Patrones de resistencia en pacientes con tuberculosis infantil a nivel nacional, en los años 2017–2022.

Abstract

Introduction: Tuberculosis (TB) is one of the most epidemiologically relevant infectious diseases in Ecuador. It is caused by the bacterial pathogen Mycobacterium tuberculosis, causing an infection that mainly affects the lung tissue. It is mainly transmitted through the respiratory route through the inhalation of microparticles that contain the bacillus and are present in the air when coughing, speaking or sneezing. The clinical presentation of pulmonary TB in children is nonspecific, the most common being night sweats, low-grade fever, dyspnea, fatigue, weight loss, and loss of appetite. Diagnostic certainty is obtained by isolating the bacillus through microbiological and molecular methods. The current scheme for sensitive tuberculosis consists of the standard combination of Isoniazid (H), Rifampicin (R), Ethambutol (E) and Pyrazinamide (Z), prescribed for at least 6 months. Due to the constant use of anti-TB drugs for several decades, it is common for several countries to report different types of strains resistant to antibiotic treatment. Among the resistance patterns described by the WHO are: monoresistant TB, polyresistant TB, multidrug-resistant TB, pre-XDR TB, XDR TB (extensively resistant and rifampicin-resistant TB. Objective: To determine the patterns of resistance to first-line treatment of childhood tuberculosis nationwide from January 2017 to December 2022. Methodology: Quantitative approach study, nonexperimental design, cross-sectional, retrospective and correlational. Results: Resistance to antifimic treatment occurred in 16% of cases, the The most frequent resistance pattern was monoresistant TB with 10.3%, divided into 8.5% for isoniazid and 1.8% for rifampicin, which in turn was the most prevalent in the age group between 5-10 years; Individually, the drug that showed the greatest resistance was isoniazid with 14.3. Discussion: At the end of the investigation, it was observed that no association was found between sociodemographic and clinical-epidemiological factors and the presence of resistance to antituberculosis drugs, which which is consistent with the results of published studies. Conclusion: Resistance to antituberculous drugs is largely influenced by gene mutation, however some studies have shown sociodemographic and clinical-epidemiological risk factors predict the presence or development of drug resistance.