Determination of drug resistance of Mycobacterium tuberculosis in the operating material

Abstract

Currently, with the improvement of epidemic indicators for tuberculosis, the number of patients with drug-resistant forms of tuberculosis is increasing, which complicates and prolongs the treatment of such patients. The aim of the work is to study the drug resistance of Mycobacterium tuberculosis obtained from surgical material. Materials and methods: the study included 74 patients with medical and diagnostic operations on the chest organs. All patients were examined by standard methods: sputum and BAL microscopy with bronchoscopy (during the procedure), molecular genetic methods, culture on dense and liquid nutrient media. The diagnosis of tuberculosis was confirmed morphologically in all patients by histological examination of surgical material. When analyzing the results of drug resistance, it was found that among the newly identified patients, more than half (59.3%) had multiple (44.6%) p<0.005 and extensively drug resistance (14.7%) p= 0.003. At the same time, 74.5% (n= 35/47) of patients had no MBT in sputum before surgery. The frequency of development of drug resistance to first-and reserve-line antibacterial drugs, the structure of drug resistance depending on the group of dispensary registration is presented. A comparative analysis of drug sensitivity testing of MBT isolated from sputum before surgery and from surgical material was performed. The results of the study showed a high percentage of MBT drug resistance obtained in the operating material in patients with negative MBT tests. More than half of the patients who did not receive antibacterial therapy before surgery have multi drug resistance and extensively drug resistance, which suggests a high regional primary drug resistance of Mycobacterium tuberculosis.