RESUMEN
In 2003, the incidence of tuberculosis in Argentina showed an increase compared to 2002. The severe national crisis at the end of the 90s has probably strongly contributed to this situation. The goal of this work was to estimate the extent of the spread of the most predominant Mycobacterium tuberculosis strains and to assess the spread of predominant M. tuberculosis clusters as determined by spoligotyping and IS6110 RFLP. The study involved 590 pulmonary, smear-positive TB cases receiving medical attention at health centers and hospitals in Northern Buenos Aires (NBA) suburbs, from October 2001 to December 2002. From a total of 208 clinical isolates belonging to 6 major clusters, 63 (30.2%) isolates had identical spoligotyping and IS6110 RFLP pattern. Only 22.2% were shown to have epidemiological connections with another member of their respective cluster. In these major clusters, 30.2% of the 208 TB cases studied by both molecular techniques and contact tracing could be convincingly attributable to a recently acquired infection. This knowledge may be useful to assess the clonal distribution of predominant M. tuberculosis clusters in Argentina, which may make an impact on TB control strategies.
Asunto(s)
Transmisión de Enfermedad Infecciosa , Mycobacterium tuberculosis/genética , Tuberculosis/microbiología , Adulto , Argentina/epidemiología , Técnicas de Tipificación Bacteriana/métodos , Niño , Análisis por Conglomerados , Elementos Transponibles de ADN/genética , ADN Bacteriano/genética , Femenino , Genotipo , Infecciones por VIH/epidemiología , Personal de Salud , Humanos , Incidencia , Masculino , Mycobacterium tuberculosis/clasificación , Mycobacterium tuberculosis/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Secuencias Repetitivas de Ácidos Nucleicos , Población Suburbana , Tuberculosis/epidemiología , Tuberculosis/transmisión , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Tuberculosis Resistente a Múltiples Medicamentos/transmisiónRESUMEN
In 2003, the incidence of tuberculosis in Argentina showed an increase compared to 2002. The severe national crisis at the end of the 90s has probably strongly contributed to this situation. The goal of this work was to estimate the extent of the spread of the most predominant Mycobacterium tuberculosis strains and to assess the spread of predominant M. tuberculosis clusters as determined by spoligotyping and IS6110 RFLP. The study involved 590 pulmonary, smear-positive TB cases receiving medical attention at health centers and hospitals in Northern Buenos Aires (NBA) suburbs, from October 2001 to December 2002. From a total of 208 clinical isolates belonging to 6 major clusters, 63 (30.2%) isolates had identical spoligotyping and IS6110 RFLP pattern. Only 22.2% were shown to have epidemiological connections with another member of their respective cluster. In these major clusters, 30.2% of the 208 TB cases studied by both molecular techniques and contact tracing could be convincingly attributable to a recently acquired infection. This knowledge may be useful to assess the clonal distribution of predominant M. tuberculosis clusters in Argentina, which may make an impact on TB control strategies.
La incidencia de la tuberculosis en Argentina mostró en 2003 un incremento en comparación con 2002. La grave crisis nacional a fines de los 90 ha probablemente contribuido en gran medida a esta situación. El objetivo del presente trabajo fue determinar la diversidad genética de aislamientos de Mycobacterium tuberculosis y el grado de dispersión de algunas cepas mayoritarias genéticamente relacionadas. El estudio involucró 590 aislamientos clínicos provenientes de muestras respiratorias con examen directo positivo, de pacientes atendidos en los hospitales y centros de salud que conforman la región Gran Buenos Aires Norte (NBA), de octubre de 2001 a diciembre de 2002. De 208 aislamientos que se encontraron en los 6 mayores clusters, 63 (30,2%) tenían patrones idénticos de spoligotyping y de IS6110 RFLP. En el 22,2% de los casos fue posible verificar la conexión epidemiológica con otro miembro del respectivo cluster. Concluimos que el 30,2% de estos agrupamientos principales pueden ser atribuidos a una infección reciente. Estos resultados pueden ser útiles para determinar la distribución clonal de los grupos predominantes de M. tuberculosis en Argentina, lo que puede impactar en las estrategias de control de la tuberculosis.
Asunto(s)
Adulto , Niño , Femenino , Humanos , Masculino , Transmisión de Enfermedad Infecciosa , Mycobacterium tuberculosis/genética , Tuberculosis/microbiología , Argentina/epidemiología , Técnicas de Tipificación Bacteriana/métodos , Análisis por Conglomerados , Elementos Transponibles de ADN/genética , ADN Bacteriano/genética , Genotipo , Personal de Salud , Infecciones por VIH/epidemiología , Incidencia , Mycobacterium tuberculosis/clasificación , Mycobacterium tuberculosis/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Secuencias Repetitivas de Ácidos Nucleicos , Población Suburbana , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Tuberculosis Resistente a Múltiples Medicamentos/transmisión , Tuberculosis/epidemiología , Tuberculosis/transmisiónRESUMEN
During a population-based study to genotype isolates of Mycobacterium tuberculosis from Buenos Aires Northern suburbs, we found isolates with molecular patterns related to those of the Beijing genotype. Five out of 590 (0.85%) patients had isolates with spoligopattern identical to that of the Beijing family. Since two of these isolates showed identical IS6110RFLP pattern, we found only four different patterns containing 11 to 19 bands. The isolates were obtained from young people (including a 7 years-old child) who were born in Argentina, and were living in a small area of our region. However, conventional contact tracing did not prove epidemiological linkage among them. These isolates were fully drug-susceptible to the first-line drugs. The comparison of the IS6110RFLP patterns from our isolates against a set of 19 reference Beijing patterns from the RIVM (The Netherlands) confirmed that the strains belonged to the Beijing lineage. These findings might be partially explained by the important migration phenomena occurred during the last decade. Further surveillance studies would help in the following of Beijing family strain dissemination in our community.
Asunto(s)
Mycobacterium tuberculosis/clasificación , Tuberculosis/microbiología , Adolescente , Adulto , Argentina/epidemiología , Asia/etnología , Técnicas de Tipificación Bacteriana , Niño , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Trazado de Contacto , ADN Bacteriano/aislamiento & purificación , Emigración e Inmigración , Genotipo , Humanos , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/aislamiento & purificación , Filogenia , Reacción en Cadena de la Polimerasa , Tuberculosis/epidemiología , Población UrbanaRESUMEN
During a population-based study to genotype isolates of Mycobacterium tuberculosis from Buenos Aires Northern suburbs, we found isolates with molecular patterns related to those of the Beijing genotype. Five out of 590 (0.85
) patients had isolates with spoligopattern identical to that of the Beijing family. Since two of these isolates showed identical IS6110RFLP pattern, we found only four different patterns containing 11 to 19 bands. The isolates were obtained from young people (including a 7 years-old child) who were born in Argentina, and were living in a small area of our region. However, conventional contact tracing did not prove epidemiological linkage among them. These isolates were fully drug-susceptible to the first-line drugs. The comparison of the IS6110RFLP patterns from our isolates against a set of 19 reference Beijing patterns from the RIVM (The Netherlands) confirmed that the strains belonged to the Beijing lineage. These findings might be partially explained by the important migration phenomena occurred during the last decade. Further surveillance studies would help in the following of Beijing family strain dissemination in our community.
RESUMEN
During a population-based study to genotype isolates of Mycobacterium tuberculosis from Buenos Aires Northern suburbs, we found isolates with molecular patterns related to those of the Beijing genotype. Five out of 590 (0.85
) patients had isolates with spoligopattern identical to that of the Beijing family. Since two of these isolates showed identical IS6110RFLP pattern, we found only four different patterns containing 11 to 19 bands. The isolates were obtained from young people (including a 7 years-old child) who were born in Argentina, and were living in a small area of our region. However, conventional contact tracing did not prove epidemiological linkage among them. These isolates were fully drug-susceptible to the first-line drugs. The comparison of the IS6110RFLP patterns from our isolates against a set of 19 reference Beijing patterns from the RIVM (The Netherlands) confirmed that the strains belonged to the Beijing lineage. These findings might be partially explained by the important migration phenomena occurred during the last decade. Further surveillance studies would help in the following of Beijing family strain dissemination in our community.
Asunto(s)
Salud Laboral , Riesgos Laborales , Tuberculosis , Enfermedades Transmisibles , HospitalesAsunto(s)
Enfermedades Transmisibles , Hospitales , Riesgos Laborales , Salud Laboral , TuberculosisRESUMEN
Tuberculosis (TB) continues to be a serious health problem in most of the districts in the 5th Sanitary Region of Buenos Aires Province (RSV) which is located in North Buenos Aires City suburbs. The aim of this study was to analyse and compare the evolution of the TB epidemiological situation in ten districts, in a thirteen year period (1984-96) and to analyse possible reasons for differences. The average annual variation (VAP) of morbidity rate was calculated in order to estimate the trends of TB in these communities along time. Reporting to the National and Provincial TB Control Programmes of TB cases is mandatory for physicians and these data were used as a source of information for the number of cases and rates. A statistical analysis was performed. Our results showed that the VAP value for the whole RSV was lower than -5.0%. On this basis several districts were identified as having a TB critical situation. The proportion of smear positive cases among TB patients reported decreased during this period, suggesting that smear microscopy was being poorly used as a diagnostic tool for TB. Furthermore, the cure rates of the patients attained--in average--only 60.0% and several warning indicators (IA)--like TB meningitis cases and mortality due to TB in people younger than thirty years old, as well as TB--HIV/AIDS association--have been observed to grow in several districts. Previous world global experience and those obtained in other provinces in our own country, suggest that the unique possible strategy for modifying this situation, is to set up the directly observed treatment (DOTS), according to World Health Organization/International Union Against Tuberculosis and Lung Diseases (WHO IVATLD) recommendations, in order to achieve the control of TB.
Asunto(s)
Tuberculosis/epidemiología , Adolescente , Adulto , Anciano , Argentina/epidemiología , Humanos , Incidencia , Persona de Mediana EdadRESUMEN
Tuberculosis (TB) continues to be a serious health problem in most of the districts in the 5th Sanitary Region of Buenos Aires Province (RSV) which is located in North Buenos Aires City suburbs. The aim of this study was to analyse and compare the evolution of the TB epidemiological situation in ten districts, in a thirteen year period (1984-96) and to analyse possible reasons for differences. The average annual variation (VAP) of morbidity rate was calculated in order to estimate the trends of TB in these communities along time. Reporting to the National and Provincial TB Control Programmes of TB cases is mandatory for physicians and these data were used as a source of information for the number of cases and rates. A statistical analysis was performed. Our results showed that the VAP value for the whole RSV was lower than -5.0
. On this basis several districts were identified as having a TB critical situation. The proportion of smear positive cases among TB patients reported decreased during this period, suggesting that smear microscopy was being poorly used as a diagnostic tool for TB. Furthermore, the cure rates of the patients attained--in average--only 60.0
and several warning indicators (IA)--like TB meningitis cases and mortality due to TB in people younger than thirty years old, as well as TB--HIV/AIDS association--have been observed to grow in several districts. Previous world global experience and those obtained in other provinces in our own country, suggest that the unique possible strategy for modifying this situation, is to set up the directly observed treatment (DOTS), according to World Health Organization/International Union Against Tuberculosis and Lung Diseases (WHO IVATLD) recommendations, in order to achieve the control of TB.