Outbreak of Multidrug-Resistant Tuberculosis in Spain
Author Information
Author(s): John V. Rullan M.D., Dionisio Herrera, M.D., Rosa Cano, M.D., Victoria Moreno, M.D., Pere Godoy, M.D., Enrique F. Peiro, M.D., Juan Castell, M.D., Consuelo Ibanez, M.D., Arturo Ortega, M.D., Leopoldo Sanchez Agudo, M.D., Francisco Pozo, M.D.
Primary Institution: Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo
Hypothesis
What are the risk factors associated with the nosocomial transmission of multidrug-resistant tuberculosis (MDRTB) among HIV-infected patients?
Conclusion
The outbreak of MDRTB was primarily due to nosocomial transmission among HIV-infected patients in a hospital setting.
Supporting Evidence
- All 48 reported cases of isoniazid and rifampin resistance were among HIV-infected patients hospitalized in the HIV-dedicated ward.
- Of the 47 patients who died, the mean interval from diagnosis to death was 77.6 days.
- Case patients were more likely to have been exposed to potentially infective wardmates than control patients.
- Employees with occupational exposure to high-risk areas had higher conversion rates than those without such exposure.
Takeaway
Some patients in a hospital got really sick from a type of tuberculosis that is hard to treat because they were near other sick people who had it, and they didn't get the right care.
Methodology
The study included a description of MDRTB cases, a case-control study comparing HIV-infected patients with and without MDRTB, and a study of tuberculin conversion among hospital employees.
Potential Biases
Potential bias due to the reliance on medical records and self-reported data from patients and employees.
Limitations
The study was limited by the lack of national TB notification in Spain and the retrospective nature of the data collection.
Participant Demographics
Mean age of patients was 34.1 years; 81.3% were male, and 66.6% were intravenous drug users.
Statistical Information
P-Value
p<0.05
Confidence Interval
[1.4, 50.5]
Statistical Significance
p<0.05
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