Science and Innovations in MedicineScience and Innovations in Medicine2500-13882618-754XFSBEI of Higher Education SamSMU of Ministry of Health of the Russian Federation4380510.35693/2500-1388-2020-5-2-140-144Research ArticleBacteriological indicators in estimating therapy efficiency for newly diagnosed pulmonary tuberculosisSamsonovKirill Yu.<p>postgraduate student of the Department of Phthisiology, phthisiosurgery and infectious diseases</p>pablo-1911@mail.ruhttps://orcid.org/0000-0001-7029-812XMordykAnna V.<p>PhD, Professor, Head of the Department of Phthisiology, phthisiosurgery and infectious diseases</p>pablo-1911@mail.ruhttps://orcid.org/0000-0001-6196-7256AroyanAnna R.<p>physician of pulmonary tuberculosis department</p>pablo-1911@mail.ruhttps://orcid.org/0000-0002-3719-2240BatishchevaTatyana L.<p>PhD, Deputy Chief Physician</p>pablo-1911@mail.ruhttps://orcid.org/0000-0002-2002-9172DrobininaTatyana A.<p>student</p>pablo-1911@mail.ruhttps://orcid.org/0000-0002-2687-0878Omsk State Medical UniversityClinical Tuberculosis Dispensary150620205214014408092020Copyright © 2020, Samsonov K.Y., Mordyk A.V., Aroyan A.R., Batishcheva T.L., Drobinina T.A.2020<p><strong>Objectives</strong> to evaluate the main bacteriological indicators for newly diagnosed pulmonary tuberculosis and to compare them with the timing of sputum smear negative reaction and abacillation.</p>
<p><strong>Materials and methods.</strong>The study included 127 people with newly diagnosed pulmonary tuberculosis. Bacteriological and radiological data were evaluated at 2, 4 and 6 months of the study. The patients were divided into 2 groups: patients with an ineffective course of chemotherapy (1st group, n = 67) and an effective chemotherapy (2d group, n = 60).</p>
<p><strong>Results.</strong>In the 1st group, the patients with the following processes prevailed over the 2nd group: destructive (86.4% vs 40.0%; р 0.001), generalized (76.1% vs 50.0%; р = 0.003), bilateral (62.7% vs 36.7%; р = 0.004), with bacterial excretion (68.7% vs 33.3%; р 0.001). The difference in mass of bacterial excretion in the compared groups was insignificant (p 0.050). The Mtb growth in solid medium was absent within 90 days in patients with effective chemotherapy (28.3% vs 1.5% in the 1st group, р 0.001). The low intensity of Mtb growth was also observed in the 2nd group (46.5% vs 21.2%; р = 0.006). XDR of Mtb was registered in 16.4% of patients in the 1st group, versus 5% in the 2nd group (p = 0.04). In the 1st group, the sputum smear microscopy was revealing bacteria discharge in 29.8% of patients during 12 months. In the 2nd group, the abacillation was registered in all the patients after 6 months of treatment. During the 68 months of chemotherapy, the abacillation was registered in 41.9% of patients in the 2nd group, and in 13.6% of patients in the 1st group (р = 0.020). After 12 months of treatment, the Mtb growth in solid medium was present in 57.6% of patients in the 1st group, compared to the 20.9% in the 2nd group (p 0.001).</p>
<p><strong>Conclusion.</strong>The results of our study indicate the relationship of Mtb drug resistance, XDR in particular, and the rate of Mtb division to the generalization of the process, the tendency for destruction of lung tissue, as well as the early appearance of bacterial excretion and, accordingly, the longer periods for sputum negative reaction and abacillation.</p>pulmonary tuberculosisbacteriological indicatorstreatment efficacyтуберкулез легкихбактериологические показатели[Borodulina EA, Yakovleva EV. Disseminated pulmonary tuberculosis: modern aspects. Science & Innovations in Medicine. 2017;2:39–43. (In Russ.). [Бородулина Е.А., Яковлева Е.В. Диссеминированный туберкулез легких: современные аспекты. Наука и инновации в медицине. 2017;2:39–43].][Sitnikova SV, Mordyk AV, Ivanova OG. The effect of HIV infection on the results of inpatient treatment of patients with associated pathology of tuberculosis/HIV infection. Tuberkulez i bolezni legkih. 2015;7:128–129. (In Russ.). [Ситникова С.В., Мордык А.В., Иванова О.Г. Влияние ВИЧ-инфекции на результаты стационарного курса лечения больных с ассоциированной патологией туберкулез/ВИЧ-инфекция. Туберкулез и болезни легких. 2015;7:128–129].][Davydkin IL, Osadchuk AM, Borodulina EA, Gricenko TA. Infiltrative pulmonary tuberculosis, peptic ulcer disease and HIV infection (comorbidity and multimorbidity of diseases). Science & Innovations in Medicine. 2016;1:19–24. (In Russ.). [Давыдкин И.Л., Осадчук А.М., Бородулина Е.А., Гриценко Т.А. Инфильтративный туберкулез легких, язвенная болезнь и ВИЧ-инфекция (коморбидность и мультиморбидность заболеваний). Наука и инновации в медицине. 2016;1:19–24].][Skornjakov SN, Shulgina MV, Arijel BM, et al. Clinical guidelines for the etiological diagnosis of tuberculosis. Medicinskij al'jans. 2014;3:39–58. (In Russ.). [Скорняков С.Н., Шульгина М.В., Ариэль Б.М. и др. Клинические рекомендации по этиологической диагностике туберкулеза. Медицинский альянс. 2014;3:39–58].][Abramov DD, Kofiadi IA, Utkin KV, et al. Polymorphism of single nucleotides in the genes of cytokines and their receptors: biological effect and methods of identification. Immunologija. 2011;5:275–280. (In Russ.). [Абрамов Д.Д., Кофиади И.А., Уткин К.В. и др. Полиморфизм одиночных нуклеотидов в генах цитокинов и их рецепторов: биологический эффект и методы идентификации. Иммунология. 2011;5:275–280].][Mordyk AV, Ivanova OG, Sulim DA, Bagisheva NV. Chronic obstructive pulmonary disease and concomitant infectious pathology. Lechashhij vrach. 2014;10:14. (In Russ.). [Мордык А.В., Иванова О.Г., Сулим Д.А., Багишева Н.В. Хроническая обструктивная болезнь легких и сопутствующая инфекционная патология. Лечащий врач. 2014;10:14].][Li W, Deng W, Xie J. The Biology and Role of Interleukin-32 in Tuberculosis. J Immunol Res. 2018:1535194. PMID: 30426023 doi: 10.1155/2018/1535194][Jagielski T, Minias A, van Ingen J, et al. Methodological and clinical aspects of the molecular epidemiology of Mycobacterium tuberculosis and other mycobacteria. Clin Microbiol Rev. 2016;29:239–290. PMID: 26912567 doi: 10.1128/CMR.00055-15][Delogu G, Sali M, Fadda G. The biology of mycobacterium tuberculosis infection. Mediterr J Hematol Infect Dis. 2013;5(1):e2013070. PMID: 24363885 doi: 10.4084/MJHID.2013.070][Kaminskaya GO, Аbdullaev RYu. Tuberculosis and lipid exchange. Tuberculosis and Lung Diseases. 2016;94(6):53–63. (In Russ.). [Каминская Г.О., Абдуллаев Р.Ю. Туберкулез и обмен липидов. Туберкулез и болезни легких. 2016;94(6):53–63]. doi.org/10.21292/2075-1230-2016-94-6-53-63][Borodulina EA, Povalyaeva LV, Borodulina EV, et al. The problem of diagnosing tuberculosis in the practice of a pulmonologist. Vestnik sovremennoj klinicheskoj mediciny. 2017;1:89–93. (In Russ.). [Бородулина Е.А., Поваляева Л.В., Бородулина Э.В. и др. Проблема диагностики туберкулеза в практике врача-пульмонолога. Вестник современной клинической медицины. 2017;1:89–93]. doi: 10.20969/VSKM.2017.10(1).89-93][Manicheva OA, Dogonadze MZ, Melnikova NN, et al. The growth rate phenotypic property of Mycobacterium tuberculosis clinical strains: dependence on tuberculosis localization, treatment, drug susceptibility. Infection and Immunity. 2018;8(2):175–186. (In Russ.). [Маничева О.А., Догонадзе М.З., Мельникова Н.Н. и др. Фенотипическое свойство скорости роста клинических штаммов Mycobacterium tuberculosis: зависимость от локализации процесса, лечения, лекарственной чувствительности. Инфекция и иммунитет. 2018;8(2):175–186]. doi: 10.15789/2220-7619-2018-2-175-186]