Drug resistance patterns among hospitalized tuberculous patients in Rio deJaneiro, Brazil, 1993-1994

The purpose of this study was to analyze the prevalence and risk factors fo r drug resistance among hospitalized patients in two tertiary care centers, an acquired immunodeficiency syndrome (AIDS) reference center and a sanato rium, in Rio de Janeiro, Brazil. From 1993-1994, 389 patients were diagnose d as having tuberculosis (TB). Isolates from 265 patients were tested for i n vitro susceptibility to rifampin and isoniazid. Resistance to one or more drugs was detected in 44 patients (16.6%) and was significantly more commo n among recurrent cases in both hospitals (p = 0.03 in the AIDS center and p = 0.001 in the sanatorium). Twenty seven patients (10.2%) had isolates re sistant to both isoniazid and rifampin. Multi-drug resistance was associate d with human immunodeficiency virus (HIV) infection among patients who had never been treated for TB. In conclusion, drug-resistant TB is high in hosp italized patients in Rio de Janeiro, especially among HIV infected patients . Therefore, measures to control TB and prevent nosocomial transmission nee d urgently to be set up in the Brazilian hospitals.