Nontuberculosis mycobacteria at a multiresistant tuberculosis reference center in Bahia: clinical epidemiological aspects.

OBJECTIVE: Examine the prevalence and clinical/epidemiological aspects of patients with nontuberculous mycobacteria (NTM) isolated from sputum provided by an outpatient clinic specializing in the treatment of multiresistant tuberculosis (MRTB) in Bahia, Brazil. METHODS: All patients followed at the MRTB outpatient clinic of the Octávio Mangabeira Specialized Hospital (HEOM) were evaluated retrospectively from July 1998 to July 2003. All patients underwent direct examinations and cultures to identify the mycobacteria species found during initial and subsequent evaluations. The following variables were recorded: age, gender, clinical symptoms and signs, pre-existing lung disease, prior TB treatment, HIV serology, and NTM species. Categorical and quantitative variables were respectively characterized using proportions and measures +/- SD. RESULTS: NTM were isolated in 19 of 231 patients (8.2%; 95%CI: 5.2%-12.3%), with the following species distribution: 58% (11/19) M. chelonae/abscessus; 16% (3/19) M. avium-intracellular complex; 16% (3/19) M. kansasii; and 11% (2/19) M. fortuitum. HIV serology was positive for just one patient (5%), from whom M. chelonae/abscessus was isolated. Productive coughing was observed in all cases. American Thoracic Society (ATS) diagnostic criteria for NTM lung disease were observed in 14 patients (74%). CONCLUSION: The prevalence of NTM isolated from patients referred to the MRTB outpatient clinic in Bahia was 8.2% (CI 95%: 5.2%-12.3%); rapid-growth mycobacteria (M. chelonae/M. fortuitum) were the most frequently isolated (68%).

Risco teratogênico: a percepção em diferentes segmentos da população / Teratogenic risk: the perception in population different sections

A percepção errônea do real risco teratogênico das drogas às quais as gestantes são expostas pode induzir a erros graves de conduta perante uma gravidez, ou pela interrupção desnecessária da gestação desejada, ou devido às seqüelas permanentes nas crianças. O conhecimento sobre o risco teratogênico é de fundamental importância para a população geral e, principalmente, para a comunidade médica. A percepção do risco teratogênico de quinze fármacos habituais e duas drogas ilícitas foi avaliada entre médicos, estudantes de medicina e mulheres leigas, utilizando-se uma escala visual, na qual os entrevistados assinalaram o risco em percentual de uma criança nascer com anomalia congênita secundária à exposição intra-útero às drogas estudadas. A média da percepção do risco teratogênico para as drogas avaliadas foi maior do que o risco real entre todos os grupos estudados. O risco real de anomalia congênita na população geral foi melhor reconhecido entre os médicos ginecologistas e obstetras. O melhor índice de acerto foi para drogas mais rotineiramente utilizadas durante a gestação (paracetamol e amoxacilina), de acordo com os obstetras.

Nontuberculosis mycobacteria at a multiresistant tuberculosis reference center in Bahia: clinical epidemiological aspects

OBJETIVO: Examine the prevalence and clinical/epidemiological aspects of patients with nontuberculous mycobacteria (NTM) isolated from sputum provided by an outpatient clinic specializing in the treatment of multiresistant tuberculosis (MRTB) in Bahia, Brazil. METHODS: All patients followed at the MRTB outpatient clinic of the Octávio Mangabeira Specialized Hospital (HEOM) were evaluated retrospectively from July 1998 to July 2003. All patients underwent direct examinations and cultures to identify the mycobacteria species found during initial and subsequent evaluations. The following variables were recorded: age, gender, clinical symptoms and signs, pre-existing lung disease, prior TB treatment, HIV serology, and NTM species. Categorical and quantitative variables were respectively characterized using proportions and measures ± SD. RESULTS: NTM were isolated in 19 of 231 patients (8.2 percent; 95 percentCI: 5.2 percent-12.3 percent), with the following species distribution: 58 percent (11/19) M. chelonae/abscessus; 16 percent (3/19) M. avium-intracellular complex; 16 percent (3/19) M. kansasii; and 11 percent (2/19) M. fortuitum. HIV serology was positive for just one patient (5 percent), from whom M. chelonae/abscessus was isolated. Productive coughing was observed in all cases. American Thoracic Society (ATS) diagnostic criteria for NTM lung disease were observed in 14 patients (74 percent). CONCLUSION: The prevalence of NTM isolated from patients referred to the MRTB outpatient clinic in Bahia was 8.2 percent (CI 95 percent: 5.2 percent-12.3 percent); rapid-growth mycobacteria (M. chelonae/M. fortuitum) were the most frequently isolated (68 percent).