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ABSTRACT: During 1996-2000, a regional anti-tuberculosis drug resistance survey was conducted in Castilla-León, Spain.
To determine the incidence of drug-resistant tuberculosis (TB) in newly treated human immunodeficiency virus (HIV) negative and HIV-positive TB patients.
Nine hundred and eighty-five Mycobacterium tuberculosis strains isolated from HIV-negative (926) and HIV-positive (59) patients were studied (one strain per patient). Univariate and multivariate analyses were used to determine the prevalence of drug resistance in high-risk groups.
Thirty-eight isolates (3.8%) showed resistance to one of the following drugs: streptomycin (S), isoniazid (H), rifampicin (R) or ethambutol (E). Of these, 36 (3.9%) were from HIV-negative and 2 (3.4%) from HIV-positive patients. The rate of drug resistance among HIV-negative patients was 1.2%, 2.0%, 0.3% and 0.8%, respectively, for S, H, R and E, and for HIV-positive patients it was 3.4%, 0%, 0% and 1.7%. Among the HIV-negative patients, monoresistance was observed in 32 (3.4%) strains and resistance to both H and R (multi-drug resistance) was detected in one.
The incidence of primary drug resistance in the surveyed area was low and increased resistance was not observed in the HIV-positive group (P = 0.99). Routine surveillance of drug resistance is recommended by the TB control programme in representative patient populations to optimise treatment regimens.
The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease 06/2006; 10(5):554-8. · 2.73 Impact Factor
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ABSTRACT: Nocardia farcinica is an infrequent infection that usually appears in patients with predisposing conditions, especially in immunosuppressed patients, although it has also been found in healthy individuals. Its importance as a new pathogen has been recognized only in recent years. Mainly, it affects the lung, indistinguishable from other types of pneumonia in the clinical and radiological characteristics. The main reason for detection is therapeutic failure.
Anales de medicina interna (Madrid, Spain: 1984) 11/2004; 21(11):554-6.
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ABSTRACT: Twenty patients with urinary tuberculosis were treated with ofloxacin (200 mg/day, 6 months), rifampin (600 mg/day, 3 months) and isoniazid (300 mg/day, 3 months) between 1989 and 1990. All patients were new cases, diagnosed by observation and/or isolation of Mycobacterium tuberculosis in one of the three morning urine samples. Bacteriological culture conversion (negativization) was assessed as a clinical guide of efficacy, comparing it, as the only parameter, against a control group (150 patients) with urinary tuberculosis who received conventional therapy. Bacteriological follow-up studies were performed in both groups monthly for 6 months, then again 6 months later and then every year for 10 years after completion of treatment. In the 20 patients, the initial culture was positive with over 100 colonies per culture (>50%); the smear was positive in 45% of the patients (most were 2+). All strains were susceptible to rifampin, isoniazid and ofloxacin. Two patients discontinued treatment. Beginning with the first month of treatment, the bacteriological conversion was 100%, 89.5% and 100% in the remaining controls. In the control group, which received conventional treatment, the conversion was: 90%, 87%, 93% and 100% in the remaining controls. Treatment with ofloxacin resulted in a bacteriological conversion similar to that following conventional treatment ( p>0.05, Fisher's exact test). After 10 years of patient follow-up, we conclude that ofloxacin, in combination with rifampin and isoniazid (both for 3 months only is effective against M. tuberculosis, providing satisfactory bacteriological and clinical efficacy.
International Microbiology 10/2002; 5(3):139-44. · 1.80 Impact Factor
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ABSTRACT: To determine the primary drug resistance (PDR) of Mycobacterium tuberculosis in ten hospitals in the Castile-León Community for a five-year period (1991-1995), in a sanitary area with almost two millions of inhabitants.
The sensitivity of 825 strains of Mycobacterium tuberculosis to antituberculous drugs was studied using the proportion method; 773 strains were from HIV-negative patients and 52 from HIV-positive patients.
Thirty-four out of the 824 strains were resistant to one or more drugs: 31 (4%) from HIV-negative patients and 3 (5.7%) from HIV-positive patients. The resistance to the different drugs for strains from HIV-negative patients was: streptomycin, 2.4%; isoniazid, 1.8%; ethambutol, 0.6%, and rifampin, 0.2%. For HIV-positive patients, resistance to streptomycin was 5.7% and to isoniazid 1.9%. Resistance to a single agent was the resistance mode observed most commonly: 23 (2.9%) in HIV-negative patients and 2 (3.3%) in HIV-positive patients. There was not a single strain resistant to isoniazid and rifampin.
The incidence of PR in the surveyed area was low, including isoniazid. The group of HIV-positive patients did not show a significant increase in resistance (p = 0.4; OR, 1.44; 95% CI, 0.43-4.86). Regular surveillance of drug resistance is recommended to adjust therapeutic regimes.
Revista Clínica Española 04/1999; 199(3):132-5. · 2.01 Impact Factor
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ABSTRACT: We make here a preliminary report of the first 65 cases of tularemia diagnosed at our hospital pertaining to an epidemic outbreak occurred in the area served by the hospital. Diagnosis was made by the presence of a consistent clinical picture and the following laboratory criteria: antibody titre to. Francisella tularensis (tube agglutination) higher than or equal to 1/160, seroconversion or recovery of the microorganism from biological material. The mean age of our patients was 53.8 +/- 13.5 years and female sex predominated (45 women). Fever, lymph node enlargement, cutaneous ulcers, asthenia, and weight loss were the most common symptoms. The presentation clinical forms included: ulceroganglionar (69%), typhoidal (14%), ganglionar (12.5%), pneumonic (1.5%), oculoganglionar (1.5%) and atypical (1.5%). The analytical data did not show significant changes with the exception of erythrocyte sedimentation rate. Streptomycin was the antibiotic of choice, followed by ciprofloxacin and gentamicin. The failure rate was 22%, and ciprofloxacin was used for retreatment in twelve occasions and ofloxacin in 1 occasion with a good response. Tularemia is an infective disease which can become endemic in Spain and that should be considered by clinicians, particularly when unilateral enlarged lymph nodes, prolonged febrile syndromes, pharyngitis with negative culture, poor response to beta-lactams and atypical pneumonia are present.
Revista Clínica Española 01/1999; 198(12):789-93. · 2.01 Impact Factor
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ABSTRACT: To study the electrophoretic RNA patterns of human rotavirus (RV) during three years in Valladolid (Spain).
From october 1986 to october 1989 we have studied the electrophoretic RNA patterns of RV in 104 fecal samples. Stools were first screened by a latex agglutination test (LA) and reactive samples were confirmed by a commercial enzymeimmunoassay (EIA) and electron microscopy (EM) (negative stain). Electropherotyping was made according to conventional methods.
96.2% of the samples studied yield a defined electropherotype. We have found 8 different types of patterns of genomic RV-RNA circulating in these three years. Two of them belonged to short pattern (C and E) and six to long pattern (A, B, D, F, G and H).
98.0% of the genomic RNA founded were of long pattern, from which pattern A was the most prevalent (72%) during the study, without a seasonal distribution. Pattern B was found in 20% of cases, while the rest were found only occasionally.
Enfermedades Infecciosas y Microbiología Clínica 11(6):309-13. · 1.49 Impact Factor
