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On Improving Chemotherapy Outcomes in Patients with Drug-Resistant Tuberculosis as a Result of Introduction of Drug Susceptibility Testing

https://doi.org/10.58838/2075-1230-2025-103-4-38-43

Abstract

The objective: to evaluate the effectiveness of chemotherapy in patients with extrapulmonary tuberculosis (EPTB) after introduction of molecular genetic and phenotypic rapid methods for drug susceptibility testing.
Subjects and Methods. From 2018 to 2021, epidemiological surveillance forms for drug-resistant tuberculosis (DR TB) (TB 06, Table 3b for Results of Drug Susceptibility Testing to First- and Second-Line Drugs) were analyzed. Those forms were approved by the Ministry of Health of the Kyrgyz Republic (KR) in 2014. During this period, molecular genetic tests (GeneXpert/MTB-Rif, LPA, MTBDRsl) began to be used for testing drug susceptibility of Mycobacterium tuberculosis (MTB), while the use of phenotypic tests (cultures on liquid (MGIT 960) media and solid media (Levenshtein-Jensen (LJ)) continued.
Results. In the Kyrgyz Republic, over 4 years (2018 - 2021), the proportion of MTB strains sensitive to anti-tuberculosis drugs was growing from 44.0% in 2018 to 58.9% in 2021. Among the drug-resistant MTB strains, the proportion of isoniazid-resistant ones increased from 18.9% to 28.7%. In 2020 and 2021, the treatment effectiveness of patients with drug-susceptible extrapulmonary tuberculosis made 84.8 and 83.9%, respectively, and almost reached the target rate of 85% of the National Tuberculosis Control Program of the Kyrgyz Republic. In Bishkek in 2018, the treatment effectiveness in patients with DR extrapulmonary tuberculosis was close to the target of the National Program (75%) and amounted to 73.5%, and in 2019 it exceeded the target rate and reached 82.4%.

About the Authors

K. M. Mukanbaev
National Phthisiology Center
Kyrgyzstan

Kasymbek M. Mukanbaev, Doctor of Medical Sciences, Chief Researcher

90-a Akhunbaeva St., Bishkek, the Kyrgyz Republic, 720020 Phone: + 996 (312) 51-03-34



A. A. Turkmenov
Akhunbaev Kyrgyz State Medical Academy
Kyrgyzstan

Alybek A. Turkmenov, Candidate of Medical Sciences, Associate Professor of Propaedeutic Surgery Department

92 Akhunbaeva St., Bishkek, the Kyrgyz Republic, 720020 Phone: + 996 (312) 54-04-95



A. A. Toktogonova
National Phthisiology Center
Kyrgyzstan

Atyrkul A. Toktogonova, Candidate of Medical Sciences, Senior Researcher, Deputy Director for Research

90-a Akhunbaeva St., Bishkek, the Kyrgyz Republic, 720020 Phone: + 996 (312) 51-03-34



M. D. Kozhomkulov
National Phthisiology Center
Kyrgyzstan

Meder D. Kozhomkulov, Researcher

90-a Akhunbaeva St., Bishkek, the Kyrgyz Republic, 720020 Phone: + 996 (312) 51-03-34



En Jun Choi
Royal Metropolitan University
Kyrgyzstan

Choi En Jun, Doctor of Medical Sciences, Acting Professor of Department of Morphological and Fundamental Disciplines

172 Moskovskaya St., Bishkek, the Kyrgyz Republic, 720010



References

1. Bobokhodzhaev O.I., Sirodzhidinova U.Yu., Nurov R.M., Pirmakhmadzoda B.P., Abdurakhimov A.A., Saydaliev S.M., Bobokhodzhaev F.O., Makhmudov M.O. Epidemic patterns and effectiveness of treatment of tuberculosis patients with different drug resistance profiles in the Republic of Tajikistan. Tuberculosis and Lung Diseases, 2023, vol. 101, no. 2, pp. 73-79. (In Russ.) http://doi.org/10.58838/2075-1230-2023-101-2-73-79

2. Kozhomkulov M.D. The prevalence of various resistance profiles of the causative agent of tuberculosis in patients with extrapulmonary forms of tuberculosis. Health Care of Kyrgyzstan, 2022, no. 2, pp. 47-51. (In Russ.)

3. Salina T.Yu., Morozova T.I. Prevalence and patterns of gene mutations associated with M. tuberculosis resistance to isoniazid and rifampicin in patients with different clinical manifestations of tuberculosis. Tuberculosis and Lung Diseases, 2023, vol. 101, no. 1, pp. 28-33. (In Russ.) http://doi.org/10.58838/2075-1230-2023-101-1-28-33

4. Ershova J.V., Volchenkov G.V., Somova T.R., Kuznetsova T.A., Kaunetis N.V., Kaminski D., Demikhova O.V., Chernousova L.N., Vasilyeva I.A., Kerr E.M., Cegielski J.P., Kurbatova E.V. Impact of GeneXpert MTB/RIF® on treatment initiation and outcomes of RIF-resistant and RIF-susceptible TB patients in Vladimir TB dispensary, Russia. BMC Infect. Dis., 2020, vol. 20, no. 1, pp. 543. https://doi.org/10.1186/s12879-020-05243-9

5. Evans D., Sineke T., Schnippel K., Berhanu R., Govathson C., Black A., Long L., Rosen S. Impact of Xpert MTB/RIF and decentralized care on linkage to care and drug-resistant tuberculosis treatment outcomes in Johannesburg, South Africa. BMC Health Serv. Res., 2018, vol. 18, no. 1, pp. 973. https://doi.org/10.1186/s12913-018-3762-x

6. Li X., Deng Y., Wang J., Jing H., Shu W., Qin J., Pang Y., Ma X. Rapid diagnosis of multidrug-resistant tuberculosis impacts expenditures prior to appropriate treatment: a performance and diagnostic cost analysis. Infect. Drug Resist., 2019, no. 12, pp. 3549-3555. https://doi.org/10.2147/IDR.S224518

7. Moga S., Bobosha K., Fikadu D., Zerihun B., Diriba G., Amare M., Kempker R.R., Blumberg H.M., Abebe T. Diagnostic performance of the GenoType MTBDRplus VER 2.0 line probe assay for the detection of isoniazid resistant Mycobacterium tuberculosis in Ethiopia. PLoS One, 2023, vol. 18, no. 4, pp. e0284737. https://doi.org/10.1371/journal.pone.0284737

8. Muneer A., Macrae B., Krishnamoorthy S., Zumla A. Urogenital tuberculosis-epidemiology, pathogenesis and clinical features. Nat. Rev. Urol., 2019, no. 16, pp. 573-598.

9. Muniyandi M., Lavanya J., Karikalan N., Saravanan B., Senthil S., Selvaraju S., Mondal R. Estimating TB diagnostic costs incurred under the National Tuberculosis Elimination Programme: a costing study from Tamil Nadu, South India. Int. Health, 2021, vol. 13, no. 6, pp. 536-544. https://doi.org/10.1093/inthealth/ihaa105

10. WHO, Global TB report, 2023.

11. Yuldashev S., Parpieva N., Alimov S., Turaev L., Safaev K., Dumchev K., Gadoev J., Korotych O., Harries A.D. Scaling up molecular diagnostic tests for drug-resistant tuberculosis in Uzbekistan from 2012-2019: Are we on the right track? Int. J. Environ. Res. Public Health, 2021, vol. 18, no. 9, pp. 4685. https://doi.org/10.3390/ijerph18094685


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For citations:


Mukanbaev K.M., Turkmenov A.A., Toktogonova A.A., Kozhomkulov M.D., Choi E.J. On Improving Chemotherapy Outcomes in Patients with Drug-Resistant Tuberculosis as a Result of Introduction of Drug Susceptibility Testing. Tuberculosis and Lung Diseases. 2025;103(4):38-43. (In Russ.) https://doi.org/10.58838/2075-1230-2025-103-4-38-43

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ISSN 2075-1230 (Print)
ISSN 2542-1506 (Online)