¿Reinfección o reactivación en la tuberculosis pulmonar? Un reto diagnóstico

Mateo Zuluaga G.

doi:10.17533/udea.rfnsp.v33n3a12

Autores/as

Mateo Zuluaga G. Universidad Pontificia Bolivariana

DOI:

https://doi.org/10.17533/udea.rfnsp.v33n3a12

Palabras clave:

tuberculosis, biología molecular, multidrogoresistencia

Resumen

La recurrencia de la tuberculosis (TB) se convierte en un reto diagnóstico debido a que en muchos casos el sistema inmune puede estar alterado como es el caso de las inmunodeficiencias. Existe otro escenario en el cual una cepa distinta de la Mycobacterium tuberculosis puede llegar del exterior y causar nuevamente la enfermedad en el paciente, independiente de su estado inmune, siendo el caso más frecuente en pacientes inmunocompetentes. La relación de reinfección con el estado inmunosupresor del paciente tiene en cuenta el comportamiento de prevalencia e incidencia de la enfermedad; en el caso del VIH a mayor prevalencia mayor es la incidencia de la tuberculosis, por lo cual se habla de coexistencia de la infección. El reto actual alerta a tener una mayor sospecha frente a ciertos casos que merezcan estudiarse de manera profunda a través de otras técnicas, buscando si se trata de una reactivación o de una reinfección, teniendo en cuenta el impacto clínico, social y económico que esto genera.

|Resumen

= 1491 veces | PDF

= 356 veces|

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Mateo Zuluaga G., Universidad Pontificia Bolivariana

Estudiante internado Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia. Monitor Microbiología y Parasitología I, Miembro de grupos de investigación Endocardio (Clinica Cardiovid), Grupo de investigación HPTU, Grupo de investigación GIERI (Hospital Pablo Tobon Uribe) Biologia de sistemas (UPB), asesor y evaluador proyectos feria explora.

Citas

(1). Millet JP, Shaw E, Orcau A, Casals M, Miró JM, Caylà JA. Tuberculosis recurrence after completion treatment in a European city: reinfection or relapse? PloS one. 2013; 8(6): e64898. DOI: https://doi.org/10.1371/journal.pone.0064898

(2). Jasmer RM, Bozeman L, Schwartzman K, Cave MD, Saukkonen JJ, Metchock B, et al. Recurrent tuberculosis in the United States and Canada: relapse or reinfection? American journal of respiratory and critical care medicine. 2004; 170 (12): 1360-1366. DOI: https://doi.org/10.1164/rccm.200408-1081OC

(3). Dobler C, Marks G. Recurrence of tuberculosis at a Sydney chest clinic between 1994 and 2006: reactivation or reinfection? Medical Journal of. 2008; 188(3): 2006-2008. DOI: https://doi.org/10.5694/j.1326-5377.2008.tb01558.x

(4). Bryant JM, Harris SR, Parkhill J, Dawson R, Diacon AH, Van Helden P, et al. Whole-genome sequencing to establish relapse or re-infection with Mycobacterium tuberculosis: a retrospective observational study. The Lancet Respiratory Medicine. Bryant et al. Open Access article distributed under the terms of CC BY; 2013; 1 (10): 786-792. DOI: https://doi.org/10.1016/S2213-2600(13)70231-5

(5). Charalambous S, Grant AD, Moloi V, Warren R, Day JH, Van Helden P, et al. Contribution of reinfection to recurrent tuberculosis in South African gold miners. The international journal of tuberculosis and lung disease. 2008; 12 (8): 942-948.

(6). Van Soolingen D. Molecular epidemiology of tuberculosis and other mycobacterial infections: main methodologies and achievements. J Intern Med. 2001; 249: 1-26. DOI: https://doi.org/10.1046/j.1365-2796.2001.00772.x

(7). Chiang C-Y, Riley LW. Exogenous reinfection in tuberculosis. The Lancet infectious diseases. 2005; 5 (10): 629-636. DOI: https://doi.org/10.1016/S1473-3099(05)70240-1

(8). Cardona P-J. Revisiting the natural history of tuberculosis. The inclusion of constant reinfection, host tolerance, and damage-response frameworks leads to a better understanding of latent infection and its evolution towards active disease. Archivum immunologiae et therapiae experimentalis. 2010; 58 (1): 7-14. DOI: https://doi.org/10.1007/s00005-009-0062-5

(9). Stead WW. The pathogenesis of pulmonary tuberculosis among older persons. Am Rev Respir Dise. 1965; 91: 811-822.

(10). Stead WW. Pathogenesis of a first episode of chronic pulmonary tuberculosis in man: recrudescense of residuals of the primary infection or exogenous reinfection? Am Rev Respir Dise. 1967; 95: 729-45.

(11). Heimbeck J. Incidence of tuberculosis in young adult women with special reference to empleoyment. Brit J Tuberc. 1938; (32): 154. DOI: https://doi.org/10.1016/S0366-0850(38)80144-7

(12). Daniels M, Ridehaligh F, Springet VH, Hall IM. Tuberculosis in young adults: report on the Prophit tuberculosis survey 1935,1944. London: Lewis HK. 1948.

(13). Madsen T, Holm J, Jensen KA. Studies on the epidemiology of tuberculosis in Demark. Acta Tuberc Scand. 1942.

(14). Stead WW. Pathogenesis of the sporadic case of tuberculosis. The New England journal of medicine. 1967; 277: 1008-1012. DOI: https://doi.org/10.1056/NEJM196711092771906

(15). Van N. Exogenous Reinfection as a cause of recurrente tuberculosis after curative treatment. The New England journal of medicine. 1999; 341: 1174-1179. DOI: https://doi.org/10.1056/NEJM199910143411602

(16). Vynnycky E, Fine PE. The natural history of tuberculosis: the implications of age-dependent risks of disease and the role of reinfection. Epidemiology and infection. 1997; 119 (2): 183-201. DOI: https://doi.org/10.1017/S0950268897007917

(17). Mathema B, Kurepina NE, Bifani PJ, Kreiswirth BN. Molecular epidemiology of tuberculosis: current insights. Clinical microbiology reviews. 2006; 19 (4): 658-685. DOI: https://doi.org/10.1128/CMR.00061-05

(18). Lambert M-L, Hasker E, Van Deun A, Roberfroid D, Boelaert M, Van der Stuyft P. Recurrence in tuberculosis: relapse or reinfection? The Lancet infectious diseases. 2003; 3 (5): 282-287. DOI: https://doi.org/10.1016/S1473-3099(03)00607-8

(19). Warren RM, Victor TC, Streicher EM, et al. Patients with active tuberculosis often have different straint the same sputum specimen. Am J Respir Crit Care Med. 2004; 169: 610-4. DOI: https://doi.org/10.1164/rccm.200305-714OC

(20). Behr MA. Tuberculosis due to multiple strains. A concern for the patient? A concern for tuberculosis control? Clin Infect Dis. 2001; 33: E42-E47. DOI: https://doi.org/10.1086/322635

(21). Chaves F, Dronda F, Alonso-Sanz M, Noriega AR. Evidence of exogenous reinfection and mixed infection with more than one strain of Mycobacterium tuberculosis among Spanish HIV-infected inmates. AIDS (London, England). 1999; 13: 615-20. DOI: https://doi.org/10.1097/00002030-199904010-00011

(22). Richardson M, Carroll NM, Engelke E, et al. Multiple Mycobacterium tuberculosis strains in early cultures from patients in a high-incidence community setting. J Clin Microbiol. 2002; 40: 2750-2754. DOI: https://doi.org/10.1128/JCM.40.8.2750-2754.2002

(23). Fine PE. BCG: the challenge continues. Scand J Infect Dis. 2001; 33: 243-245. DOI: https://doi.org/10.1080/003655401300077144

(24). Small PM, Shafer RW, Hopewell PC et al. Exogenous reinfection with multidrug-resistant Mycobacterium tuberculosis in patients with advanced HIV infection. The New England journal of medicine. 1993; 328: 1137-1144. DOI: https://doi.org/10.1056/NEJM199304223281601

(25). Barnes PF, El-Haji, Preston-Martin S et al. Transmission of tuberculosis among the urban homeless. JAMA : the journal of the American Medical Association. 1996; 275: 305–307. DOI: https://doi.org/10.1001/jama.275.4.305

(26). Genewein A, Telenti A, Bernasconi C, et al. Molecular approach to identifying route of transmission of tuberculosis in the community. Lancet. 1993; 342: 841–844. DOI: https://doi.org/10.1016/0140-6736(93)92698-S