Perfil de resistência a fármacos antituberculose em um hospital de referência do Estado de Minas Gerais

A tuberculose e uma patologia grave, infecciosa e transmissivel de grande relevância para a saude publica mundial. A capacidade de adquirir resistencia aos antimicrobianos de escolha para a terapeutica tem dificultado o tratamento de pacientes tuberculosos. O objetivo do presente estudo foi verificar em um hospital de referencia de Juiz de Fora, Minas Gerais, o perfil de resistencia das micobacterias isoladas de pacientes com tuberculose a partir da modificacao do esquema terapeutico de 2009. Foi realizada uma analise retrospectiva em 45 culturas positivas de pacientes com tuberculose pulmonar e com teste de sensibilidade no periodo de janeiro de 2012 a maio de 2014. Das 45 culturas identificadas como M. tuberculosis: 30 (67%) foram sensiveis a todos os farmacos testados (estreptomicina, isoniazida, rifampicina, etambutol e pirazinamida). As monorresistentes corresponderam a 3 (7%), com resistencia a: estreptomicina (2,33%), isoniazida (2,33%) e rifampicina (2,33%). As que apresentaram multirresistencia corresponderam a 10 casos (22%), com resistencia a: isoniazida + rifampicina (13,2%), isoniazida + rifampicina + estreptomicina (2,2%), isoniazida + rifampicina + etambutol (4,4%), isoniazida + rifampicina + etambutol + estreptomicina (2,2%). Por fim, as polirresistencias corresponderam a 2 (4%), com resistencia a isoniazida + estreptomicina. Os resultados apresentados demonstraram que 33% das amostras apresentaram algum tipo de resistencia ao tratamento, com predominio de multirresistencia. Nesses casos houve evidente prolongamento de tratamento gerando maiores custos e toxicidade. Verifica-se a importância do teste de sensibilidade aos antimicrobianos para definir melhor o esquema para cada caso e observar a adesao ao tratamento a fim de diminuir as resistencias. Tuberculosis is a serious, infectiousand transmissible disease of great relevance to global public health. The ability to acquire resistance to antimicrobials of choice for therapy has hampered the treatment of TB patients. The aim of this study was to verify in a referral hospital in Juiz de Fora, Minas Gerais, the resistance profile of mycobacteria isolated from patients with tuberculosis from the modification of the treatment regimen 2009. A retrospective analysis was performed on 45 positive cultures from patients with pulmonary tuberculosis and susceptibility testing from January 2012 to May 2014. Of the 45 positive cultures from were identified M. tuberculosis: 30 (67%) were sensitive to all drugs tested (streptomycin, isoniazid, rifampicin, ethambutol and pyrazinamide). The monorresistente 3 (7%), with resistance to: streptomycin (2.33%), isoniazid (2.33%) and rifampicin (2.33%). The that presented multidrug resistance accounted for 10 cases (22%), with resistance: isoniazid + rifampicin (13.2%), rifampicin + isoniazid + streptomycin (2.2%), rifampicin + isoniazid + ethambutol (4.4%), isoniazid + rifampicin + streptomycin + ethambutol (2.2%). Finally, the matched polirresistencias 2 (4%) with resistance: espreptomicycin+ isoniazid. The results presented demonstrated that 33% of the samples showed any resistance to treatment, with a prevalence of multidrug resistance. In these cases there is clear prolongation of treatment leading to higher costs and toxicity. There is the importance of antimicrobial susceptibility test to better define the schema for each case and observe adherence to treatment in order to reduce the resistances.