International Medical Journal, Vol. 24., Iss. 2, 2018, P. 79−83.
PREDICTION OF CHEMORESISTANT PULMONARY TUBERCULOSIS SEVERITY DEPENDING ON MYCOBACTERIUM TUBERCULOSIS GENOTYPES
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Today, the problem of Mycobacterium Tuberculosis (MTB) resistance to antimycobacterial drugs (AMBD) becomes increasingly important, resulting in the reduction in effectiveness of patients treatment and the prevalence of chemoresistant tuberculosis. To develop the methods for predicting the clinical course of the pulmonary chemoresistant tuberculosis depending on the MTB genotypes during the intensive phase of treatment using the VNTR−genotyping method, the patients with primary resistance of MBT were examined. The dynamics of the clinical course was assessed by the dynamics of intoxication syndrome, the closure of destruction of the lung parenchyma and termination of mycobacterial excretion. The obtained results showed the dependence of the clinical laboratory indicators dynamics on the MTB genotype in patients with chemoresistant pulmonary tuberculosis during the intensive phase of treatment. Among the patients with Beijing genotype, the conversion of sputum culture was 2.5 times less than in patients with the other genotypes. They were recorded three times less cases of healing cavities of destruction of the pulmonary parenchyma. In patients with Beijing genotype, intoxication syndrome was observed 3 times more often than in patients with the other genotypes. Thus, determination of the genotypes of Mycobacterium tuberculosis at the stage of diagnosis and during the intensive phase of treatment is of great importance for predicting the course and effectiveness of treatment of chemoresistant pulmonary tuberculosis
Key words: Mycobacterium tuberculosis, chemoresistant pulmonary tuberculosis, VNTR−genotyping, intensive phase of treatment, prediction.