title: [Drug resistance profile of Mycobacterium tuberculosis in the state of Mato Grosso do Sul, Brazil, 2000-2006].
abstract: OBJECTIVE
  To determine the drug resistance profile of Mycobacterium tuberculosis in the state of Mato Grosso do Sul, Brazil, between 2000 and 2006.
  
  
  METHODS
  Descriptive study of reported tuberculosis cases in the Brazilian Case Registry Database. We included only those cases in which M. tuberculosis culture was positive and sensitivity to drugs (rifampicin, isoniazid, streptomycin and ethambutol) was tested. Löwenstein-Jensen and Ogawa-Kudoh solid media were used for cultures, as was an automated liquid medium system. Sensitivity tests were based on the proportion method.
  
  
  RESULTS
  Among the 783 cases evaluated, males predominated (69.7%), as did patients in the 20-49 year age bracket (70%), a diagnosis of pulmonary tuberculosis (94.4%) and positive HIV serology (8.6%); 645 (82.4%) were new cases, and 138 (17.6%) had previously been treated. Resistance to at least one drug was found in 143 cases (18.3%). The primary resistance (PR) rate was, respectively, 8.1%, 1.6%, 2.8% and 12.4%, for monoresistance, multidrug resistance (MDR), other patterns of resistance and resistance to at least one drug, whereas the acquired resistance (AR) rate was 14.5%, 20.3%, 10.9% and 45.7%, respectively, and the combined resistance (CR) rate was 9.2%, 4.9%, 4.2% and 18.3%, respectively. In PR, streptomycin was the most common drug, whereas isoniazid was the most common in AR and CR (7.2% and 3.7%, respectively).
  
  
  CONCLUSIONS
  These high levels of resistance undermine the efforts for tuberculosis control in Mato Grosso do Sul. Acquired MDR was 12.7 times more common than was primary MDR, demonstrating that the previous use of drug therapy is an indicator of resistance. These levels reflect the poor quality of the health care provided to these patients, showing the importance of using the directly observed treatment, short course strategy, as well as the need to perform cultures and sensitivity tests for the early diagnosis of drug resistance.
authors.affiliation: Programa Estadual de Controle da Tuberculose, Secretaria de Estado da Saúde de Mato Grosso do Sul, Campo Grande, MS, Brasil. marli.marques2008@gmail.com
authors.forename: Marli
authors.initials: M
authors.lastname: Marques
authors.forename: Eunice Atsuko Totumi
authors.initials: EA
authors.lastname: Cunha
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruffino-Netto
authors.forename: Sonia Maria de Oliveira
authors.initials: SM
authors.lastname: Andrade
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000145:classification / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D013307:Streptomycin / Q000627:therapeutic use; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D013307:Streptomycin