Pathophysiology
doi: 10.25005/2074-0581-2018-20-2-3-293-298
COMPARATIVE ANALYSIS OF MTB STRAINS WITH DIFFERENT TYPES OF DRUG RESISTANCE IN PULMONARY TUBERCULOSIS IN THE KYRGYZ REPUBLIC

A.A. Toktogonova1, A.A. Asambaev2

1Therapeutic Department, National Center for Phthisiology, Bishkek, Kyrgyz Republic
2Medical Center of the I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic

Objective: A comparative analysis of the frequencies of MTB strains with different types of drug resistance (DR) among different contingents of pulmonary tuberculosis in the Kyrgyz Republic for 2 years.

Methods: The results of tests for drug sensitivity (TDS) of the TB agent have been studied according to the data of the National Reference Laboratory, bacteriological laboratories of Bishkek and Osh cities that conducted TDS for the regions of the Kyrgyz Republic for 2016-2017.

Results: Among TB patients registered in 2017 in compare with 2016 year, statistically significant less frequently registered case (р<0,001, c², OR=1.237, 95% CI 1.13-1.63 vs. 1211 cases in 2016 year). MTB complexes using the Xpert-MTB/RIF method were identified in 2017 more (706/11.7% vs. 574/9.0%, р<0,001, c², OR=1.341, 95% CI 1.19-1.51), but the resistance of MTB to rifampicin was diagnosed 1.8 times less (299/52.1% versus 270/38.2%, р<0,001, c², OR=1.756, 95% CI 1.40-2.19). It was found that in 2017, sensitive strains were registered less often (1012/38.7% versus 1138/43.1%, p=0.002, c², OR=1.199, 95% CI 1.07-1.34) and more often strains of TB with XDR (127/4.8% versus 72/2.7%, р<0,001, c², OR=1.821, 95% CI 1.36-2.44) than in 2016. Reduction of strains with preserved sensitivity of MBT is observed due to their decrease among new ones (р<0,001, c², OR=1,183, 95% CI 1.04-1.35) and previously treated cases of TB (p=0.048, c², OR=1.439, 95% CI 1.00-2.06). The increase in strains of TB with XDR is 2.7 times higher among new cases (21/1.2% vs 8/0.4%, p=0.020, c², with Yates correction, OR=2.745, 95% CI 1.21-6.21), and among previously treated TB 1.5 times (p=0.028, c², OR=1.519, 95% CI 1.04-2.21).

Conclusion: The results of the conducted studies indicate that the proportion of sensitive strains of TB tendency to decrease. The situation of MDR-TB in the country is unfavourable and has not changed in two years, moreover, in 2017 there was a 1.8-fold increase in strains of TB with XDR (p<0,001), especially 2.7 times in new cases (p=0.020) than in 2016.

Keywords: Tuberculosis, drug sensitivity tests, MTB strains, resistance, MDR-TB, XDR-TB.

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Authors' information:

Toktogonova Atyrkul Akmatbekovna,
Candidate of Medical Sciences, Leading Researcher of the Therapeutic Department, National Center for Phthisiology

Asambaev Abdykadyr Asambaevich,
Candidate of Medical Sciences, Associate Professor, Phthisiatrician of the Medical Center, I.K. Akhunbaev Kyrgyz State Medical Academy

Conflicts of interest: No conflict

Address for correspondence:

Toktogonova Atyrkul Akmatbekovna

Candidate of Medical Sciences, Leading Researcher of the Therapeutic Department, National Center for Phthisiology

720020, Kyrgyz Republic, Bishkek, Akhunbaev str., 90a

Tel.: (+996) 771 110117

E-mail: atyrkul7@gmail.com

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