科研之友
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摘要
background:tuberculosis become important challenge to health care settings. brazil has high prevalence of the disease and rio de janeiro has high incidence rates with 30% of cases notified at hospitals. objective: to evaluate prevalence of initial and acquired drug resistance at a general hospital, reference for aids treatment in rio de janeiro and to identify associated factors. methods: mycobacterium tuberculosis strains from 165 patients were analyzed, between august 1996 and february 1998. results: twenty per cent (33/165) were resistant to at least one drug; 13% (12/165) to isoniazid; 3.64% (6/165) to rifampin and 3.64% (6/165) to both. among hiv seropositive subjects (52/165); 28.85% (15/52) were resistant to at least one drug. acquired resistance occurred in 15.79% of 19 patients that mentioned previous antitb treatment. association statistically significant was found with non cavitation on x-ray in bivariate analyses (p=0.05). eighty four patients refereed no previous treatment (npt). resistance to 1 or more drugs was found in 28.57% (24/84) of npt patients. association statistically significant with initial resistance was found with health care workers (p=0.004), unemployment (p=0.03), and diarrhea (p=0.01) in bivariate analyses. on multivariate analyses, health care workers (p=0.002) remained significantly associated with initial resistance. conclusions: high resistance rates was found. it corroborates that hospitals needs attention for tb control especially which concerns to health care works infection.
