The peculiarities of the patients with mono-resistant and poly-resistant tuberculosis

Abstract

Summary Objective. Mono-resistant tuberculosis is the resistance to one of the first-line anti-tuberculosis drug, excluding the rifampicin, and poly-resistant tuberculosis means the resistance to more than one first-line anti-tuberculosis drug (izoniazid, rifampicine, streptomycine, ethambutol, with the exception of the combination of izoniazid and rifampicine. The study was conducted to assess the main peculiarities of the patients with mono-resistant and poly-resistant tuberculosis and their treatment outcome.Material and methods. A cross-sectional, analytical, and retrospective study was performed, which included 124 new cases with mono-resistant and poly-resistant tuberculosis, diagnosed during 2014-2019. The patients were distributed into two groups: the 1st group included 85 (68.5%) cases with mono-resistant tuberculosis and the 2nd group – 39 (31.5%) cases with poly-resistant tuberculosis. Results. Among 85 cases from the 1st group, 69 (81.2%) cases were resistant to streptomycine, 15 (17.5%) to izoniazid, and 1 (1.2%) to ethambutol. Among 39 cases of the 2nd group: 32 (82.0%) were resistant to izoniazid + streptomycine and 7 (18.0%) to isoniazid + ethambutol + streptomycine. The peculiarities of the patients did not show statistical differences in terms of the men/female rate and the affected age groups. Most of them had a socially-economical vulnerable state and high-risk factors. Patients were more frequently detected through the passive case-finding. No differences, according to the localization and extensibility, between the groups were established. The treatment success was registered in 66 (77.6%) cases of the 1st group and 31 (79.5%) cases of the 2nd group. The death occurred in 10 (11.8%) cases of the 1st group and 6 (15.4%) cases of the 2nd group. Conclusions. Within the mono-resistance predominated resistance against the streptomycine and in poly-resistance was noted the resistance against the isoniazid + streptomycine. No differences in general characteristics, social-economical status, high-risk factors, localization, and extensibility of tuberculosis were found. The treatment outcome was suboptimal with a high rate of death in both groups. Individualized approach should be used in all patients for the improvement of the treatment outcome.