RESUMO
For the early diagnosis of multidrug resistant tuberculosis, 67 sputum samples obtained from primary patients with different clinical forms of pulmonary tuberculosis were examined by the molecular genetic test using the TB-Biochip test system. Having a high sensitivity and specificity, the molecular genetic test for determining the drug sensitivity of Mycobacterium tuberculosis substantially accelerates its diagnosis (2-3 days) before the real-time mode of a patient's admission to the clinic. The method allows identification of mutations in the rpoB (resistance to R), katG, inhG, and ahpC (resistance to H) genes, which permits timely correction of performed specific treatment.
Assuntos
Análise Mutacional de DNA/métodos , DNA Bacteriano/genética , Mycobacterium tuberculosis/genética , Escarro/microbiologia , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Adolescente , Adulto , Idoso , Criança , DNA Bacteriano/análise , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tuberculose Resistente a Múltiplos Medicamentos/genética , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Adulto JovemRESUMO
The prevalence of drug-resistant tuberculosis and especially multidrug-resistant tuberculosis arouses special alarm and these forms of tuberculosis are widespread in the countries of the former Soviet countries. To study this problem in the republic, the authors analyze the records obtained by the Research Institute of Pulmonary Diseases from all TB facilities in 2000-2007 and the data of a test for drug sensitivity in Mycobacterium tuberculosis in the cohort of new cases of tuberculosis in 2006-2007. Sixty-nine (100%) TB service facilities have submitted the records. A total of 33 019 new cases of tuberculosis in 2000-2007 have been analyzed. The results of a test for drug resistance in MBT in 503 new cases have been included into the study and analyzed. The analysis suggests that there is a certain share of conventionality and inadequate validity of the data obtained from consolidated areas. In each of the 11 zones, there are areas with great variations in morbidity and morbidity rates. This shows it necessary to make a target monitoring of the epidemic situation in the regions and to strive not to consolidate for ease the neighboring administrative areas for ease during an analysis; it is expedient to divide the areas into adequately minimum ones. This point monitoring requires individualized electronic systems that provide the input of personified information on each new case of tuberculosis. It is recommended that the individualized electronic system for monitoring the basic epidemiological parameters, including the prevalence of drug-resistant tuberculosis, to be introduced, by taking into account the demographic, social, and geographical features of administrative areas.