Publicado

2018-07-01

Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos

Drug resistance in Mycobacterium tuberculosis: contribution of constituent and acquired mechanisms

DOI:

https://doi.org/10.15446/rsap.v20n4.50575

Palabras clave:

Resistencia a medicamentos, mycobacterium tuberculosis, tuberculosis resistente a múltiples medicamentos (es)
Drug resistance, mycobacterium tuberculosis, tuberculosis, multidrug resistant (en)

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Autores/as

  • Verónica Gómez Tangarife Corporación para Investigaciones Biológicas
  • Alex Julián Gómez Restrepo Corporación para Investigaciones Biológicas
  • Jaime Alberto Robledo Restrepo Corporación para Investigaciones Biológicas
  • José Mauricio Hernández Sarmiento Corporación para Investigaciones Biológicas
En presencia de aislamientos de Mycobacterium tuberculosis (MTB) multifármaco-resistentes (MTB-MDR) y con resistencia extendida (MTB-XDR) las tasas de fracaso de los esquemas estandarizados de tratamiento son altas, constituyéndose en un verdadero problema de salud pública a nivel mundial. La fármaco-resistencia en MTB se debe principalmente a mutaciones en genes blanco; sin embargo, una proporción de aislamientos fármaco-resistentes no presentan mutaciones en dichos genes, sugiriendo la participación de otros mecanismos, tales como permeabilidad reducida de la pared celular, modificación enzimática y/o bombas de eflujo. La resistencia clínica a los medicamentos anti-tuberculosos (anti-TB) ocurre en gran parte como resultado de la selección de mutantes resistentes durante la falta de adherencia del paciente al tratamiento, inapropiados seguimientos y prescripción médica, dosis subóptimas de fármacos y dificultad de acceso a los servicios de salud y al tratamiento. Los Avances de la biología molecular y la secuenciación del genoma de MTB han contribuido a mejorar el entendimiento de los mecanismos de resistencia a los principales medicamentos anti-TB. Un mejor conocimiento de los mecanismos de fármaco-resistencia en MTB contribuirá a la identificación de nuevos blancos terapéuticos, al diseño de nuevos medicamentos, al desarrollo de nuevos métodos diagnósticos y/o mejorar las técnicas que actualmente están disponibles para la detección rápida de TB fármaco-resistente. Este artículo presenta una revisión actualizada de los mecanismos y las bases moleculares de la resistencia de MTB a medicamentos anti-TB.

Due to the emergence of multi-drug resistant (MDR-MTB) and extensively drug-resistant (XDR-MTB) Mycobacterium tuberculosis (MTB) isolates, the failure rates of standard treatment regimens are high, thus becoming a major public health challenge worldwide. Resistance to anti-tuberculous (anti-TB) drugs is attributed mainly to specific mutations in target genes; however, a proportion of drug-resistant MTB isolates do not have mutations in these genes, which suggests the involvement of other mechanisms, such as the low permeability of the mycobacterial cell wall, enzymatic modification and/or efflux pumps.
Clinical drug resistance to anti-TB drugs occurs largely as a result of the selection of resistant mutants caused by poor patient adherence to treatment, inappropriate follow-ups and prescriptions, suboptimal doses of drugs and poor access to health services and treatment. Major advances in molecular biology tools and the availability of the complete genome sequences of MTB have contributed to improve understanding of the mechanisms of resistance to the main anti-TB drugs. Better knowledge of the drug-resistance of MTB will contribute to the identification of new therapeutic targets to design new drugs, develop new diagnostic tests and/or improve methods currently available for the rapid detection of drug-resistant TB. This article presents an updated review of the mechanisms and molecular basis of drug resistance in MTB.

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Cómo citar

APA

Gómez Tangarife, V., Gómez Restrepo, A. J., Robledo Restrepo, J. A. y Hernández Sarmiento, J. M. (2018). Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos. Revista de Salud Pública, 20(4), 491–497. https://doi.org/10.15446/rsap.v20n4.50575

ACM

[1]
Gómez Tangarife, V., Gómez Restrepo, A.J., Robledo Restrepo, J.A. y Hernández Sarmiento, J.M. 2018. Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos. Revista de Salud Pública. 20, 4 (jul. 2018), 491–497. DOI:https://doi.org/10.15446/rsap.v20n4.50575.

ACS

(1)
Gómez Tangarife, V.; Gómez Restrepo, A. J.; Robledo Restrepo, J. A.; Hernández Sarmiento, J. M. Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos. Rev. salud pública 2018, 20, 491-497.

ABNT

GÓMEZ TANGARIFE, V.; GÓMEZ RESTREPO, A. J.; ROBLEDO RESTREPO, J. A.; HERNÁNDEZ SARMIENTO, J. M. Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos. Revista de Salud Pública, [S. l.], v. 20, n. 4, p. 491–497, 2018. DOI: 10.15446/rsap.v20n4.50575. Disponível em: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/50575. Acesso em: 20 jul. 2024.

Chicago

Gómez Tangarife, Verónica, Alex Julián Gómez Restrepo, Jaime Alberto Robledo Restrepo, y José Mauricio Hernández Sarmiento. 2018. «Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos». Revista De Salud Pública 20 (4):491-97. https://doi.org/10.15446/rsap.v20n4.50575.

Harvard

Gómez Tangarife, V., Gómez Restrepo, A. J., Robledo Restrepo, J. A. y Hernández Sarmiento, J. M. (2018) «Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos», Revista de Salud Pública, 20(4), pp. 491–497. doi: 10.15446/rsap.v20n4.50575.

IEEE

[1]
V. Gómez Tangarife, A. J. Gómez Restrepo, J. A. Robledo Restrepo, y J. M. Hernández Sarmiento, «Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos», Rev. salud pública, vol. 20, n.º 4, pp. 491–497, jul. 2018.

MLA

Gómez Tangarife, V., A. J. Gómez Restrepo, J. A. Robledo Restrepo, y J. M. Hernández Sarmiento. «Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos». Revista de Salud Pública, vol. 20, n.º 4, julio de 2018, pp. 491-7, doi:10.15446/rsap.v20n4.50575.

Turabian

Gómez Tangarife, Verónica, Alex Julián Gómez Restrepo, Jaime Alberto Robledo Restrepo, y José Mauricio Hernández Sarmiento. «Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos». Revista de Salud Pública 20, no. 4 (julio 1, 2018): 491–497. Accedido julio 20, 2024. https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/50575.

Vancouver

1.
Gómez Tangarife V, Gómez Restrepo AJ, Robledo Restrepo JA, Hernández Sarmiento JM. Resistencia a Medicamentos en Mycobacterium tuberculosis: contribución de mecanismos constitutivos y adquiridos. Rev. salud pública [Internet]. 1 de julio de 2018 [citado 20 de julio de 2024];20(4):491-7. Disponible en: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/50575

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2. Analy Aispuro Pérez, Ulises Osuna-Martínez, Jose Angel Espinoza-Gallardo, Luis Alfredo Dorantes-Álvarez, Gerardo Kenny Inzunza-Leyva, Kimberly Estefania Dorantes-Bernal, Geovanna Nallely Quiñonez-Bastidas. (2024). Prevalence of Drug-Resistant Tuberculosis in HIV-Positive and Diabetic Patients in Sinaloa, Mexico: A Retrospective Cross-Sectional Study. Tropical Medicine and Infectious Disease, 9(4), p.89. https://doi.org/10.3390/tropicalmed9040089.

3. Marlen Astrid Rojas Suárez, Juan Carlos García Ubaque. (2021). Gestión de riesgo para la prevención primaria de tuberculosis en una entidad administradora de planes de beneficios en salud en Colombia. Revista de Salud Pública, 23(6), p.1. https://doi.org/10.15446/rsap.v23n6.95857.

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