RESUMEN
SETTING: The true prevalence of multidrug-resistant tuberculosis (MDR-TB) in Ukraine is not known. Available data are a decade old and limited to only one province. OBJECTIVE: To determine the prevalence of MDR-TB among new and previously treated TB cases in Ukraine and explore the risk factors associated with drug resistance. METHODS: A total of 1550 sputum smear-positive pulmonary TB patients were recruited from 40 clusters throughout Ukraine. Sputum specimens were examined using culture, drug susceptibility testing and pncA gene sequencing. RESULTS: The proportion of MDR-TB among new and previously treated TB cases was respectively 24.1% (95%CI 20.7-27.6) and 58.1% (95%CI 52.1-64.1). More than one third (38.0%) of MDR-TB or rifampicin (RMP) resistant cases showed resistance to either a fluoroquinolone (FQ) or a second-line injectable agent or both. Resistance to pyrazinamide and FQs was low in patients with RMP-susceptible TB. Among new TB cases, the odds of MDR-TB were higher among patients who were younger, female and living in south-eastern provinces, as well as among human immunodeficiency virus-positive patients who belonged to a low socio-economic group. CONCLUSIONS: Our study showed that the burden of MDR-TB in Ukraine was much greater than previously assumed. Urgent actions are needed to prevent further spread of drug-resistant TB in Ukraine.
Asunto(s)
Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Adulto , Anciano , Antituberculosos/farmacología , Femenino , Infecciones por VIH , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/aislamiento & purificación , Prevalencia , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Esputo/microbiología , Encuestas y Cuestionarios , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Tuberculosis Resistente a Múltiples Medicamentos/prevención & control , Ucrania/epidemiología , Adulto JovenRESUMEN
P. aeruginosa wound infection was induced in white mice to test new preparations against P. aeruginosa. This model ensures the nearest approximation to the course of P. aeruginosa chronic infection, i.e. it reproduces the focus of inflammation and the prolonged course of the disease (the positive decision on application No. 4, 324, 555 of November 2, 1987, has been obtained). The essence of the method consists in obtaining the model of P. aeruginosa wound infection by a combined trauma of the skin (burn and incision): P. aeruginosa is introduced in a dose of 6 X 10(9)-8 X 10(9) microbial cells into the burn blister through the incision made 3 hours after the burn and then 20-24 hours later in a dose of 10(9)-2 X 10(9) microbial cells, introduced under the crust formed by that time.
Asunto(s)
Modelos Animales de Enfermedad , Infecciones por Pseudomonas/microbiología , Infección de Heridas/microbiología , Animales , Quemaduras/complicaciones , Quemaduras/microbiología , Enfermedad Crónica , Ratones , Infecciones por Pseudomonas/etiología , Pseudomonas aeruginosa/aislamiento & purificación , Pseudomonas aeruginosa/patogenicidad , Piel/lesiones , Factores de Tiempo , Infección de Heridas/etiologíaRESUMEN
Two new selective media were prepared for the isolation of P. aeruginosa cultures from clinical material: RChZh medium with ramrod inhibitor and Zh medium including a selective complex (hydrazine sulfate, gramurin, ethonium, N-cetylpyridine chloride). The media are characterized by marked selective characteristics, simple to use, contain no unavailable reagents, inexpensive, and easy to prepare.