Title:	Avaliação da resistência aos tuberculostáticos de primeira linha em cepas do complexo Mycobacterium Tuberculosis isolados no Distrito Federal
Other Titles:	Evaluation of resistance to first-line tuberculostatic drugs in isolates of Mycobacterium Tuberculosis complex in Federal District
Authors:	Lima, Glaura Regina de Castro e Caldo
Orientador(es)::	Naves, Janeth de Oliveira Silva
Assunto::	Tuberculose Multidroga resistência Bactérias
Issue Date:	28-Feb-2016
Data de defesa::	21-Dec-2015
Citation:	LIMA, Glaura Regina de Castro e Caldo. Avaliação da resistência aos tuberculostáticos de primeira linha em cepas do complexo Mycobacterium tuberculosis isolados no Distrito Federal. 2015. [110] f., il. Tese (Doutorado em Ciências Farmacêuticas)—Universidade de Brasília, Brasília, 2015.
Abstract:	Tuberculosis (TB) continues to be a major cause of morbidity and mortality worldwide and the multi-drug resistant TB is a threat to the world and needs measures to be avoided. To evaluate whether the four-drug therapy in fixed dose combination (4-FDC) is more effective and safer than the separate drugs (SD) therapy for the treatment of pulmonary TB in the literature and determine the resistance to first-line antituberculosis drugs in isolates of Mycobacterium tuberculosis in the Federal District were the objectives of this work. A systematic review with meta-analysis of studies found was conducted to analyze the new treatment for pulmonary TB, and to evaluate the resistance to first-line tuberculostatic drugs in isolates of Mycobacterium tuberculosis complex in Federal District of Brazil a crosssection descriptive study was undertaken in LACEN-DF in isolates collected from 2001 to 2013. A comparison of the sensitivity profiles before and after the introduction of the fixeddose combination treatment for tuberculosis. From 2011 to 2013 (sensitivity tests using the SIRE BACTEC MGIT 960® system were compared with a molecular one using Genotype MTBDRplus®, capable to detect the main mutations of genes associated to resistance to rifampicine and to isoniazide. The secondary resistance rates to first-line antituberculosis drugs in the period 2001-2013 were 4.8% to isoniazid, 1.3% to rifampicin and 4.7% to streptomycin. The rates of MDR-TB, XDR-TB and other resistances were 7.7%, 0.7% and 0.7%, respectively. Comparing the period 2001-2003 with 2011-2013, a tendency of decrease in multidrug resistance was observed, with an increase of monoresistance to first-line antituberculosis drugs in the analyzed periods. The rate of secondary multi-resistance has fallen after the introduction of the new treatment, which gives patients higher chance of healing taking less toxic drugs that are cheaper for the government. The mono-resistance to streptomicine increased, indicating a possible endogenous reactivation by isolates before 1980 decade. The mutations found in the rpoB gene, responsible for resistance to rifampicin, were located at codon 531 and those responsible for resistance to isoniazid in the katG gene at codon 315 and in the inhA gene at codon 15. The accuracy of GenoType MTBDRplus® in DF for detecting the resistance to rifampicine and to isoniazide was confirmed when compared with the conventional sensitivity test with less response time for detecting the resistance. According to results found in this work the GenoType MTBDRplus® essays was included in the routine of LACEN-DF for the early diagnose and control of multidrugresistant tuberculosis in Federal District, producing substantial benefits for the fast diagnosis confirmation and its resistance profile.
metadata.dc.description.unidade:	Faculdade de Ciências da Saúde (FS) Departamento de Farmácia (FS FAR)
Description:	Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, 2015.
metadata.dc.description.ppg:	Programa de Pós-Graduação em Ciências Farmacêuticas
DOI:	http://dx.doi.org/10.26512/2015.12.T.19596
Appears in Collections:	Teses, dissertações e produtos pós-doutorado

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.