The Effectiveness of Treating Tuberculosis with Multiple and Pre-extensively Drug Resistance in Adolescents Depending on the Drug Susceptibility Testing Methods
https://doi.org/10.58838/2075-1230-2025-103-3-18-23
Abstract
The objective: to evaluate effectiveness of treating respiratory tuberculosis with multiple and pre-extensively drug resistance in adolescents depending on the drug susceptibility testing methods.
Subjects and Methods. In Group 1 consisting of new patients (16 adolescents), the pathogen was identified in the institute’s laboratory (Amplitub-MLU-RV, Amplitub-FQ-RV, BACTEC MGIT 960; DST for the full spectrum of anti-tuberculosis drugs). In Group 2 consisting of 35 adolescents admitted for repeated treatment (comparison group), the pathogen was identified at the place of residence (GeneXpert MTB/RIF), by culture on solid nutrient media.
Results. In all 16 (100%) patients of Group 1, chemotherapy (CT) was prescribed taking into account the full DR spectrum according to individual regimens, the achieved outcome was assessed as “effective treatment”. In 12/35 (34.3%) patients of Group 2 with a positive sputum test, chemotherapy was prescribed with no consideration of the full DR spectrum, the outcome was “treatment failure”. A statistical relationship was established between the risk factor “chemotherapy with no consideration of the full DR spectrum” and the outcome “treatment failure” (χ²=7.174; p=0.008). The presented results prove the importance of information on the full DR spectrum in adolescents for the prescription of chemotherapy according to individual regimens.
About the Authors
L. V. Panova
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Ludmila V. Panova, Doctor of Medical Sciences, Leading Researcher of Children and Adolescents Department
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-30-23
E. A. Krushinskaya
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Ekaterina A. Krushinskaya, Junior Researcher of Children and Adolescents Department
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-30-23
T. G. Smirnova
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Tatyana G. Smirnova, Candidate of Medical Sciences, Head of Microbiology Department
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-30-23
E. S. Ovsyankina
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Elena S. Ovsyankina, Doctor of Medical Sciences, Professor, Honored Doctor of Russia, Head of Children and Adolescents Department
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-30-23
E. E. Larionova
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Elena E. Larionova, Candidate of Medical Sciences, Head of Microbiology Laboratory
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-30-23
References
1. Klinicheskie rekomendatsii Tuberkulez u detey. [Clinical guidelines on tuberculosis in children]. Rossiyskoe Obschestvo Ftiziatrov Publ., 2022, 111 p. Available: http://disuria.ru/_ld/11/1194_kr22a15a19MZk.pdf Accessed September 27, 2024
2. Panova L.V., Ovsyankina E.S., Averbakh M.M., Poluektova F.A., Piskunova O.A. Informative value of rapid microbiological diagnostic tests and experience of studying a procalcitonin assay in the evaluation of the activity of a mycobacterial population in children and adolescent with destructive pulmonary tuberculosis. Tuberculosis and Lung Diseases, 2015, no. 1, pp. 29-35. (In Russ.) https://doi.org/10.21292/2075-1230-2015-0-1-29-34
3. Ergeshov A.E., Chernousova L.N., Andreevskaya S.N. New technologies for the diagnosis of drug-resistant tuberculosis. Vestnik RAMN, 2019, vol. 74, no. 6, pp. 413-422. (In Russ.) https://doi.org/10.15690/vramn1163
4. Drain P.K., Gardiner J., Hannah H. et al. Guidance for studies evaluating the accuracy of biomarker-based nonsputum tests to diagnose tuberculosis. J. Infect. Dis., 2019, vol. 220, suppl. 3, pp. 108-115. https://doi.org/10.1093/infdis/jiz356
5. Olbrich L., Nliwasa M., Sabi I., Ntinginya N.E., Khosa C., Banze D. et al. RaPaed-AIDA-TB Consortium. Rapid and accurate diagnosis of pediatric tuberculosis disease: a diagnostic accuracy study for pediatric tuberculosis. Pediatr. Infect. Dis. J., 2023, vol. 42, no. 5, pp. 353-360. https://doi.org/10.1097/INF.0000000000003853
6. Penn-Nicholson A., Gomathi S.N., Ugarte-Gil C., Meaza A., Lavu E., Patel P. et al. Truenat Trial Consortium; Members of the Truenat Trial Consortium. A prospective multicentre diagnostic accuracy study for the Truenat tuberculosis assays. Eur. Respir. J., 2021, vol. 58, no. 5, pp. 1-11. https://doi.org/10.1183/13993003.00526-2021
7. Vessière A., Font H., Gabillard D., Adonis-Koffi L., Borand L., Chabala C. et al. Impact of systematic early tuberculosis detection using Xpert MTB/RIF Ultra in children with severe pneumonia in high tuberculosis burden countries (TB-Speed pneumonia): a stepped wedge cluster randomized trial. BMC Pediatr., 2021, vol. 21, no. 1, pp. 136. https://doi.org/10.1186/s12887-021-02576-5
8. Universal Access to TB Prevention and Care: Towards Universal Health Coverage (UHC) 2023-2027. Available: https://www.who.int/ru/news/item/23-03-2023-who-steps-up-the-director-general-s-flagship-initiative-to-combat-tuberculosis Accessed September 27, 2024
9. WHO, Management of Multidrug-Resistant Tuberculosis in Children: a Field Guide, 2019. Available: https://sentinel-project.org/wp-content/uploads/2019/02/Updated_DRTB-Field-Guide-2019-V3. pdf Accessed October 17, 2024
10. WHO, Use of targeted next-generation sequencing to detect drug-resistant tuberculosis: rapid communication, July 2023 ISBN 978-92-4-007637-2 (electronic version). Available: https://iris.who.int/bitstream/handle/10665/371687/9789240076372-eng.pdf?sequence=1 Accessed November 10, 2024
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For citations:
Panova L.V., Krushinskaya E.A., Smirnova T.G., Ovsyankina E.S., Larionova E.E. The Effectiveness of Treating Tuberculosis with Multiple and Pre-extensively Drug Resistance in Adolescents Depending on the Drug Susceptibility Testing Methods. Tuberculosis and Lung Diseases. 2025;103(3):18-23. (In Russ.) https://doi.org/10.58838/2075-1230-2025-103-3-18-23
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