RESUMO
BACKGROUND: Diabetes mellitus is a public health problem in Mexico, and the trend of the disease is increasing. From 2000 to 2017, 7.32 million new cases were diagnosed, with pulmonary mycoses being one of the most serious complications. AIMS: To describe the frequency and the clinical characteristics of patients diagnosed with pulmonary mycoses, and to identify the risk factors associated with this entity. METHODS: Case-control study, paired by gender (1:1-3) and age (± 5 years), that analyzed patients with pulmonary mycosis (mucormycosis, histoplasmosis, coccidioidomycosis, blastomycosis, aspergillosis, cryptococcosis, paracoccidioidomycosis) and studied the risk factors present in each patient. RESULTS: From the 162 patients studied, 56 suffered pulmonary mycosis and 106 were controls. The median of the age was 51 and 50 years for the cases and for the controls, respectively. Multiple logistic regression analysis showed that patients with diabetes mellitus had an odds ratio of 8,3 (p < 0.001), and patients with a history of tuberculosis had an odds ratio of 8,8 (p < 0.001). CONCLUSIONS: Our results show that 52% of the patients with pulmonary mycoses had a history of diabetes mellitus. Diabetes mellitus is a relevant risk factor for pulmonary mycoses, which are usually diagnosed in advanced stages and have a high mortality.
Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Pneumopatias Fúngicas/epidemiologia , Adulto , Estudos de Casos e Controles , Comorbidade , Feminino , Infecções por HIV/epidemiologia , Humanos , Pneumopatias Fúngicas/microbiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Tuberculose/epidemiologiaRESUMO
INTRODUCTION: In Mexico, there is an alarming increase in the number of cases of Mycobacterium bovis infection on pulmonary and extrapulmonary presentations. The lack of timely identification triggers complications and increases mortality. OBJECTIVE: To know the frequency of M. bovis infections in clinical samples of patients with tuberculosis in the mycobacteria laboratory of a reference hospital in Mexico City. METHOD: Prospective, descriptive study. Strains isolated from biological material were studied in Löwestein-Jensen and MGITI960 cultures. M. bovis was identified by amplifying the RD9 fragment with end-point polymerase chain reaction (PCR). RESULTS: Eight-hundred and fifty tuberculosis-diagnosed patients were included; in 441 cases, Mycobacterium tuberculosis was confirmed by positive culture (250 pulmonary, 65 ganglionic, 39 renal, 34 meningeal, 25 miliary, 14 pleural, 8 peritoneal, 4 bone and 2 pericardial cases). Forty-eight strains (10.8%) were typified as M. bovis by amplification of the RD9 fragment with end-point PCR. CONCLUSIONS: M. bovis is not currently thought of a causative agent of tuberculosis, which could be the cause of pharmacological treatment failure. In this study, the main extrapulmonary form was observed to be cervical lymphadenopathy.
INTRODUCCIÓN: En México existe un incremento alarmante de casos de infección pulmonar y extrapulmonar por Mycobacterium bovis. La falta de identificación oportuna deriva en complicaciones y eleva la mortalidad. OBJETIVO: Conocer la frecuencia de infecciones por Mycobacterium bovis en muestras clínicas de pacientes con tuberculosis, identificadas en el laboratorio de micobacterias en un hospital de concentración de la Ciudad de México. MÉTODO: Estudio prospectivo, descriptivo. Se estudiaron cepas aisladas de material biológico en cultivos Löwestein-Jensen y MGITI960. La identificación de Mycobacterium bovis se realizó mediante la amplificación del fragmento RD9 por PCR punto final. RESULTADOS: Se incluyeron 850 pacientes con diagnóstico de tuberculosis, en 441 casos se confirmó Mycobacterium tuberculosis por cultivo positivo (250 casos pulmonares, 65 ganglionares, 39 renales, 34 meníngeos, 25 miliares, 14 pleurales, ocho peritoneales, cuatro óseos y dos pericárdicos). Se tipificaron 48 cepas (10.8 %) como Mycobacterium bovis por amplificación del fragmento RD9 por PCR punto final. CONCLUSIONES: Actualmente no se piensa en Mycobacterium bovis como agente causal de tuberculosis, lo que pudiera ser la causa del fracaso del tratamiento farmacológico. En este estudio se observó que la principal forma extrapulmonar es la linfadenopatía cervical.