Prevalence of Multidrug-Resistant Mycobacterium tuberculosis in the Lambayeque Region, Peru. 2019-2020
Keywords:
Mycobacterium tuberculosis, multidrug-resistant tuberculosis, Rifampin, Isoniazid, Prevalence, PeruAbstract
Introduction: Tuberculosis remains a public health problem, with its control compromised by the growing resistance to anti-tuberculosis drugs at both global and national levels.
Objective: To determine the prevalence of multidrug-resistant tuberculosis among the cases reported in Lambayeque, Peru, during the years 2019 and 2020.
Material and Methods: A descriptive cross-sectional study was conducted on a population consisting of data from 10 553 cultures of patients suspected of tuberculosis, processed during the years 2019 and 2020. The sample size consisted of 1 210 cultures positive for Mycobacterium tuberculosis, selected through convenience sampling. The variables analyzed included sex, age, place of origin, healthcare subsector, health facility, localization, smear microscopy results, history of treatment, culture results, etiological agent, and resistance profile.
Results: The prevalence of multidrug-resistant Mycobacterium tuberculosis was found to be 2.7%. Prevalence was higher among previously untreated patients compared to those who had been treated before (1.8% vs. 0.9%). Males accounted for 63.6% of multidrug-resistant tuberculosis cases, and 51.5% were between 25 and 44 years old. The province of Chiclayo accounted for 78.8% of these cases, of which 75.7% were diagnosed in the Ministry of Health facilities. A total of 81.8% of cases had an initial positive smear microscopy, and in 100% of cases, the localization was pulmonary.
Conclusions: The results of this study indicated that the presence of multidrug-resistant Mycobacterium tuberculosis was low in the Lambayeque region during the study period.
Downloads
References
1. World Health Organization. Global Tuberculosis Report 2021 [Internet]. Geneva: WHO; 2021 [Citado 23/03/2024]. Disponible en: https://www.who.int/publications/i/item/9789240037021
2. Soto-Cabezas MG, Munayco CV, Escalante O, Valencia E, Arica J, Yagui MJ. Perfil epidemiológico de la tuberculosis extensivamente resistente en el Perú, 2013-2015. Rev Panam Salud Publica [Internet]. 2020 [Citado 23/03/2024]; 44:e29. Disponible en: https://iris.paho.org/handle/10665.2/52264
3. Quispe N, Asencios L, Obregon C, Velázquez GE, Mitnick CD, Lindeborg M, et al. The fourth national anti-tuberculosis drug resistance survey in Peru. Int J Tuberc Lung Dis [Internet]. 2020; 24(2):207-213. Disponible en: http://doi.org/10.5588/ijtld.19.0186
4. Pecho-Silva S. Tratamiento de tuberculosis MDR / XDR en Perú. ¿Vamos por buen camino? Rev Peru Investig Salud [Internet]. 2020 [Citado 23/03/2024]; 4(3):134-7. Disponible en: https://revistas.unheval.edu.pe/index.php/repis/article/view/699
5. Ventura-Flores R, Vergara MA. Susceptibilidad y Perfil de Resistencia de Mycobacterium tuberculosis a drogas de primera línea, Lambayeque 2011. Rev Exp Med [Internet]. 2015 [Citado 23/03/2024];1(1):11-4. Disponible en: https://rem.hrlamb.gob.pe/index.php/REM/article/view/7
6. Estrada JA. Caracterización epidemiológica, clínica y microbiológica de casos nuevos de tuberculosis pulmonar de un centro de salud, Chiclayo 2019. [Tesis Especialidad]. Lambayeque: Facultad de Ciencias Biológicas, Universidad Nacional Pedro Ruiz Gallo; 2019 [Citado 23/03/2024]. Disponible en: https://hdl.handle.net/20.500.12893/9991
7. Singh P, Saket VK, Kachhi R. Diagnosis of TB: From conventional to modern molecular protocols. Front Biosci [Internet]. 2019; 11(1):38-60. Disponible en: http://doi.org/10.2741/E845
8. Allué-Guardia A, García JI, Torrelles JB. Evolution of Drug-Resistant Mycobacterium tuberculosis Strains and Their Adaptation to the Human Lung Environment. Front Microbiol [Internet]. 2021; 12:612675 .Disponible en: http://doi.org/10.3389/fmicb.2021.61267
9. Fennelly KP. Particle sizes of infectious aerosols: implications for infection control. Lancet Respir Med [Internet]. 2020; 8(9):914-24. Disponible en: http://doi.org/10.1016/S2213-2600(20)30323-4
10. Túñez V, García MR, Pérez ML, Lado FL. Epidemiología de la tuberculosis. Santiago de Compostela: Servicio Medicina Preventiva y Salud Pública [Internet]. 2002 [Citado 23/03/2024]; 39(5):172-80. Disponible en: https://www.elsevier.es/es-revista-medicina-integral-63-articulo-epidemiologia-tuberculosis-13029943
11. Alvarado RL. Incidencia y características socioepidemiológicas de la micobacteriosis en la región Lambayeque. 2014 – 2016. [Tesis Especialidad]. Lambayeque: Facultad de Ciencias Biológicas, Universidad Nacional Pedro Ruiz Gallo; 2019. Disponible en: https://repositorio.unprg.edu.pe/handle/20.500.12893/8288
12. Ministerio de salud. Norma técnica de salud para el cuidado integral de la persona afectada por tuberculosis, familia y comunidad [Internet]. Lima: Dirección General de Intervenciones Estratégicas en Salud Pública, MINSA; 2023 [Citado 23/03/2024]. Disponible en: https://www.gob.pe/institucion/minsa/informes-publicaciones/4417562-norma-tecnica-de-salud-para-el-cuidado-integral-de-la-persona-afectada-por-tuberculosis-familia-y-comunidad
13. Tiberi S, Vjecha MJ, Zumla A, Galvin J, Migliori GB, Zumla A. Accelerating development of new shorter TB treatment regimens in anticipation of a resurgence of multi-drug resistant TB due to the COVID-19 pandemic. Int J Infect Dis [Internet]. 2021;113 Suppl 1:S96-S99. Disponible en: http://doi.org/10.1016/j.ijid.2021.02.067
14. Silva C, Suárez C. Covid-19 and tuberculosis: the encounter between new threats and old diseases. Rev Fac Med Hum [Internet]. 2021 [Citado 23/03/2024];21(1):251-2. Disponible en: https://inicib.urp.edu.pe/rfmh/vol21/iss1/35
15. Migliori GB, Thong PM, Alffenaar JW, Denholm J, Tadolini M, Alyaquobi F, et al. Gauging the impact of the COVID-19 pandemic on tuberculosis services: a global study. Eur Respir J [Internet]. 2021; 58(5):2101786. Disponible en: http://doi.org/10.1183/13993003.01786-2021
16. Shivekar SS, Kaliaperumal V, Brammacharry U, Sakkaravarthy A, Vidya CK, Alagappan C, et al. Prevalencia y factores asociados con la tuberculosis multirresistente en el sur de la India. Scientific Reports [Internet]. 2020, 10: 17552. Disponible en: http://doi.org/10.1038/s41598-020-74432-y
17. Lin PL, Flynn JL. Understanding latent tuberculosis: a moving target. J Immunol [Internet]. 2010;185(1):15-22. Disponible en: http://doi.org/10.4049/jimmunol.0903856
18. Chai Q, Zhang Y, Liu CH. Mycobacterium tuberculosis: An Adaptable Pathogen Associated With Multiple Human Diseases. Front Cell Infect Microbiol [Internet]. 2018 ;8:158. Disponible en: http://doi.org/10.3389/fcimb.2018.00158
19. Cohen A, Mathiasen VD, Schön T, Wejse C. The global prevalence of latent tuberculosis: a systematic review and meta-analysis. Eur Respir J [Internet]. 2019 ;54(3):1900655. Disponible en: http://doi.org/10.1183/13993003.00655-2019
20. Shenoy VP, Kumar A, Chawla K. Rapid detection of multidrug resistant tuberculosis in respiratory specimens at a tertiary care centre in south coastal Karnataka using Genotype MTBDR plus assay. Iran J Microbiol [Internet]. 2018 [Citado 23/03/2024];10(5):275-80. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339998/
21. Manson AL, Cohen KA, Abeel T, Desjardins CA, Armstrong DT, Barry CE, et al. Genomic analysis of globally diverse Mycobacterium tuberculosis strains provides insights into the emergence and spread of multidrug resistance. Nat Genet [Internet]. 2017; 49(3):395-402. Disponible en: http://doi.org/10.1038/ng.3767
22. Dagne B, Desta K, Fekade R, Amare M, Tadesse M, Diriba G, et al. The Epidemiology of first and second-line drug-resistance Mycobacterium tuberculosis complex common species: Evidence from selected TB treatment initiating centers in Ethiopia. PLoS One [Internet]. 2021; 16(1):e0245687. Disponible en: http://doi.org/10.1371/journal.pone.0245687
23. Chala B, Usmael A. Prevalence of Multidrug Resistant Mycobacterium tuberculosis among Tuberculosis Patients Admitted to Adama Hospital Medical College, Adama, Ethiopia: A Retrospective Study. Journal of Tuberculosis Research [Internet].2020; 8(3): 148-57. Disponible en: http://doi.org/10.4236/jtr.2020.83013
24. Sotgiu G, Centis R, D'ambrosio L, Migliori GB. Tuberculosis treatment and drug regimens. Cold Spring Harb Perspect Med [Internet]. 2015; 5(5):a017822. Disponible en: http://doi.org/10.1101/cshperspect.a017822
25. Huapaya RM. Factores de riesgo asociados a tuberculosis multidrogorresistente en pacientes del centro de salud San Cosme - La Victoria. 2016 y 2017. [Tesis Especialidad]. Lima: Facultad de Medicina Humana, Universidad Ricardo Palma; 2018 [Citado 23/03/2024]. Disponible en: https://repositorio.urp.edu.pe/handle/20.500.14138/1406
26. Desissa F, Workineh T, Beyene T. Risk factors for the occurrence of multidrug-resistant tuberculosis among patients undergoing multidrug-resistant tuberculosis treatment in East Shoa, Ethiopia. BMC Public Health [Internet].2018; 18: 422. Disponible en: http://doi.org/10.1186/s12889-018-5371-3
27. Muro JA, Regalado SJ. Características Clínico-epidemiológicas de pacientes con Tuberculosis Multidrogorresistente atendidos en el primer nivel de atención de la región Lambayeque 2018-2022. [Tesis Especialidad]. Lambayeque: Facultad de Ciencias de la Salud, Universidad Señor de Sipán; 2023 [Citado 23/03/2024]. Disponible en: https://repositorio.uss.edu.pe/handle/20.500.12802/10960
28. Tanta LA. Prevalencia de mutación genética en pacientes con tuberculosis resistente a isoniazida en Lima Norte durante el período 2016-2018 [Tesis Especialidad]. Lima: Facultad de Medicina Humana, Universidad Ricardo Palma; 2019 [Citado 23/03/2024]. Disponible en: https://repositorio.urp.edu.pe/handle/20.500.14138/1879
29. Singh R, Dwivedi SP, Gaharwar US, Meena R, Rajamani P, Prasad T. Recent updates on drug resistance in Mycobacterium tuberculosis. J Appl Microbiol [Internet]. 2020; 128(6):1547-67. Disponible en: http://doi.org/10.1111/jam.14478
30. Elion DO, Abdul JB, Linguissi LS, Epola M, Vouvoungui JC, Mabiala A, et al. Epidemiological profile of multidrug-resistant and extensively drug-resistant Mycobacterium Tuberculosis among Congolese patients. Ann Clin Microbiol Antimicrob [Internet]. 2021; 20(1):84. Disponible en: http://doi.org/10.1186/s12941-021-00488-x
31. Otokunefor K, Otokunefor TV, Omakwele G. Multi-drug resistant Mycobacterium tuberculosis in Port Harcourt, Nigeria. Afr J Lab Med [Internet].. 2018; 7(2):805. Disponible en: http://doi.org/10.4102/ajlm.v7i2.805
32. Tobin EH, Tristram D. Tuberculosis [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [Citado 23/03/2024]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK441916/
33. Heemskerk D, Caws M, Marais B, Farrar J. Tuberculosis in Adults and Children [Internet]. Londres: Springer; 2015 [Citado 23/03/2024]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK344402/
34. Seung KJ, Keshavjee S, Rich ML. Multidrug-Resistant Tuberculosis and Extensively Drug-Resistant Tuberculosis. Cold Spring Harb Perspect Med [Internet]. 2015; 5(9):a017863. Disponible en: http://doi.org/10.1101/cshperspect.a017863
35. Higuita-Gutiérrez LF, Arango-Franco CA, Cardona-Arias JA. Causal association of antibiotic use and resistant tuberculosis infection: Case control meta-analysis. Rev Esp Salud Pública [Internet]. 2018 [Citado 23/03/2024]; 92: e201809067. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30181530/
36. Pfrommer E, Dreier C, Gabriel G, Dallenga T, Reimer R, Schepanski K, et al. Enhanced tenacity of mycobacterial aerosols from necrotic neutrophils. Sci Rep [Internet]. 2020; 10(1):9159. Disponible en: http://doi.org/10.1038/s41598-020-65781-9
37. Simmons JD, Stein CM, Seshadri C, Campo M, Alter G, Fortune S, et al. Immunological mechanisms of human resistance to persistent Mycobacterium tuberculosis infection. Nat Rev Immunol [Internet]. 2018; 18(9):575-89. Disponible en: http://doi.org/10.1038/s41577-018-0025-3
38. Loddenkemper R, Lipman M, Zumla A. Clinical Aspects of Adult Tuberculosis. Cold Spring Harb Perspect Med [Internet]. 2015; 6(1):a017848. Disponible en: http://doi.org/10.1101/cshperspect.a017848
39. Ministerio de salud. Plan de acción de soporte nutricional para reducir el riesgo laboral por enfermedades ocupacionales [Internet]. Lima: Unidad de Recursos Humanos – San Juan de Lurigancho, MINSA; 2021 [Citado 23/03/2024]. Disponible en: http://www.hospitalsjl.gob.pe/ArchivosDescarga/2021/PLAN_ACCION_SOPORTE_NUTRICIONAL.pdf
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Revista Habanera de Ciencias Médicas
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All the content of this magazine is in Open Access, distributed according to the terms of the Creative Commons Attribution-Noncommercial 4.0 License that allows non-commercial use, distribution and reproduction without restrictions in any medium, provided that the primary source is duly cited.
Download PDF
