculosis, 66% in the year 2022, 9% with DR TB, 84% males predominate, between 20 and 40 years old with 88%. It was detected that in 62% of the cases standardized treatment with injectable antibiotics and quinolones was recommended, 58% of the patients are immunocompromised due to HIV. The cases of MDR detected by Gen Xpert were 73% of cases and XDR diagnosed by PSD with 27%. The correlation between clinical management and TB cases 9% of drug-resistant patients began their treatment during the 4 years of study.
Tuberculosis (TB), a chronic infectious disease that has existed for millions of years and has not been eradicated, is of worldwide concern due to worrying statistics in the number of deaths caused by this disease and at the moment confirmed cases continue to increase with some type of resistance to antibiotics, such as resistance to rifampicin (RR), to isoniazid and rifampicin (MDR), resistance to fluoroquinolones and second-line injectables (XDR). Objective: To determine the clinical management of drug-resistant tuberculosis in immunocompromised patients at the Dr. José Daniel Rodríguez Maridueña hospital from 2019 to 2022. To identify the cases diagnosed with drug- resistant tuberculosis in immunocompromised patients. Characterize the clinical management of diagnosed patients. Investigate diagnostic techniques for cases of drug- resistant tuberculosis in immunocompromised patients. To correlate the association between immunocompromised patients diagnosed with drug-resistant tuberculosis and the clinical management received. Results: It was possible to investigate 869 patients with tuberculosis, 66% in the year 2022, 9% with DR TB, 84% males predominate, between 20 and 40 years old with 88%. It was detected that in 62% of the cases standardized treatment with injectable antibiotics and quinolones was recommended, 58% of the patients are immunocompromised due to HIV. The cases of MDR detected by Gen Xpert were 73% of cases and XDR diagnosed by PSD with 27%. The correlation between clinical management and TB cases 9% of drug-resistant patients began their treatment during the 4 years of study.
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TUBERCULOSIS, MANEJO CLINICO, RESISTENCIA A MEDICAMENTOS, HOSPITAL DE INFECTOLOGIA DR. JOSE DANIEL RODRIGUEZ MARIDUEÑA, CANTON GUAYAQUIL, ECUADOR