CHEMOTHERAPY OF TUBERCULOSIS: PROBLEMS AND PERSPECTIVES

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Abstract

Challenges of tuberculosis chemotherapy under conditions of high drug resistant (DR) tuberculosis burden are discussed. Ultimate results of treatment by standard regimens of 1658 patients with new tuberculosis cases and relapses were analyzed. Favorable ultimate results were observed among both patients with new tuberculosis cases and relapses having drugs sensitivity. Efficacy of tuberculosis treatment by standard regimens of chemotherapy is decreasing as a result of DR amplification. Risk factors of unfavorable ultimate result among pulmonary tuberculosis patients are primary resistance to isoniazid (OR =2,1) and multiple drug resistance of M. tuberculosis (OR =8,0). Earlier onset of treatment and correct individual therapy with second line drugs as a result of rapid methods of DR tuberculosis diagnostics are those approaches which provide the best therapeutic effect among multiple drug resistant tuberculosis patients both in culture conversion (97,7%) and cavity closure rate (82,7%).

 

About the authors

I. A. Vasil’eva

Central Tuberculosis Research Institute of RAMS, Moscow, the Russian Federation

Author for correspondence.
Email: vasil39@list.ru
доктор медицинских наук, профессор, руководитель отдела фтизиатрии ФГБУ «Центральный научно-исследовательский институт туберкулеза» РАМН Адрес: 107564, Москва, Яузская аллея, д. 2 Тел./факс: (499) 748-30-26 Россия

A. G. Samoilova

Central Tuberculosis Research Institute of RAMS, Moscow, the Russian Federation

Email: a.samoilova.ctri@mail.ru
кандидат медицинских наук, старший научный сотрудник отдела фтизиатрии ФГБУ «Центральный научно-исследовательский институт туберкулеза» РАМН Адрес: 107564, Москва, Яузская аллея, д. 2 Тел.: (499) 785-90-52 Россия

A. E. Ergeshov

Central Tuberculosis Research Institute of RAMS, Moscow, the Russian Federation

Email: cniit@cniitramn.ru
доктор медицинских наук, профессор, заместитель директора по научной и лечебной работе ФГБУ «Центральный научно-исследовательский институт туберкулеза» РАМН Адрес: 107564, Москва, Яузская аллея, д. 2 Тел.: (499) 785-90-60 Россия

T. R. Bagdasaryan

Central Tuberculosis Research Institute of RAMS, Moscow, the Russian Federation

Email: norair04@mail.ru
кандидат медицинских наук, заведующая терапевтическим отделением ФГБУ «Центральный научно-исследовательский институт туберкулеза» РАМН Адрес: 107564, Москва, Яузская аллея, д. 2 Тел.: (499) 785-90-52 Россия

L. N. Chernousova

Central Tuberculosis Research Institute of RAMS, Moscow, the Russian Federation

Email: lchernousova@mail.ru
доктор биологических наук, профессор, руководитель отдела микробиологии ФГБУ «Центральный научно-исследовательский институт туберкулеза» РАМН Адрес: 107564, Москва, Яузская аллея, д. 2 Тел.: (499) 748-30-15 Россия

References

  1. World Health Organization. Global tuberculosis control: WHO report 2010. Geneva, 2010.
  2. Otraslevye pokazateli protivotuberkuleznoi raboty v 2008–2009 gg.: statisticheskie materialy. Tsentral'nyi nauchno-issledovatel'skii institut organizatsii i informatizatsii zdravookhraneniya Ministerstva zdravookhraneniya i sotsial'nogo razvitiya Rossiiskoi Federatsii [Sectoral indicators of TB control in 2008-2009: statistical materials. Central Research Institute for Public Health and the Ministry of Health and Social Development of the Russian Federation]. Moscow, 2011.
  3. Khomenko A.G. Tuberculosis yesterday, today and tomorrow. Probl. tub. = Problems of tuberculosis. 1997: 6; 9-11.
  4. Rudoi N.M. Lekarstvennaya ustoichivost' mikobakterii tuberkuleza [Drug resistance in Mycobacterium tuberculosis]. Moscow, 1969, 287 p.
  5. Rossman M.D., MacGregor R.R. Tuberculosis: clinical management and new challenges. N.Y., McGraw Hill Inc., 1995.
  6. Bastian I., Portals F. Tuberkulez s mnozhestvennoi lekarstvennoi ustoichivost'yu [Multi-drug-resistant tuberculosis]. Moscow, Meditsina i zhizn', 2003.
  7. Mitchinson D.A., Nunn A.J. Influence of initial drug resistance on the response to short-course chemotherapy of pulmonary tuberculosis. Am. Rev. Respir. Dis. 1986; 133: 423–430.
  8. World Health Organization. Guidelines for the programmatic management of drug-resistant tuberculosis. Emergency update 2008. Geneva, 2008.
  9. Otraslevye pokazateli protivotuberkuleznoi raboty v 2009–2010 gg.: statisticheskie materialy TsNIIOIZ [Sectoral indicators of TB control in 2009-2010: FPHI statistical materials]. Moscow, 2011. 60 p.
  10. Tuberkulez v Rossiiskoi Federatsii, 2010 g. Analiticheskii obzor statisticheskikh pokazatelei, ispol'zuemykh v Rossiiskoi Federatsii [Tuberculosis in the Russian Federation, 2010 Analytical review of statistical indicators used in the Russian Federation]. Moscow, 2011. 280 p.
  11. Grandjean L., Moore D. Tuberculosis in the developing world: recent advances in diagnosis with special consideration of extensively drug-resistant tuberculosis (XDR-TB). Curr. Opin. Infect. Dis. 2008; 21 (5): 454–461.
  12. Raja S., Ching J., Xi L., Hughes S.J., Chang R., Wong W., McMillan W., Gooding W.E., McCarty K.S., Chestney M., Luketich J.D., Godfrey T.E. Technology for automated, rapid, and quantitative PCR or reverse transcription-PCR clinical testing. Clin Chem. 2005; 51 (5): 882–890.
  13. Boeheme C.C., Nabeta P., Hillemann D. , Nicol M.P., Shenai S., Krapp F., Allen J., Tahirli R., Blakemore R., Rustomjee R., Milovic A., Jones M., O’Brein S.M., Persing D.H., Ruesch-Gerdes S., Gotuzzo E., Rodrigues C., Alland D., Perkins M. D. Rapid molecular detection of tuberculosis and rifampin resistance. N. Engl. J. Med. 2010; 363 (11): 1005–1015.
  14. Helb D., Jones M., Story E., Boehm. C., Wallace E., Ho K., Kop J., Owens M. R., Rodgers R., Banada P., Safi H., Blakemore R. Rapid detection of Mycobacterium tuberculosis and rifampin resistance by use of on-demand, near-patient technology. J. Clin. Microbiol. 2010; 48 (1): 229–237.
  15. Hillemann D., Rusch-Gerdes S., Richter E. Evaluation of the GenoType MTBDRplus assay for rifampin and isoniazid susceptibility testing of Mycobacterium tuberculosis strains and clinical specimens. J. Clin. Microbiol. 2007; 45 (8): 2635–2640.
  16. Hillemann D., Rusch-Gerdes S., Richter E. Feasibility of the GenoType MTBDRsl assay for fluoroquinolone, amikacin-capreomycin, and ethambutol resistance testing of Mycobacterium tuberculosis strains and clinical specimens. J. Clin. Microbiol. 2007; 47 (6): 1767–1772.
  17. Gryadunov D.A., Zimenkov D.V., Mikhailovich V.M., Nasedkina T.V., Dement'eva E.I.,Rubina A.Yu., Pan'kov S.V., Barskii V.E., Zasedatelev A.S. Hydrogel biochip technology and its application in medical practice. Meditsinskii alfavit = Medical alphabet. 2009; 3: 10–14.
  18. Vasil'eva I.A., Chernousova L.N., Zasedatelev A.S., Sobolev A.Yu., Mikhailovich V.M. The clinical significance of microarray technology definition of drug resistance in Mycobacterium tuberculosis. Probl. tub. = Problems of tuberculosis. 2002; 6: 21–24.
  19. Isakova Zh.T. The practical significance of the test system "TB-Biochip MDR» in rapid identification of M. tuberculosis strains of multidrug-resistant. Klin. lab. diagnostika = Clinical and laboratory diagnostics. 2009; 2: 50–51.
  20. Kuz'min A.V., Vasil'eva I.A., Chernousova L.N. The effectiveness of chemotherapy destructive pulmonary tuberculosis based on rapid detection of drug susceptibility to isoniazid and rifampicin test system "TB-Biochip". Probl. tub. i bol. legkikh = Problems of tuberculosis and lung diseases. 2006; 8: 17–23.
  21. Vasil'eva I.A., Samoilova A.G., Bagdasaryan T.R., Zimina V.N., Chernousova L.N. Dependence of results of treatment of patients with pulmonary tuberculosis from the spectrum of drug resistance. Probl. tub. i bol. legkikh = Problems of tuberculosis and lung diseases. 2011; 10: 28.
  22. Erokhin V.V. Romanova L.K. Kletochnaya biologiya legkikh v norme i pri patologii [Cell biology of lung in health and disease]. Moscow, Meditsina, 2000. 456 p.

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