IMPACT OF EXPRESS SUSCEPTIBILITY TESTING TO RIFAMPICIN OF M. TUBERCULOSIS ON CHEMOTHERAPY EFFICIENCY IN THOSE SUFFERING FROM MULTIPLE DRUG RESISTANT TUBERCULOSIS

Goal of the study: to compare efficiency of anti-tuberculosis chemotherapy prescribed basing on drug susceptibility testing results obtained by GeneXpertMTB/RIF with relevant correction as per data of culture on liquid media and basing on drug susceptibility testing through culture on liquid media only.

Materials and methods. 185 pulmonary tuberculosis patients in the age from 18 to 60 years were included into the study and divided into three groups: Groups 1 and 2 included those susceptible and resistant to rifampicin respectively which was detected by GeneXpert MTB/RIF. Group 3 was formed retrospectively out of patients suffering from multiple drug resistance in whom no test systems had been used.

Results. If chemotherapy regimen was appropriately chosen basing on rifampicin susceptibility data obtained only through GeneXpert MTB/RIF, the time of sputum conversion confidently did not differ for those suffering from multiple drug resistance and those without it.

Prescription of chemotherapy regimen basing on GeneXpert MTB/RIF results with consequent correction as per culture results obtained by Bactec MGIT 960 confidently enhances treatment outcomes in multiple drug resistant tuberculosis patients both regarding sputum conversion rate and cavity healing compared to the group where treatment regimen was corrected basing on results of culture on liquid media. Using GeneXpert MTB/RIF significantly reduces the number of chemotherapy regimens corrections or transfers to the other regimen. Under-detection of rifampicin resistance when using GeneXpert MTB/RIF compared to Bactec MGIT 960 was fixed on the level of 1.5% (95% CI 0.42-5.44%).

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