Dynamics of primary multidrug drug resistance in Novokuznetsk over 10 years period

Abstract

The aim of the study was to estimate the dynamics of primary drug resistance in a big industrial city of Western Siberia with high burden of TB (incidence is about 100/100 000) and HIV (prevalence is 1320/100 0000) with proportion of HIV-positive patients among new TB cases about 33% (2014). Materials and methods: the results of drug susceptibility tests (DST) to I line anti-TB drugs among new TB cases of civil sector were studied over 10 years period (2004-2014). In 2004 (593 new TB cases, includig 65 cases of HIV/TB) DST to first line drugs was conducted in 304 (82,8%) of 367 culture positive cases; in 2014 (542 new cases, including 183 cases of TB/HIV) DST to first line drugs was conducted in 210 (75,3%) of 279 culture positive new cases. DST were performed on Lowenstein-Jensen media using absolute concentration method. Results: resitance to at least one I line drug was found in 52% (n=159) in 2004, and 56,9% (n=118) in 2014. Any resistance with H+/-SE was found in 42,5% (n=129) in 2004, and decreased to 15,71% (n=33) in 2014. The level of primary MDR increased from 18,8% (n=57) in 2004 to 32,4% (n=64) in 2014 without a single case of primary XDR TB. Conclusion: primary MDR was detected in every third new TB patient in Novokuznetsk in 2014. Steady increase of primary MDR nearly 2 times (from 17,8 to 32,4%) for a ten years period signals the urgent need to revise the TB care concept.