RESUMO
OBJECTIVES: Our clinical experience suggested that hepatitis C virus (HCV) infection in this Texas-Mexico border area might have features, especially risk factors, that differ from some other areas of the United States. Therefore, we conducted a prospective analysis to investigate the epidemiology, risk factors, and certain other characteristics of HCV infection in the El Paso region. METHODS: During a 2-yr period, individuals with a positive HCV serology were considered as "patients" and those with a negative hepatitis serology panel were "controls." A questionnaire survey was conducted in person or by telephone with individuals (patients and controls) who agreed to participate in the interview process. RESULTS: We identified and interviewed 320 patients and 307 controls. All of the contacted patients and controls agreed to be interviewed. Many established and potential risk factors for HCV transmission were documented in the patients. Furthermore, multiple potential risk factors were often present in individual patients. However, on multivariate analysis only injection drug use, blood transfusion, and tattooing were found to be significant independent risk factors for HCV infection. In the great majority of patients, tattoos were applied by friends (including gang members), inmates in jail/prison, or self, rather than commercial parlors. CONCLUSIONS: Tattooing is an independent risk factor for HCV infection in this United States-Mexico border area. The role of nonsterile tattooing practices in HCV transmission merits additional examination in regard to precise risk settings, frequency, and mechanisms of infection.
Assuntos
Hepatite C/epidemiologia , Hepatite C/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , México , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/complicações , Tatuagem/efeitos adversos , Texas/epidemiologiaRESUMO
Mycobacterium fortuitum is often considered to be merely a saprophytic organism in spite of adequate evidence to the contrary. To illustrate the clinical manifestations and relative frequency of M. fortuitum infections, six recently observed cases are presented. These include five patients with cutaneous infection or abscess disease after trauma (one of whom also had suppurative adenitis) and one patient with a cauda equina abscess and meningitis. The most frequently reported M. fortuitum illnesses are cutaneous and deeper infections after trauma, pulmonary disease, and corneal infection. Infections associated with contamined trauma, including corneal infection, are related to the widespread distribution of M. fortuitum in nature. Pulmonary infection is usually superimposed on preexisting lung disease. Local measures, including debridement, drainage, and sometimes excision, are the treatment for cutaneous infections, abscesses, and corneal infections. Although drug therapy has been ineffective, patients with pulmonary disease frequently recover spontaneously.