{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:08:15Z","timestamp":1791976095656,"version":"4.4.0"},"reference-count":75,"publisher":"Universidad Nacional de Colombia","issue":"4","license":[{"start":{"date-parts":[[2018,7,1]],"date-time":"2018-07-01T00:00:00Z","timestamp":1530403200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. salud p\u00fablica"],"abstract":"<jats:p>En presencia de aislamientos de Mycobacterium tuberculosis (MTB) multif\u00e1rmaco-resistentes (MTB-MDR) y con resistencia extendida (MTB-XDR) las tasas de fracaso de los esquemas estandarizados de tratamiento son altas, constituy\u00e9ndose en un verdadero problema de salud p\u00fablica a nivel mundial. La f\u00e1rmaco-resistencia en MTB se debe principalmente a mutaciones en genes blanco; sin embargo, una proporci\u00f3n de aislamientos f\u00e1rmaco-resistentes no presentan mutaciones en dichos genes, sugiriendo la participaci\u00f3n de otros mecanismos, tales como permeabilidad reducida de la pared celular, modificaci\u00f3n enzim\u00e1tica y\/o bombas de eflujo. La resistencia cl\u00ednica a los medicamentos anti-tuberculosos (anti-TB) ocurre en gran parte como resultado de la selecci\u00f3n de mutantes resistentes durante la falta de adherencia del paciente al tratamiento, inapropiados seguimientos y prescripci\u00f3n m\u00e9dica, dosis sub\u00f3ptimas de f\u00e1rmacos y dificultad de acceso a los servicios de salud y al tratamiento. Los Avances de la biolog\u00eda molecular y la secuenciaci\u00f3n 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 f\u00e1rmaco-resistencia en MTB contribuir\u00e1 a la identificaci\u00f3n de nuevos blancos terap\u00e9uticos, al dise\u00f1o de nuevos medicamentos, al desarrollo de nuevos m\u00e9todos diagn\u00f3sticos y\/o mejorar las t\u00e9cnicas que actualmente est\u00e1n disponibles para la detecci\u00f3n r\u00e1pida de TB f\u00e1rmaco-resistente. Este art\u00edculo presenta una revisi\u00f3n actualizada de los mecanismos y las bases moleculares de la resistencia de MTB a medicamentos anti-TB.<\/jats:p>","DOI":"10.15446\/rsap.v20n4.50575","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T15:22:56Z","timestamp":1545146576000},"page":"491-497","source":"Crossref","is-referenced-by-count":13,"title":["Resistencia a Medicamentos en Mycobacterium tuberculosis: contribuci\u00f3n de mecanismos constitutivos y adquiridos"],"prefix":"10.15446","volume":"20","author":[{"given":"Ver\u00f3nica","family":"G\u00f3mez Tangarife","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Juli\u00e1n","family":"G\u00f3mez Restrepo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime Alberto","family":"Robledo Restrepo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mauricio","family":"Hern\u00e1ndez Sarmiento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6146","published-online":{"date-parts":[[2018,7,1]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Chiang C-Y, Centis R, Migliori GB. 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