RESUMO
ABSTRACT Objective To present the frequency and species diversity of non-tuberculous mycobacteria, estimate the prevalence of non-tuberculous mycobacterial pulmonary disease, describe the epidemiological profile, and determine the follow-up of patients with non-tuberculous mycobacterial pulmonary disease living in a region with a high burden of tuberculosis. Methods This a retrospective cohort observational study using data records obtained from the Instituto Adolfo Lutz - Santos and from the São Paulo Sistema de Vigilância de Tuberculose do Estado de São Paulo in the period between 2000 and 2009. The studied variables were: socio-demographic characteristics, current and past history of tuberculosis, aspects related to diagnosis, and treatment and associated diseases. Results We included 319 non-tuberculous mycobacteria isolates in the study, corresponding to 257 patients. The species Mycobacterium kansasii (28.5%) and Mycobacterium fortuitum (16.6%) presented the higher occurrence. In 10.9% (24) of the patients, there was a criterion for confirming a case of pulmonary disease due to non-tuberculous mycobacteria. In relation to gender and age, male and individuals over 50 years old were the most frequent. Considering the confirmed cases, 47.8% had a past history of tuberculosis. Conclusion The lack of information about the cases is evident, since pulmonary disease due to non-tuberculous mycobacteria is not mandatory. The therapeutic regimen according to the identified species is fundamental for success in combating the infections caused by non-tuberculous mycobacteria. Besides that, information about the regional epidemiology of pulmonary disease caused by non-tuberculous mycobacteria and the search for associations with other comorbidities are important to establish the correct treatment. In order to improve surveillance of pulmonary diseases by non-tuberculous mycobacteria, we suggest the implantation of a sentinel surveillance and of population-based studies.
Assuntos
Humanos , Masculino , Pneumopatias/epidemiologia , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Brasil/epidemiologia , Estudos Retrospectivos , Seguimentos , Pessoa de Meia-Idade , Micobactérias não TuberculosasRESUMO
ABSTRACT Objective This study describes epidemiological and clinical features of patients with confirmed infection by SARS-CoV-2 diagnosed and treated at Hospital Israelita Albert Einstein , which admitted the first patients with this condition in Brazil. Methods In this retrospective, single-center study, we included all laboratory confirmed COVID-19 cases at Hospital Israelita Albert Einstein , São Paulo, Brazil, from February until March 2020. Demographic, clinical, laboratory and radiological data were analyzed. Results A total of 510 patients with a confirmed diagnosis of COVID-19 were included in this study. Most patients were male (56.9%) with a mean age of 40 years. A history of a close contact with a positive/suspected case was reported by 61.1% of patients and 34.4% had a history of recent international travel. The most common symptoms upon presentation were fever (67.5%), nasal congestion (42.4%), cough (41.6%) and myalgia/arthralgia (36.3%). Chest computed tomography was performed in 78 (15.3%) patients, and 93.6% of those showed abnormal results. Hospitalization was required for 72 (14%) patients and 20 (27.8%) were admitted to the Intensive Care Unit. Regarding clinical treatment, the most often used medicines were intravenous antibiotics (84.7%), chloroquine (45.8%) and oseltamivir (31.9%). Invasive mechanical ventilation was required by 65% of Intensive Care Unit patients. The mean length of stay was 9 days for all patients (22 and 7 days for patients requiring or not intensive care, respectively). Only one patient (1.38%) died during follow-up. Conclusion These results may be relevant for Brazil and other countries with similar characteristics, which are starting to deal with this pandemic.
RESUMO Objetivo Descrever as características epidemiológicas e clínicas de pacientes com infecção confirmada pelo SARS-CoV-2, diagnosticados e tratados no Hospital Israelita Albert Einstein, que admitiu os primeiros pacientes com essa condição no Brasil. Métodos Neste estudo retrospectivo, de centro único, incluímos todos os casos com confirmação laboratorial de COVID-19 no Hospital Israelita Albert Einstein, em São Paulo (SP) de fevereiro a março de 2020. Foram analisados dados demográficos, clínicos, laboratoriais e radiológicos. Resultados Foram incluídos 510 pacientes com diagnóstico confirmado de COVID-19. A maioria dos pacientes era do sexo masculino (56,9%), com média de idade de 40 anos. Foi relatada história de contato próximo com um caso positivo/suspeito por 61,1% dos pacientes, e 34,4% tinham história de viagens internacionais recentes. Os sintomas mais comuns foram febre (67,5%), congestão nasal (42,4%), tosse (41,6%) e mialgia/artralgia (36,3%). A tomografia computadorizada de tórax foi realizada em 78 (15,3%) pacientes, e 93,6% deles apresentaram resultados anormais. A hospitalização foi necessária para 72 (14%) pacientes, e 20 (27,8%) foram admitidos na Unidade de Terapia Intensiva. Quanto ao tratamento clínico, os medicamentos mais utilizados foram antibióticos intravenosos (84,7%), cloroquina (45,8%) e oseltamivir (31,9%). A ventilação mecânica invasiva foi necessária em 65% dos pacientes na Unidade de Terapia Intensiva. O tempo médio de internação foi 9 dias para todos os pacientes (22 e 7 dias para pacientes que necessitaram ou não de cuidados intensivos, respectivamente). Apenas um (1,38%) paciente morreu durante o acompanhamento. Conclusão Estes resultados podem ser relevantes para o Brasil e outros países com características semelhantes, que começaram a lidar com essa pandemia.