Abstract
There was studied the profile of drug resistance to the main (I line) and reserve (II line) antituberculosis drugs in patients with MDR and XDR tuberculosis, depending of the case of the disease. According to the randomized retrospective research 200 patients with MDR and XDR tuberculosis, who received treatment in the clinic of hospital Municipal institution «Dnipropetrovsk rigional clinical association «Phthisiology» Dnipropetrovsk regional Council» during the period 2010 – 2012 were involved. Data about patients contained the data on a case of the disease and the results of the test of drug sensitivity to MBT. XDR – TB was revealed in 7.5% of patients with MDR tuberculosis. In patients with MDR tuberculosis as compared with patients with XDR tuberculosis «new cases» were diagnosed in 19.5% against 18.5% (p <0.05). In patients with MDR tuberculosis and with XDR tuberculosis resistance to the antituberculosis drug more commonly developed to S - 88.5%, E - 55% and Z - 24%. The presence of MDR-TB and XDR-TB prevails in patients, who underwent previous courses of treatment with anti-TB drugs in case history as compared with patients with «new cases» of treatment. The development of resistance to anti-TB drugs depends on the availability of these drugs in the previous treatment regimens.
Highlights
Ɏɨɪɦɭɜɚɧɧɹ ɪɟɡɢɫɬɟɧɬɧɨɫɬɿ ɦɿɤɨɛɚɤɬɟɪɿʀ ɬɭɛɟɪɤɭɥɶɨɡɭ (ɆȻɌ) ɞɨ ɫɬɚɧɞɚɪɬɧɨʀ ɩɪɨɬɢɬɭɛɟɪɤɭɥɶɨɡɧɨʀ ɬɟɪɚɩɿʀ ɽ ɨɞɧɿɽɸ ɡ ɜɿɞɦɿɧɧɢɯ ɪɢɫ ɫɭɱɚɫɧɨɝɨ ɬɭɛɟɪɤɭɥɶɨɡɭ. ȼ ɍɤɪɚʀɧɿ ɱɚɫɬɨɬɚ ɩɟɪɜɢɧɧɨʀ ɪɟɡɢɫɬɟɧɬɧɨɫɬɿ ɫɬɚɧɨɜɢɬɶ ɜɿɞ 7 ɞɨ 20% ɯɜɨɪɢɯ ɭ ɪɿɡɧɢɯ ɪɟɝɿɨɧɚɯ ɤɪɚʀɧɢ, ɚ ɜɬɨɪɢɧɧɚ ɪɟɡɢɫɬɟɧɬɧɿɫɬɶ ɫɹɝɚɽ ɛɥɢɡɶɤɨ 75% [7]
TB with extremely drug resistant depending on the case of the disease
Freivald V.A. There was studied the profile of drug resistance
Summary
Ɏɨɪɦɭɜɚɧɧɹ ɪɟɡɢɫɬɟɧɬɧɨɫɬɿ ɦɿɤɨɛɚɤɬɟɪɿʀ ɬɭɛɟɪɤɭɥɶɨɡɭ (ɆȻɌ) ɞɨ ɫɬɚɧɞɚɪɬɧɨʀ ɩɪɨɬɢɬɭɛɟɪɤɭɥɶɨɡɧɨʀ ɬɟɪɚɩɿʀ ɽ ɨɞɧɿɽɸ ɡ ɜɿɞɦɿɧɧɢɯ ɪɢɫ ɫɭɱɚɫɧɨɝɨ ɬɭɛɟɪɤɭɥɶɨɡɭ. ȼ ɍɤɪɚʀɧɿ ɱɚɫɬɨɬɚ ɩɟɪɜɢɧɧɨʀ ɪɟɡɢɫɬɟɧɬɧɨɫɬɿ ɫɬɚɧɨɜɢɬɶ ɜɿɞ 7 ɞɨ 20% ɯɜɨɪɢɯ ɭ ɪɿɡɧɢɯ ɪɟɝɿɨɧɚɯ ɤɪɚʀɧɢ, ɚ ɜɬɨɪɢɧɧɚ ɪɟɡɢɫɬɟɧɬɧɿɫɬɶ ɫɹɝɚɽ ɛɥɢɡɶɤɨ 75% [7]. Ɋɟɪɟɞ ɯɜɨɪɢɯ ɧɚ ɬɭɛɟɪɤɭɥɶɨɡ, ɹɤɿ ɦɚɥɢ ɜ ɚɧɚɦɧɟɡɿ ɩɨɩɟɪɟɞɧɿ ɤɭɪɫɢ, ɥɿɤɭɜɚɧɧɹ ɩɪɨɬɢɬɭɛɟɪɤɭɥɶɨɡɧɢɦɢ ɩɪɟɩɚɪɚɬɚɦɢ ɆɊɌȻ ɫɬɚɧɨɜɢɬɶ ɜɿɞ 72 ɞɨ 82% [4,5]. Ɇɟɬɚ ɞɨɫɥɿɞɠɟɧɧɹ – ɜɫɬɚɧɨɜɢɬɢ ɩɪɨɮɿɥɶ ɦɟɞɢɤɚɦɟɧɬɨɡɧɨʀ ɪɟɡɢɫɬɟɧɬɧɨɫɬɿ ɆȻɌ ɞɨ ɨɫɧɨɜɧɢɯ (I ɪɹɞɭ) ɬɚ ɪɟɡɟɪɜɧɢɯ (II ɪɹɞɭ) ɩɪɨɬɢɬɭɛɟɪɤɭɥɶɨɡɧɢɯ ɩɪɟɩɚɪɚɬɿɜ ɭ ɯɜɨɪɢɯ ɧɚ ɆɊɌȻ ɬɚ ɊɊɌȻ, ɡɚɥɟɠɧɨ ɜɿɞ ɜɢɩɚɞɤɭ ɡɚɯɜɨɪɸɜɚɧɧɹ. ɆȺɌȿɊȱȺɅɂ ɌȺ ɆȿɌɈȾɂ ȾɈɋɅȱȾɀȿɇɖ ɉɪɨɮɿɥɶ ɦɟɞɢɤɚɦɟɧɬɨɡɧɨʀ ɪɟɡɢɫɬɟɧɬɧɨɫɬɿ ɆȻɌ ɞɨ ɩɪɨɬɢɬɭɛɟɪɤɭɥɶɨɡɧɢɯ ɩɪɟɩɚɪɚɬɿɜ (ɉɌɉ) I ɬɚ II ɪɹɞɭ ɭ ɯɜɨɪɢɯ ɧɚ ɆɊɌȻ ɬɚ ɊɊɌȻ ɡɚɥɟɠɧɨ ɜɿɞ ɜɢɩɚɞɤɭ ɡɚɯɜɨɪɸɜɚɧɧɹ ɜɢɜɱɚɜɫɹ ɭ ɪɚɧɞɨɦɿɡɨɜɚɧɨɦɭ ɪɟɬɪɨɫɩɟɤɬɢɜɧɨɦɭ ɞɨɫɥɿɞɠɟɧɧɿ.
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