Rifampicin-monoresistant Mycobacterium tuberculosis disease among children in Cape Town, South Africa.
Int J Tuberc Lung Dis
; 16(1): 76-81, 2012 Jan.
Article
em En
| MEDLINE
| ID: mdl-22236850
ABSTRACT
SETTING:
Tygerberg Children's Hospital (TCH) and Brooklyn Chest Hospital (BCH), South Africa.OBJECTIVES:
To describe paediatric cases of rifampicin (RMP) monoresistant tuberculosis (RMR-TB) disease.DESIGN:
Records of children with culture-confirmed RMR-TB between 1 March 2003 and 28 February 2009 were identified from a prospectively recorded database of drug-resistant TB at TCH and BCH. Mutation analysis was performed on available specimens.RESULTS:
Eighteen children with a median age of 6.9 years (range 2 months-12.8 years) were identified. Nine (50%) were human immunodeficiency virus (HIV) infected and four (22%) were HIV-exposed but non-infected. Eleven (61%) had had previous TB treatment or prophylaxis. Nine children (50%) had cavitary disease and five children (22%) had extra-pulmonary disease. Twelve (67%) had adult TB source cases, including five (42%) adults with known RMR-TB. Primary transmission occurred among 11 children (61%) and acquisition of RMR-TB was possible in seven (39%) with prior RMP exposure. Median delay to specific RMR-TB treatment was 70 days (range 23-188). One child died from RMR-TB meningitis. Gene mutations consistent with RMR-TB were confirmed in five available samples.CONCLUSION:
RMR-TB disease is increasingly encountered, particularly among HIV-infected and HIV-exposed non-infected children. Delay in commencing appropriate treatment for RMR-TB and high rates of cavitary disease could be a source of RMR-TB transmission.
Texto completo:
1
Base de dados:
MEDLINE
Métodos Terapêuticos e Terapias MTCI:
Plantas_medicinales
Assunto principal:
Rifampina
/
Tuberculose Pulmonar
/
Farmacorresistência Bacteriana
/
Antibióticos Antituberculose
/
Mycobacterium tuberculosis
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
País/Região como assunto:
Africa
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
África do Sul