Caracterização molecular de isolados de Mycobacterium tuberculosis droga resistente em unidade de referência em Fortaleza, Ceará

• Ano de defesa: 2018
• Autor(a) principal: Campelo, Thales Alves
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Tuberculose; Reação em Cadeia da Polimerase Multiplex
• Link de acesso: http://www.repositorio.ufc.br/handle/riufc/39310

The tuberculosis (TB) disease is highly infectious, caused by the bacillus Mycobacterium tuberculosis, and it is estimated that a quarter of the world's population is infected. Brazil is among the 20 countries responsible for 84% of TB cases. Resistant multidrug TB (MDR) is defined as resistance to isoniazid (I) and rifampicin (R) and is a serious problem for TB control. According to the World Health Organization, in 2016 it was estimated that there were 490,000 cases of MDR-TB, with 4.1% of new TB cases and 19% of cases with a history of previous treatment being MDR-TB. Also described are resistors type TB-XDR (extensively resistant) and TB-TDR (totally drug resistant). The emergence of MDR-TB stresses the need for antimicrobial susceptibility testing, drug resistance surveillance, and case follow-up. In this context, the present study evaluated and understood the frequency and transmission variables of TB and DR-DR (resistant drug) related to home and community environment. Mutations were identified in genes related to resistance to rifampicin, isoniazid, fluoroquinolones, aminoglycosides through molecular techniques and spatial georeferencing analysis of the cases in the metropolitan region of Fortaleza. The 49 isolates were divided into two groups: the control group, composed of patients with resistance up to two drugs, and the group that was constituted by individuals with resistance to three or more drugs. Out of the total, we obtained 19 patients in the case group and 30 patients in the control group. In the control group there was a predominance of the female gender 60% (18/30) compared to the cases, 26.3% (5/19), the difference was statistically significant (p = 0.0213). In relation to comorbidities, the case group was statistically significant with a higher frequency of participants with diabetes, 52.6% (10/19), different from the control group, 52.6% (6/30; p=0.017). The presence of point mutations was observed in 39 samples. Out of these, 36 presented at codon 94 of the gene katG codon 315, thus representing 92.0% (36/39). In the spatial analysis, case and control groups were observed mainly in areas of low socioeconomic status of Fortaleza.