Surveillance Of Tuberculosis In An Acute Care Hospital In The City Of Buenos Aires, Argentina

Background: Tuberculosis (Tb) is one of main public health problems worldwide. In Argentina in 2015, 10,713 cases were notified to the National Health Surveillance System, resulting in a rate of 24.8 cases per 100,000 inhabitants. Tb is a contagious infectious disease whose degree of transmission is related to the number of baciliferous patients. Methods & Materials: Retrospective and observational studies based on data obtained from written and computarized laboratory records (BD Epicenter™) were analyzed. Inpatient and outpatient samples between 2008 and 2016 with positive culture for Mycobacterium tuberculosis complex were included. To perform statistical analysis, the Chi-square test was applied. Results: We identified 1057 samples with positive culture result for Tb corresponding to 728 patients. 62.3% were men, with a median age of 39,8 years (60% between 14-44 years). 70,5% of the samples were respiratory; blood culture (9%), pleural fluid (4%), ganglion biopsy (3%), cerebrospinal fluid (2%) and others (11.5%). 71,8% were outpatients and 28.2% inpatients. 43% were HIV-infected patients, 16% with other pathologies and 41% no data on base disease. 87.9% (41.6% HIV positive, p-value: 0.969) of isolates were sensitive to Isoniazid (I) and Rifampicin (R), 12,1% were resistant: 2.34% to R (70.6% HIV positive, p-value: 0.027), 6.04% to I (31.8% HIV positive, p-value: 0.0065) and 3.71% were resistant to both (63% HIV-infected patient, p-value: 0.024), being multi drug resistance, MDR. Conclusion: Resistance to Rifampicin allows to predict multi-resistance. This study showed 4% more resistance to Isoniazid than to Rifampicin. There was a significant increase in the frequency of multi resistance in the 9 years studied. In HIV-infected patients (with extra pulmonary symptoms as the main manifestation), a higher frequency of resistance to rifampicin, isoniazid and multi resistance was observed in comparison to non-HIV patients. Surveillance is critical for transmission control in the community; the emergence and increase of antibiotic resistance in HIV-infected patients present a difficult challenge to control the disease. In HIV-infected patients bacilloscopy has low performance, so we should always do the culture and sensitivity to antibiotics. The prevalence of Tuberculosis in adults and young adults demonstrates a sustained transmission in the community.