El aumento de la tuberculosis resistente a la medicación

BALTIMORE – La tuberculosis, una de las enfermedades infecciosas más mortíferas, está de vuelta con fuerza, en particular en África. La tuberculosis sumamente resistente a la medicación (TSRM) es una variedad de la enfermedad difícil de tratar, que ataca allí donde los sistemas de salud han sido siempre deficientes, en particular en zonas con gran prevalencia del VIH. Si no se contienen los brotes locales, se crean instrumentos y se formulan estrategias para identificar y tratar la TSRM y se invierte en mejoras a más largo plazo en la lucha contra la tuberculosis, esta enfermedad podría transformar nuestras balas mágicas farmacológicas contra la tuberculosis en cartuchos de fogueo.

El desarrollo de la quimioterapia antituberculosa desde el decenio de 1940 hasta el de 1970 transformó la en otro tiempo mortífera “peste blanca” en una enfermedad curable, pero el espectro de la resistencia a los medicamentos ha ensombrecido el tratamiento antituberculoso desde el comienzo de la era antibiótica. Hace quince años, una epidemia de tuberculosis resistente a la medicación (TRM) en la ciudad de Nueva York casi provocó el pánico antes de que una inyección de fondos en gran escala en la infraestructura de salud pública le pusiera coto en los Estados Unidos y el interés del público decayese. Sin embargo, el problema de la resistencia a los medicamentos ha persistido y las medidas adoptadas al respecto no han sido suficientes para contenerla a escala mundial.

Entra en escena la TSRM. La Organización Mundial de la Salud calcula que en 2004 hubo 425.000 casos nuevos de TSRM, de los que el 60 por ciento correspondieron a China, la India y Rusia, pero fue un brote de TSRM en personas infectadas con el VIH en KwaZulu-Natal (Sudáfrica) lo que centró la atención mundial en las cuestiones relativas a los organismos sumamente resistentes a la medicación.

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