[Prevalence of primary drug resistance in M. tuberculosis in four administrative areas of the North-Western Federal District of the Russian Federation].

The paper describes the results of radiometric BACTEC assay of drug susceptibility of Mycobacterium tuberculosis strains, isolated from 81 new cases of tuberculosis, to first- and second-line antituberculosis drugs in four administrative areas of the North-Western Federal District of the Russian Federation. The results of determination of drug susceptibility to the antituberculosis drugs by the absolute concentration method and the BACTEC method are also compared. Primary drug resistance has been revealed in 58.0%; multidrug resistance in 34.6%. Comparison of the results of determination of drug susceptibility by the methods revealed no significant discrepancy between both methods; however, the procedure for drug susceptibility to some drugs requires improvement.

[Analysis of fatal cases of tuberculosis in the Arkhangelsk region in 2004].

Analysis of tuberculosis mortality in the civil sector of the Arkhangelsk Region in 2004 revealed that 55.4% of all death cases had been notified in patients with tuberculosis caused by multidrug-resistant Mycobacterium tuberculosis (MBT). In the above group of patients, 101 (85.6%) patients had not received chemotherapy with drug MBT resistance being kept in mind: tuberculosis autopsy was established in 15 patients with multidrug-resistance MBT at autopsy; in 5 patients MBT resistance to 7 and 8 antituberculosis agents had ruled out the use of etiotropic therapy; 81 patients had not received adequate treatment due to the shortage and spectrum of second-line antituberculosis drugs. The second cause of death from tuberculosis was the acutely progressive, disseminated forms of the disease, even, during treatment, leading to a fatal outcome, which were detectable in patients with a new case of tuberculosis (33.8% of all deaths) and its recurrence (5.6%).

[Impact of drug resistance of the causative agent on the outcomes of treatment for pulmonary tuberculosis in the Arkhangelsk Region].

The present study was undertaken to assess the results of treatment in patients with pulmonary tuberculosis in the Arkhangelsk Region in 1999 and to analyze the results of treatment in relation to the infection with Mycobacterium tuberculosis with different profiles of sensitivity to antituberculous drugs. The outcomes of treatment were assessed in relation to the infection with Mycobacterium tuberculosis with different profiles of sensitivity to antituberculous drugs in 76 patients to whom the BACTEC test was applied. Beneficial effects of therapy were recorded in 150 (63.9%) of the 235 new cases. In 29 (12.3%) patients, it ended in death, ineffective treatment was recorded in 20 (8.5%) first detected patients; 29 (12.3%) new cases discontinued treatment; the result of therapy was unknown in 7 (3.0%). There was a low efficiency of chemotherapy (26.2%), its inefficiency in 24 (39.4%) patients; treatment was discontinued in 18 (29.5%) cases and its outcome was unknown in 1 (1.6%) patient. Resistance to one antituberculous agent timely used in the effective chemotherapy regimen did not affect the outcome of treatment. The spread of drug resistance in pulmonary tuberculosis in the Arkhagelsk Region directly affects the outcome of the disease.

[Spread of multidrug resistance of Mycobacterium and its impact on the efficiency of treatment in patients with tuberculosis in the penitentiaries of the Arkhangelsk Region].

The paper deals with drug resistance of Mycobacterium tuberculosis in the prisons of the Arkhangelsk Region. The present study was undertaken to examine the spread of multidrug resistance of Mycobacterium tuberculosis and its impact on the outcomes of treatment of new cases of tuberculosis in the penitentiaries of the Arkhangelsk Region.

Impact of drug-resistant Mycobacterium tuberculosis on treatment outcome of culture-positive cases of tuberculosis in the Archangel oblast, Russia, in 1999.

The objective of this study was to evaluate the outcome of treatment of culture-positive cases of tuberculosis registered in Archangel, Russia, in 1999, and to analyse the influence of Mycobacterium tuberculosis drug resistance on treatment outcome. The outcome of tuberculosis treatment was evaluated for 235 new and 61 previously treated culture-positive cases diagnosed in 1999. Of the 235 new cases, there were 150 (63.8%) cases of treatment completion, 20 (8.5%) cases of treatment failure, 29 (12.3%) cases of death during treatment, and 29 (12.3%) cases in which the patient failed to pick up medications for at least 2 consecutive months. The outcome in 7 (3%) cases was unknown, as the patients were transferred outside the oblast region. Among the 61 previously treated cases, the rate of treatment completion was low (26.2%), and rates of treatment failure (23%) and failure to pick up medications for at least 2 consecutive months (29.5%) were high. The relation between the susceptibility pattern of the infecting strain as determined by the Bactec method and tuberculosis treatment outcome was analysed for 76 patients. The majority (69%) of patients infected with drug-susceptible strains was cured. A large proportion (58.8%) of patients infected with Mycobacterium tuberculosis resistant to more than two drugs did not respond to treatment, i.e. the treatment failed or the patients died. The high rates of death (16.7%) and failure (66.7%) among patients infected with multidrug-resistant strains illustrate the negative impact of multidrug resistance on the outcome of tuberculosis treatment. Pan-resistance was significantly associated with treatment failure (P<0.001). The spread of resistant Mycobacterium tuberculosis has a serious negative impact on the outcome of tuberculosis treatment in Archangel, Russia.