Department of Phthisiology, Karaganda State Medical University, Karaganda, Republic of Kazakhstan.
Department of Therapeutic Disciplines, South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan.
Microb Drug Resist. 2020 Aug;26(8):997-1004. doi: 10.1089/mdr.2019.0326. Epub 2020 Mar 16.
Half a million new cases of multidrug-resistant tuberculosis (MDR-TB) are registered annually, and therefore, the issue of the development of new fast and reliable methods for diagnosis of tuberculosis (TB) remains urgent in modern phthisiology. The aim of this study was to investigate the effects of the Xpert MTB/RIF molecular genetic method on the diagnosis, clinical and radiological features, and efficacy of treatment of MDR-TB. Patients with MDR-TB were divided into two groups. The first (study) group included patients ( = 412) in whom a mutation in the gene responsible for the presence of () and resistance to rifampicin were detected using the Xpert MTB/RIF assay. The second group consisted of patients ( = 540) in whom TB was diagnosed using bacterioscopy and multidrug resistance was detected using inoculation on dense and liquid culture media. The results of bacterioscopic, bacteriological, molecular genetic, clinical studies and the efficacy of the treatment of 952 patients with MDR pulmonary TB were studied. The result of GeneXpert MTB/RIF was compared with the results of sputum bacterioscopy and culture methods on a dense Levenshtein-Jensen nutrient medium and on a liquid nutrient medium in a BACTEC 960 automated microbiological system. The "Successful treatment" outcome ("cured" and "treatment completed") prevailed among patients who underwent timely diagnosis of MDR-TB using the Xpert MTB/RIF assay and reached 73.8%. In the second group of patients, it was 49.3% ( = 0.000). Timely diagnosis of MDR-TB using the Xpert MTB/RIF assay increased the efficacy of anti-TB chemotherapy.
每年有 50 万例耐多药结核病 (MDR-TB) 新发病例，因此，在现代肺病学中，开发新的快速、可靠的结核病诊断方法仍然是当务之急。本研究旨在探讨 Xpert MTB/RIF 分子遗传学方法对 MDR-TB 的诊断、临床和影像学特征以及治疗效果的影响。将 MDR-TB 患者分为两组。第一组（研究组）包括 412 例患者，使用 Xpert MTB/RIF 检测法检测到负责存在 () 和对利福平耐药的基因突变。第二组由 540 例患者组成，使用细菌学检查诊断结核病，并使用密集和液体培养培养基进行药敏试验。研究了 952 例 MDR 肺结核患者的细菌学、细菌学、分子遗传学、临床研究结果和治疗效果。将 GeneXpert MTB/RIF 的结果与痰细菌学检查和培养方法的结果进行了比较，该方法在密集的 Levenshtein-Jensen 营养培养基和 BACTEC 960 自动化微生物系统中的液体营养培养基上进行。在及时使用 Xpert MTB/RIF 检测法诊断 MDR-TB 的患者中，“成功治疗”结果（“治愈”和“治疗完成”）占优势，达到 73.8%。在第二组患者中，这一比例为 49.3%（ = 0.000）。及时使用 Xpert MTB/RIF 检测法诊断 MDR-TB 可提高抗结核化疗的疗效。
