Abstract
The use of molecular genetic tests as a part of tuberculosis patients examination made it possible to reduce the time for TB diagnosis and determination of drug resistance (DR) of M. tuberculosis (MTB) in Arkhangelsk Region. Early detection of multiple drug resistant tuberculosis (MDR TB) made it possible to prescribe the adequate chemotherapy regimen promptly and thus to improve treatment outcomes.The objective of the study: to evaluate the results of treatment of MDR TB patients in whom MDR TB was diagnosed by molecular genetic tests. It was assumed that the introduction of molecular genetic tests would result in improved treatment outcomes in MDR TB patients [(the research project of the International Union Against Tuberculosis and Lung Diseases and Tuberculosis Control Program of Arkhangelsk Region of the PROVE-IT LPA (Policy Relevant Outcomes from Validating Evidence on Impact of Line Probe Assays)].Subjects: 295 MDR TB patients detected in Arkhangelsk Region were enrolled in the study. MDR TB was detected by molecular genetic tests in the main group (132 patients) and by culture in the control group (163 patients). Patients from both groups received the standard chemotherapy regimen. Chemotherapy outcomes were compared in both groups.Results. Treatment outcomes were better in the group (MGT group) where molecular genetic tests were used for drug susceptibility testing (p = 0.003) versus the comparison group where the culture was used. Effective treatment was documented more frequently (65.2%) in the MGT group versus the comparison group (44.8%). All-cause mortality was lower in the MGT group (7.6%) than in the comparison group (15.9%). There were no statistically significant differences between the groups in the time when sputum conversion (by smear and culture) was achieved.
Highlights
The use of molecular genetic tests as a part of tuberculosis patients examination made it possible to reduce the time for TB diagnosis and determination of drug resistance (DR) of M. tuberculosis (M TB) in Arkhangelsk Region
Treatment outcomes were better in the group (M GT group) where molecular genetic tests were used for drug susceptibility testing (p = 0.003) versus the comparison group where the culture was used
Группу сравнения (ГС) составили 163 больных, у которых М лекарственной устойчивости (ЛУ) -ТБ выявлен с использованием культуральных методов, которые применялись в Архангельской области до 2009 г. [Bact/Alert или метод абсолютных концентраций (МАК) на среде Левенштейна - Йенсена (ЛЙ)]
Summary
Treatment outcomes were better in the group (M GT group) where molecular genetic tests were used for drug susceptibility testing (p = 0.003) versus the comparison group where the culture was used. В мире зарегистрировано 558 000 случаев ТБ с лекарственной устойчивостью (ЛУ) к рифампицину, среди которых 82% М ЛУ -ТБ [14]. Результаты мировых исследований, а также длительного мони торинга Л У M. tuberculosis (М Б Т ) свидетельствуют, что М ЛУ -ТБ встречается в 3,9% новых случаев и в 21% - c повторным возникновением заболевания [1]. В Архангельской области регистрируются одни из самых высоких в мире показателей МЛУ среди но вых случаев ТБ [17]. П ри менение МГМ позволило сократить время опре деления лекарственной чувствительности МБТ и обнаружения случаев М ЛУ -ТБ [4]. Цель исследования: оценка результатов лечения пациентов с МЛУ-ТБ, которым ЛУ МБТ опреде лена с помощью МГМ
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
