Comparative Analysis of M. tuberculosis Drug Susceptibility Test Results among Tuberculosis Cases in Russia from 2023 to 2024

The objective: to assess frequency of detection of M. tuberculosis resistant to anti-tuberculosis drugs in tuberculosis patients with various histories of previous treatment, to determine the coverage with susceptibility testing to first-line and reserve drugs in the Russian Federation in 2023-2024.

Subjects and Methods. The analysis was based on national statistical data and results of microbiological tuberculosis diagnosis collected in regions of the Russian Federation. Susceptibility testing for isoniazid, rifampicin, bedaquiline, linezolid, and fluoroquinolones was used to assess the prevalence of drug resistance. The rates were calculated as a percentage of patients who underwent the relevant testing and had a confirmed history of previous treatment.

Results. In 2024, the Russian Federation recorded a 9.4% decrease in the number of new tuberculosis cases compared to 2023, while the proportion of microbiologically confirmed cases remained stable at 53%. Among new cases, the proportion of tuberculosis with multidrug resistance (MDR) increased from 33.1% to 34.1%, as did the proportion of cases with monoresistance to isoniazid, which increased from 10.7% to 11.8%. Meanwhile, the monoresistance to rifampicin decreased. Among tuberculosis relapses, MDR-TB accounted for 58.6% of cases, while resistance to fluoroquinolones decreased from 35.3% in 2023 to 32.6% in 2024. Coverage with susceptibility testing to reserve drugs increased: up to 80.8% to bedaquiline and up to 81.2% to linezolid, with a low level of resistance to these drugs (<7.5%).

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