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ABSTRACT Background: Prognostic factors in previously healthy young patients with COVID-19 remained understudied. Objective: The objective of the study was to identify factors associated with in-hospital death or need for invasive mechanical ventilation (IMV) in young (aged ≤ 65 years) and previously healthy patients with COVID-19. Methods: We conducted a prospective cohort study that included patients admitted with COVID-19. The primary outcome was in-hospital death/need for IMV. Secondary outcomes included need for IMV during follow-up, days on IMV, length of stay (LOS), hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP), and pulmonary embolism (PE). Bivariate and multivariate analyses were performed. Results: Among 92 patients, primary outcome occurred in 16 (17%), death in 12 (13%), need for IMV in 16 (17%), HAP/VAP in 7 (8%), and PE in 2 (2%). Median LOS and IMV duration were 7 and 12 days, respectively. Independent associations were found between the primary outcome and male sex (Adjusted odds ratio [aOR] 7.1, 95%CI 1.1-46.0, p < 0.05), D-dimer levels > 1000ng/mL (aOR 9.0, 95%CI 1.6-49.1, p < 0.05), and RT-PCR Ct-value ≤ 24 on initial swab samples (aOR 14.3, 95%CI 2.0-101.5, p < 0.01). Conclusions: In young and non-comorbid COVID-19 patients, male sex, higher levels of D-dimer, and low SARS-CoV-2 RT-PCR Ct-value on an initial nasopharyngeal swab were independently associated with increased in-hospital mortality or need for IMV.

https://doi.org/10.24875/ric.22000162

Prevención de eventos de superpropagación de COVID-19 en autobuses que transportaron pacientes presintomáticos
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Ochoa-Hein, Eric

; Huertas-Jiménez, Martha A.

; Chávez-Ríos, Alma R.

; Haro-Osnaya, Anabel

; De Paz-García, Roxana

; Colín-Ugalde, Alberto G.

; Leal-Morán, Patricia E.

; Vargas-Fernández, Abril T.

; Vargas-Fernández, José F.

; González-González, Ricardo

; Rajme-López, Sandra

; González-Lara, María F.

; Ponce-De León, Alfredo

; Sifuentes-Osornio, José

; Galindo-Fraga, Arturo

Gaceta médica de México

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Ago 2022, Volume 158 Nº 4 Páginas 204 - 209

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Introducción: Ha ocurrido superpropagación de COVID-19 cuando individuos sintomáticos sin uso de cubrebocas abordaron autobuses. Objetivo: Reportar el riesgo de superpropagación cuando individuos presintomáticos abordaron autobuses junto con pasajeros no vacunados, pero se mantuvieron intervenciones preventivas no farmacológicas. Métodos: Estudio prospectivo de personal de salud transportado durante dos semanas en autobuses a un centro de vacunación contra COVID-19. Fue obligatorio llevar ventanas abiertas, uso correcto de cubrebocas y exclusión de personas con síntomas. La vigilancia prospectiva identificó a trabajadores con COVID-19 los 14 días siguientes a la vacunación. Cada pasajero asintomático de autobuses donde se detectaron casos fue vigilado durante un periodo similar. Los resultados de tamizaje voluntario estuvieron disponibles para los trabajadores que se realizaron prueba el mes previo o el siguiente a la vacunación. Resultados: 1879 trabajadores abordaron 65 autobuses. El tiempo a bordo varió de tres a ocho horas. Veintinueve casos de COVID-19 y cuatro casos asintomáticos fueron identificados entre 613 pasajeros de 21 autobuses. La mediana de tiempo entre la vacunación y el inicio de síntomas de COVID-19 fue de seis días. Fue identificado un caso de transmisión sospechada en autobús. Conclusiones: Las intervenciones preventivas no farmacológicas estrictas redujeron sustancialmente el riesgo de superpropagación de COVID-19 en autobuses ocupados por individuos presintomáticos.

Abstract Introduction: COVID-19 superspreader events have occurred when symptomatic individuals without wearing face masks boarded buses. Objective: To report the risk of superspreader events when presymptomatic individuals boarded buses together with unvaccinated passengers, but with non-pharmacological preventive interventions being maintained. Methods: Prospective study of health personnel transported in buses to a COVID-19 vaccination center for two weeks. Open windows, correct use of face masks and exclusion of symptomatic individuals were mandatory. Prospective surveillance identified workers with COVID-19 within 14 days after vaccination. Each asymptomatic passenger of buses where cases were identified was monitored for a similar time period. Voluntary screening results were available for workers who were tested in the month before or after vaccination. Results: 1,879 workers boarded 65 buses. On-board time ranged from three to eight hours. Twenty-nine cases of COVID-19 and four asymptomatic cases were identified among 613 passengers of 21 buses. Median time between vaccination and COVID-19 symptoms onset was six days. One case of suspected transmission on a bus was identified. Conclusions: Strict nonpharmacological preventive interventions substantially reduced the risk of COVID-19 superspreader events in buses boarded by presymptomatic individuals.

https://doi.org/10.24875/gmm.21000772 23 downloads

Significant Rise in SARS-CoV-2 Reinfection Rate in Vaccinated Hospital Workers during the Omicron Wave: A Prospective Cohort Study
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Ochoa-Hein, Eric

; Leal-Morán, Patricia E.

; Nava-Guzmán, Karen A.

; Vargas-Fernández, Abril T.

; Vargas-Fernández, José F.

; Díaz-Rodríguez, Fabricio

; Rayas-Bernal, Joel Armando

; González-González, Ricardo

; Vázquez-González, Pavel

; Huertas-Jiménez, Martha A.

; Rajme-López, Sandra

; Ramos-Cervantes, Pilar

; Ibarra-González, Violeta

; García-Andrade, Luis A.

; Ledesma-Barrientos, Fernando

; Ponce-de-León, Alfredo

; Sifuentes-Osornio, José

; Galindo-Fraga, Arturo

Revista de investigación clínica

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Ago 2022, Volume 74 Nº 4 Páginas 175 - 180

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Relatively low SARS-CoV-2 reinfection rates have been reported in vaccinated individuals, but updates considering the Omicron variant are lacking. Objective: The objective of the study was to provide a current estimate of the SARS-CoV-2 reinfection rate in a highly immunized population. Methods: A prospective cohort of Mexican hospital workers was followed (March 2020-February 2022). Reinfection was defined as the occurrence of two or more episodes of COVID-19 separated by a period of ≥ 90 days without symptoms. The reinfection rate was calculated as the number of reinfection episodes per 100,000 persons per day. Results: A total of 3732 medical consultations were provided to 2700 workers, of whom 1388 (51.4%) were confirmed COVID-19 cases. A total of 73 reinfection cases were identified, of whom 71 (97.3%) had completed their primary vaccination series and 22 (30.1%) had had a booster dose before the second episode. The overall reinfection rate was 23.1 per 100,000 persons per day (as compared to a rate of 1.9 per 100,000 persons per day before the Omicron wave). Conclusions: The SARS-CoV-2 reinfection rate rose significantly during the Omicron wave despite a high primary vaccination coverage rate. Almost one-third of reinfected workers had a vaccine booster ≥ 14 days before the last COVID-19 episode.

https://doi.org/10.24875/ric.22000159 18 downloads

Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19: Experience in a Third-Level Medical Center
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Martínez-Guerra, Bernardo A.

; de-León-Cividanes, Nereyda A.

; Tamez-Torres, Karla M.

; Román-Montes, Carla M.

; Rajme-López, Sandra

; Ortiz-Brizuela, Edgar

; Aguilar-Salinas, Carlos A.

; Sierra-Madero, Juan

; Sifuentes-Osornio, José

; Ponce-de-León, Alfredo

; González-Lara, María F.

Revista de investigación clínica

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Fev 2022, Volume 74 Nº 1 Páginas 40 - 50

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Trials evaluating safety and efficacy of tocilizumab in coronavirus disease 19 (COVID-19) show contradictory results. Objective: The objective of the study was to evaluate the effect of tocilizumab in hospital mortality among patients with severe COVID-19 in a third-level medical center. Methods: This prospective cohort study included patients with severe and critical COVID-19. Primary outcome was death during hospitalization. Secondary outcomes included invasive mechanical ventilation (IMV), days on IMV, ventilator-free days (VFDs), length of hospital stay (LOS), and development of hospital-acquired infections (HAIs). Bivariate, multivariate, and propensity score matching analysis were performed. Results: During the study period, 99/794 (12%) patients received tocilizumab. Male patients, health care workers, and patients with increased inflammatory markers received tocilizumab more frequently. No difference in hospital mortality was observed between groups (34% vs. 34%, p = 0.98). Tocilizumab was not independently associated with mortality. No significant treatment effects were observed in propensity score analysis. IMV was more frequent (46% vs. 11%, p < 0.01) and LOS was longer (12 vs. 7 days, p < 0.01) in the tocilizumab group, reflecting increased severity. Although HAIs were more frequent in the tocilizumab group (22% vs. 10%, p < 0.01), no difference was seen after adjusting for IMV (38% vs. 40%, p = 0.86). Conclusions: In our study, tocilizumab was not associated with decreased hospital mortality among patients with severe COVID-19.

https://doi.org/10.24875/ric.21000404 27 downloads

COVID-19: What’s Next?
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Ponce-de-León, Alfredo

; Niembro-Ortega, María Dolores

; González-Lara, María F.

Revista de investigación clínica

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Out 2021, Volume 73 Nº 5 Páginas 329 - 334

Resumo: En | Texto: En | PDF: En

Since December 2019, when severe acute respiratory syndrome coronavirus 2 emerged in Wuhan, China, this virus and the resulting disease, coronavirus disease (COVID-19), has spread worldwide. What has occurred in this year and a half goes beyond anything we have dealt with, as humankind, in the past two centuries, perhaps obscured only by war. An incredible number of articles, whether scientific or in the press, have been published, making it impossible to discern between what is biological and what is social in nature. Here, we aim to reflect on the basic structure of the virus and associate its behavior to that of determining factors of the human condition that may be modifiable soon. Needless to say, we find our effort clearly incomplete, and that both scientific and social aspects regarding COVID-19 or any other pandemic encountered in the future, will be constantly changing, from their beginning to their end.

https://doi.org/10.24875/ric.21000362 5 downloads

Surge in Ventilator-Associated Pneumonias and Bloodstream Infections in An Academic Referral Center Converted to Treat COVID-19 Patients
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Ochoa-Hein, Eric

; González-Lara, María F.

; Huertas-Jiménez, Martha A.

; Chávez-Ríos, Alma R.

; de-Paz-García, Roxana

; Haro-Osnaya, Anabel

; González-González, Ricardo

; Cruz-Juárez, Blanca S.

; Hernández-Gilsoul, Thierry

; Rivero-Sigarroa, Eduardo

; Ponce-de-León, Alfredo

; Sifuentes-Osornio, José

; Galindo-Fraga, Arturo

Revista de investigación clínica

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Ago 2021, Volume 73 Nº 4 Páginas 210 - 215

Resumo: En | Texto: En | PDF: En

Background: Healthcare-associated infections (HAIs) are important adverse events that must be prevented. Objective: The objective of the study was to report and study possible changes in HAI rates as well as their causes after the COVID-19 hospital surge capacity response (HSCR) in an academic referral center. Methods: This was a before-after observational study. The Infection Prevention and Control (IPC) program (prospective surveillance, prevention bundles, antibiotic stewardship, continuing education, and feedback) was transiently disrupted after the start of HSCR (March 2020). HAI rates were compared before (January 2019-February 2020) and after (April-July 2020) HSCR, and plausible predisposing factors in affected patients were compared. Results: An increase in the HAI rate from 6.2 to 11.8 cases/1000 patient-days was noted between periods due to increases in ventilator-associated pneumonia and bloodstream infection (BSI) rates. More critically ill patients were admitted during HSCR, and use of invasive devices increased. Prone positioning and infusion of muscle relaxants became commonplace. The nurse-to-patient ratio in the intensive care unit decreased, and 4 h shifts were introduced to avoid fatigue. The BSI rate decreased after the IPC program with additional measures was reintroduced in May 2020. Conclusions: The strain on the workforce and modifications to the IPC program very possibly underlay the findings. IPC programs continue to be essential during the pandemic.

https://doi.org/10.24875/ric.21000130 108 downloads

Factors Associated with COVID-19 and Asymptomatic Carriage in Healthcare Workers of a COVID-19 Hospital
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Ochoa-Hein, Eric

; Rajme-López, Sandra

; Leal-Morán, Patricia E.

; Vargas-Fernández, Abril T.

; González-Lara, María F.

; Alberto-Hernández, María F.

; Bustos-Román, Daniel E.

; Valverde-Ramos, Lirio N.

; Ramos-Cervantes, Pilar

; Cervantes-Villar, Luz E.

; Ibarra-González, Violeta

; Ponce-de-León, Alfredo

; Galindo-Fraga, Arturo

; Kershenobich-Stalnikowitz, David

; Sifuentes-Osornio, José

Revista de investigación clínica

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Abr 2021, Volume 73 Nº 2 Páginas 65 - 71

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Risk factors for coronavirus disease (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) asymptomatic carriage (AC) in healthcare workers (HCWs) have been scarcely characterized. Objective: The objective of the study was to study factors associated with COVID-19 and AC in HCWs of a COVID-19 academic medical center. Methods: This is a case-control study. Cases were either symptomatic or asymptomatic HCWs with a positive SARS-CoV-2 polymerase chain reaction (PCR) test result between March 16 and May 21 of 2020. Adjusted odds ratios (aOR) were calculated by means of multivariable logistic regression. In addition, each subject was followed for 14 days to inform outcomes. Results: One hundred thirty of 249 (52.2%) symptomatic HCWs had COVID-19; 10 were hospitalized but none died. Of 987 asymptomatic HCWs, 37 (3.7%) were AC; 6 of the remaining 950 asymptomatic HCWs with a negative PCR test result were found to be presymptomatic COVID-19 cases the following 14 days. Nurses were more frequently present in the COVID-19 group (51.5% vs. 37.0%), but multivariable analysis rendered non-significant results. After adjustment for age, comorbidities, and working place, factors found to be associated with AC were: working in wards as a nurse (aOR = 9.19, 95% confidence interval [CI] = 1.05-80.22, p = 0.045), kitchen personnel (aOR = 4.09, 95% CI = 1.55-10.83, p = 0.005), and being a physician (aOR = 0.12, 95% CI = 0.03-0.54, p = 0.006). Conclusions: HCW category was the predominant factor associated with AC of SARS-CoV-2 in this study.

https://doi.org/10.24875/ric.20000592 259 downloads

Clinical and Epidemiological Characteristics of Patients Diagnosed with COVID-19 in a Tertiary Care Center in Mexico City: A Prospective Cohort Study
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Mendez-Probst, Carlos E.

; Velazquez-Fernandez, David

; Castillejos-Molina, Ricardo

; Ponce-de-León, Alfredo

Revista de investigación clínica

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Ago 2020, Volume 72 Nº 4 Páginas 250 - 251

Resumo: En | Texto: En | PDF: En

https://doi.org/10.24875/ric.20000301 68 downloads

10.

Clinical and Epidemiological Characteristics of Patients Diagnosed with COVID-19 in a Tertiary Care Center in Mexico City: A Prospective Cohort Study
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Ortiz-Brizuela, Edgar

; Villanueva-Reza, Marco

; González-Lara, María F.

; Tamez-Torres, Karla M.

; Román-Montes, Carla M.

; Díaz-Mejía, Bruno A.

; Pérez-García, Esteban

; Olivas-Martínez, Antonio

; Rajme-López, Sandra

; Martinez-Guerra, Bernardo A.

; León-Cividanes, Nereyda A. de

; Fernández-García, Oscar A.

; Guerrero-Torres, Lorena

; Torres-González, Lorena

; Carrera-Patiño, Fabián A.

; Corral-Herrera, Ever A.

; Hernández-Alemón, Aldo N.

; Tovar-Vargas, Maria de los Ángeles

; Serrano-Pinto, Yamile G.

; Espejo-Ortiz, Cristian E.

; Morales-Ortega, María de la L.

; Lozano-Cruz, Óscar A.

; Cárdenas-Fragoso, José L.

; Vidal-Mayo, José de J.

; Hernández-Gilsoul, Thierry

; Rivero-Sigarroa, Eduardo

; Domínguez-Cherit, Guillermo

; Cervantes-Villar, Luz E.

; Ramos-Cervantes, Maria del P.

; Ibarra-González, Violeta

; Calva-Mercado, Juan J.

; Sierra-Madero, Juan G.

; López-Íñiguez, Álvaro

; Ochoa-Hein, Eric

; Crabtree-Ramírez, Brenda E.

; Galindo-Fraga, Arturo

; Guerrero-Almeida, María de L.

; Ruiz-Palacios, Guillermo M.

; Gulías-Herrero, Alfonso

; Sifuentes-Osornio, José

; Kershenobich-Stalnikowitz, David

; Ponce-de-León, Alfredo

Revista de investigación clínica

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Jun 2020, Volume 72 Nº 3 Páginas 165 - 177

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic. Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC). Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020. Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m2 and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died. Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.

https://doi.org/10.24875/ric.20000211 533 downloads

11.

Nontuberculous mycobacterial infection in a tertiary care center in Mexico, 2001-2017
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Lopez-Luis, Bruno Ali

; Sifuentes-Osornio, José

; Pérez-Gutiérrez, María Teresa

; Chávez-Mazari, Bárbara

; Bobadilla-del-Valle, Miriam

; Ponce-de-León, Alfredo

Brazilian Journal of Infectious Diseases

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Jun 2020, Volume 24 Nº 3 Páginas 213 - 220

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: Nontuberculous mycobacteria (NTM) comprise several pathogens with a complex profile of virulence, diverse epidemiological and clinical patterns as well as host specificity. Recently, an increase in the number of NTM infections has been observed; therefore, the objective of this study was to evaluate the clinical characteristics and outcomes of these infections. Methods: We included patients with NTM infections between 2001-2017 and obtained risk factors, clinical features and outcomes; finally, we compared this data between slowly growing (SGM) and rapidly growing mycobacteria (RGM). Results: A total of 230 patients were evaluated, 158 (69%) infected and 72 (31%) colonized/pseudoinfected. The average annual incidence in the first 11 years of the study was 0.5 cases per 1000 admissions and increased to 2.0 cases per 1000 admissions later on. The distribution of NTM infections was as follows: bloodstream and disseminated disease 72 (45%), lung infection 67 (42%), skin and soft tissue infection 19 (12%). Mycobacterium avium complex was the most common isolate within SGM infections, and HIV-infected patients were the most affected. Within RGM infections, M. fortuitum was the most common isolate from patients with underlying conditions such as cancer, type-2 diabetes mellitus, presence of invasive devices, and use of immunosuppressive therapy. We did not find significant differences in deaths and persistent infections between disseminated SGM infection when compared to disseminated RGM infection (42% vs. 24%, p = 0.22). However, disseminated SGM infection required a longer duration of therapy than disseminated RGM infection (median, 210 vs. 42 days, p = 0.01). NTM lung disease showed no significant differences in outcomes among treated versus non-treated patients (p = 0.27). Conclusions: Our results show a significant increase in the number of Non-tuberculosis-mycobacteria infections in our setting. Patients with slow-growing-mycobacteria infections were mainly persons living with human immunodeficiency virus . Older patients with chronic diseases were common among those with rapidly-growing-mycobacteria infections. For non-tuberculosis-mycobacteria lung infection, antibiotic therapy should be carefully individualized.

https://doi.org/10.1016/j.bjid.2020.04.012 326 downloads

12.

Wuhan: Back to the Future and the Return of Coronaviruses
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Ponce-de-León, Alfredo

; Galindo-Fraga, Arturo

; Ruiz-Palacios, Guillermo M.

; Sifuentes-Osornio, José

Revista de investigación clínica

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Fev 2020, Volume 72 Nº 1 Páginas 5 - 7

Resumo: En | Texto: En | PDF: En

https://doi.org/10.24875/ric.20000023 84 downloads

13.

Seroprevalence of brucellosis among dairy farm workers in Mexico
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Cervera-Hernández, Miguel E

; Ordaz-Vázquez, Anabel

; Torres-González, Pedro

; Chávez-Mazari, Bárbara

; Soberanis-Ramos, Orbelin

; Sifuentes-Osornio, José

; Ponce de León, Alfredo

; Bobadilla-del Valle, Miriam

Salud Pública de México

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Jun 2016, Volume 58 Nº 3 Páginas 366 - 370

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract: Objective: To describe the seroprevalence and associated factors for brucellosis among dairy farm workers. Materials and methods: We performed a secondary analysis of a data set and sera from a previous cross-sectional study in a dairy farm. Sera were tested for Brucella spp. antibodies by the slide agglutination test. Seropositivity was defined as a titer ≥1:40; recent infection was titers ≥1:160. Results: We tested 331 human sera. Seroprevalence of brucellosis was 18.1% (60/331; 95% CI 14.1-22.7); 13.3% of them (8/60; 95% CI 5.9 24.5) corresponded to recent infection. Highexposure occupation (calf caretaker; OR 3.3; 95%CI 1.1 - 9.7), daily hours in contact with cows (OR 1.1; 95%CI 1.03 - 1.2), and living on-site (OR 2.2; 95% CI 1.1 - 4.4) remained independently associated with seropositivity. Conclusions: We found a high seroprevalence of brucellosis among dairy farm workers, as well as a significant association among those with prolonged and close contact with cattle.

Resumen: Objetivos: Describir la seroprevalencia y factores asociados con la brucelosis en los trabajadores de una cuenca lechera. Material y métodos: Se realizó un análisis secundario de datos y sueros obtenidos en una cuenca lechera. Se buscaron anticuerpos contra Brucella spp. en los sueros por medio de la prueba de aglutinación en placa. Se definió seropositividad a partir de un título ≥1:40, e infección reciente con títulos ≥1:160. Resultados: Se analizaron 331 sueros humanos. La seroprevalencia de brucelosis fue de 18.1% (60/331; IC 95% 14.1-22.7); el 13.3% (8/60; IC 95% 5.9 24.5) correspondieron a infección reciente. Alta exposición (becerrero; RM 3.3; IC 95% 1.1 - 9.7), horas diarias en contacto con vacas (RM 1.1; IC 95% 1.03 - 1.2), y vivir en el establo (RM 2.2; IC 95% 1.1 - 4.4) estuvieron asociadas independientemente con seropositividad. Conclusiones: Se encontró alta seroprevalencia de brucelosis en trabajadores de una cuenca lechera, y asociación en aquellos con contacto cercano y prolongado con vacas.

https://doi.org/10.21149/spm.v58i3.7896 744 downloads

14.

Seroprevalence of brucellosis among dairy farm workers in Mexico
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Cervera-Hernández, Miguel E

; Ordaz-Vázquez, Anabel

; Torres-González, Pedro

; Chávez-Mazari, Bárbara

; Soberanis-Ramos, Orbelin

; Sifuentes-Osornio, José

; Ponce de León, Alfredo

; Bobadilla-del Valle, Miriam

Salud Pública de México

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Jun 2016, Volume 58 Nº 3 Páginas 366 - 370

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

https://doi.org/10.21149/spm.v58i3.7896 745 downloads

15.

Tuberculosis activa en una cohorte de reclusos infectados por VIH en una cárcel de la Ciudad de México: características clínicas y epidemiológicas
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Hernández-León, Christian

; Badial-Hernández, Florentino

; Ponce-de-León, Alfredo

; Sierra-Madero, Juan G

; Martínez-Gamboa, Areli

; Crabtree-Ramírez, Brenda

; Bautista-Arredondo, Sergio

; González-Aguirre, Adrián

; Guerrero-Almeida, María de Lourdes

; Valle, J Miriam Bobadilla del

; González-Rodríguez, Andrea

; Sifuentes-Osornio, José

Salud Pública de México

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Dez 2012, Volume 54 Nº 6 Páginas 571 - 578

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

OBJECTIVE: To determine the clinical and epidemiological characteristics of prison inmates with active tuberculosis in HIV-positive prison populations. MATERIALS AND METHODS: We conducted a cohort study in HIV-infected subjects in a prison in Mexico City, with the aim of determining clinical and epidemiological characteristics of cases with active TB. RESULTS: We detected 172 HIV infected inmates and TB in 28 of them (16.3%) - 21 (12.2) with pulmonary TB - with an incidence rate of 7.7/100 persons/year for active TB and 4.7/100 persons/year for pulmonary TB. No drug resistance was found. Two clusters (4 and 2 subjects) were observed after RFLP-typing of 18 isolates, with a transmission rate of 11% by molecular and clinical analysis. CONCLUSIONS: The prevalence of active TB was found to be a thousand times greater than in the general population. Evidence of transmission inside the prison was also found

OBJETIVO: Determinar las características clínicas y epidemiológicas de los casos con tuberculosis (TB) activa en población de cárceles con VIH, que se ve especialmente afectada por ambas epidemias. La infección por VIH incrementa significativamente la probabilidad del desarrollo de TB. MATERIAL Y MÉTODOS: Se realizó un estudio de cohorte en sujetos infectados por VIH e internados en un reclusorio de la Ciudad de México. RESULTADOS: Se encontraron 172 pacientes con VIH, 28 con TB activa (16.3%) - 21 (12.2%) con afección pulmonar - con una tasa de incidencia de 7.7 por 100 sujetos/año para TB activa y de 4.7 por 100 sujetos/ año para TB pulmonar. No se encontró drogorresistencia. Dieciocho aislados fueron tipificados por RFLP, con una tasa de transmisión calculada de 11%. CONCLUSIÓN: Se encontró una prevalencia de TB en esta población mil veces superior a la observada en la población general y datos sugerentes de transmisión al interior de la cárcel.

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