The New Definition and Epidemiology of Extensive Drug Resistant Tuberculosis in 2020

Abstract

The objective: to study the epidemiology and incidence of XDR tuberculosis given the updated definition.Subjects and Methods. The results of replies to the specialized inquiry by the Russian Ministry of Health about results of microbiological diagnostics and MTB drug susceptibility tests were studied. To assess the incidence of pre-extensive drug resistance, general population data were used, and for extensive drug resistance, data from 8 regions of Russia were used.Results. The incidence of pre-extensive drug resistance was 39,1% [95% CI 38,4–39,8] among tuberculosis cases with rifampicin resistance including 26,8% in new cases [95% CI 25,8–27,9]; among all cases receiving treatment for whom DST results were available, it made 20,2%, including primary resistance in 9,7%. The incidence of XDR among cases with pre-extensive drug resistance was 3,0% [95% uncertainty interval 1,8–5,3] for all cases, including primary resistance in 1,6% [95% uncertainty interval 0,2–5,7].Conclusion. Despite the low incidence of pre-extensive drug resistance, it is expected to increase primarily due to growing resistance to fluoroquinolones. Resistance to innovative drugs, in particular XDR, is not yet a serious problem.