Drugresistance of Mycobacterium tuberculosis from surgical material taken from patients with pulmonary tuberculosis

Abstract

At present, with the improvement of epidemic indicators for tuberculosis, the number of patients with drug-resistant forms of tuberculosis is increasing, which complicates and increases the duration of treatment of such patients. The aim of the work is to study drug resistance of mycobacterium tuberculosis (MBT) obtained from surgical material.

Methods. 74 patients with radical and di-agnostic operations on the chest organs were included into the study. All patients were examined by standard methods: microscopy, molecular genetic methods, culturing on so lid and liquid nutrient media of sputum, and, in case of bronchoscopy, BALF. The diagnosis of tuberculosis was confirmed morphologically in all patients by histological examination of the surgical material. When analyzing the results of DR MBT, it was found that among the newly diagnosed patients, more than half (59.3%) had multiple (44.6%; p<0.001) and extensive drug resistance (14.7%; p=0.003), while in 74.5% (n=35/47) before the operation MBT were not detected in sputum. The frequency of development of drug resistance to anti-tuberculosis drugs of the first and reserve lines, and the structure of drug resistance depending on the group of dispensary registration are presented. Comparative analysis of MBT LS isolated from sputum before operations and from the operating material was conducted. 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 patients who did not receive antibiotic therapy before surgery have MDR and XDR, which suggests a high regional primary drug resistance of Mycobacterium tuberculosis.