科研之友
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摘要
objective: to analyze the clinical characteristics and evolution of a group of patients with positive sputum cultures for multidrug-resistant (mdr) mycobacterium tuberculosis and treated at a referral center in the city of rio de janeiro, brazil. methods: based on the positive results in sputum cultures for mdr m. tuberculosis, 50 patients were selected, and their clinical data were obtained from the brazilian ministry of health mdr-tb database. the frequencies of noncompliance, relapses, failures and previous treatments for tb up to diagnosis of mdr-tb were compiled. the radiological patterns were classified as unilateral or bilateral, and with or without cavitation. two years after the end of the standard treatment for mdr-tb, the outcome (cure, failure, noncompliance or death) for each patient was evaluated and reassessed every two years. the post-treatment follow-up period was eight years. results: the mean number of previous treatments was 2.3 ㊣ 0.9. the mean interval between the initial diagnosis and the development of mdr-tb was 2.0 ㊣ 1.7 years. two years after the initial treatment for mdr-tb, 2 patients had abandoned treatment, 8 had died, 18 had been cured, and 22 had presented treatment failure. the bivariate analysis showed that bilateral pulmonary involvement and cavitary pattern markedly reduced the chances for cure, with a relative risk of 1-0.6 (40%) and 1-0.7 (30%), respectively. at the end of the follow-up period, 2 patients had abandoned treatment, 9 had presented treatment failure, 17 had been cured, and 22 had died. conclusions: bilateral pulmonary involvement and cavity pattern greatly reduced the chances for cure of the patients with mdr-tb. most patients who presented treatment failure died within the 8-year follow-up period.
