[Tuberculosis in the elderly in a general hospital in the Region of Madrid, 1994-2003].
BACKGROUND
Tuberculosis in the elderly is a health problem that is on the increase nowadays in industrialised countries. The aim of this study is to describe epidemiological, clinical and microbiological characteristics of tuberculosis in elderly patients in a general hospital in the Region of Madrid from 1994 to 2003.


METHODS
Only microbiologically and/or histopathologically confirmed tuberculosis were studied. Epidemiological, clinical and microbiological variables were analyzed. Microbiological and histopathological laboratory results and medical records were collected.


RESULTS
The proportion of cases occurring among the elderly rose from 12.4% between 1994 and 1998 to 17.8% between 1999 and 2003 (p <0.05). A total of 160 tuberculosis cases were studied: 92.5% were microbiologically (culture) confirmed and 7.5% histopathologically confirmed. The average time to culture positivity was 18.8 days (SD: 6.5). 88.7% isolates were susceptible to streptomycin, isoniazid, rifampin, ethambutol, and pyrazinamide. The main locations of tuberculosis were pulmonary (59.4%), ganglionary (11.9%) and genitourinary (10.0%). A positive smear in the sputum was discovered for 52.6% of pulmonary tuberculosis. The most prevalent risk factors were immunosuppression (14.8%) and diabetes mellitus (12.3%). Neither of them were VIH, intravenous drug users or immigrants. 50.7% cases were hospitalized.


CONCLUSIONS
Tuberculosis in the elderly is on the increase in our region nowadays. The epidemiological pattern of tuberculosis in the elderly differs from that observed in younger patients. Therefore specific control and prevention strategies are needed in order to reduce tuberculosis incidence in aged populations.
García-Fernández
C
C
Servicio de Medicina Preventiva, Hospital 12 de Octubre, Avda. de Córdoba s/n, 28041 Madrid. cristina.garcia@salud.madrid.org
Vera López
I
I
Jaén Herreros
F
F
Sanz-Gallardo
M I
MI
Palenque Mataix
E
E
de Juanes Pardo
J R
JR
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*; D014505:Urban Population