Характеристика больных, заболевших туберкулезом, в г. Кишинэу в 2015 г.

Abstract

Цель исследования: характеристика больных, заболевших туберкулезом (ТБ), в г. Кишинэу в 2015 г. Материалы и методы. Проведено ретроспективное описательное исследование, в ходе которого проанализированы данные 668 пациентов с ТБ, диагностированных в г. Кишинэу в 2015 г. Результаты. Данные социальных характеристик показали, что в г. Кишинэу в 2015 г. чаще всего пациент с ТБ ‒ это мужчина молодого возраста, из социально уязвимых слоев населения, без медицинского страхования. Анализ методов выявления ТБ установил, что лишь 22,3% больных выявлены при периодическом обследовании групп высокого риска. Среди заболевших ТБ было впервые выявленных 60,3%, с рецидивом ‒ 21,7%, после перерыва в лечении –10,3%, после неудачи лечения ‒ 5,7 %. У 14 (2,0%) ‒ туберкулез выявлен посмертно. Среди 674 пациентов с прижизненной диагностикой туберкулеза преобладал ТБ легких ‒ 638 (94,7%), среди них у 193 (30,3%) больных микроскопия мокроты на кислотоустойчивые микобактерии была положительной, а 187 (29,3%) больных имели положительные результаты посева мокроты на среду Левенштейна ‒ Йенсена или в системе Bactec 960, результат Xpert MTB/Rif был положительным у 259 (40,6%). У 118/187 (63,1%) пациентов диагностирована множественная лекарственная устойчивость возбудителя. Через 12 мес. оценка лечения проведена у 647 пациентов: успешный курс лечения ‒ у 393 (60,7%) пациентов, 80 (12,4%) ‒ умерли, 174 (26,9%) ‒ продолжали лечение.

The objective of the study: to characterize patients who developed tuberculosis in Chisinau in 2015. Subjects and methods. The retrospective descriptive study was conducted aimed to analyze data of 668 tuberculosis patients diagnosed in Chisinau in 2015. Results. The social characteristics demonstrated that in 2015 in Chisinau a tuberculosis patient was most often a young man belonging to socially marginalized population with no medical insurance. The analysis of tuberculosis detection methods showed that only 22.3% of patients were detected through regular screening in risk groups. Among tuberculosis patients, new cases made 60.3%, relapses – 21.7%, those after treatment interruption – 10.3%, and those after treatment failure – 5.7%. In 14 (2.0%) patients, tuberculosis was detected post-mortem. Out of 674 patients with life time diagnosed tuberculosis, pulmonary tuberculosis prevailed – 638 (94.7%), of them, 193 (30.3%) had a positive result of sputum microscopy for acid-fast bacilli, and 187 (29.3%) patients had a positive result of sputum culture by Lowenstein-Jensen or Bactec 960, and the result of Xpert MTB/Rif was positive in 259 (40.6%) patients. Multiple drug resistance was diagnosed in 118/187 (63.1%) patients. In 12 months, treatment outcomes were assessed in 647 patients: treatment was successful in 393 (60.7%) patients; 80 (12.4%) patients died, and 174 (26.9%) were still on treatment. Key words: tuberculosis, detection methods, social characteristics, microbiological parameters, treatment outcomes

The objective of the study: to characterize patients who developed tuberculosis in Chisinau in 2015. Subjects and methods. The retrospective descriptive study was conducted aimed to analyze data of 668 tuberculosis patients diagnosed in Chisinau in 2015. Results. The social characteristics demonstrated that in 2015 in Chisinau a tuberculosis patient was most often a young man belonging to socially marginalized population with no medical insurance. The analysis of tuberculosis detection methods showed that only 22.3% of patients were detected through regular screening in risk groups. Among tuberculosis patients, new cases made 60.3%, relapses – 21.7%, those after treatment interruption – 10.3%, and those after treatment failure – 5.7%. In 14 (2.0%) patients, tuberculosis was detected post-mortem. Out of 674 patients with life time diagnosed tuberculosis, pulmonary tuberculosis prevailed – 638 (94.7%), of them, 193 (30.3%) had a positive result of sputum microscopy for acid-fast bacilli, and 187 (29.3%) patients had a positive result of sputum culture by Lowenstein-Jensen or Bactec 960, and the result of Xpert MTB/Rif was positive in 259 (40.6%) patients. Multiple drug resistance was diagnosed in 118/187 (63.1%) patients. In 12 months, treatment outcomes were assessed in 647 patients: treatment was successful in 393 (60.7%) patients; 80 (12.4%) patients died, and 174 (26.9%) were still on treatment. Key words: tuberculosis, detection methods, social characteristics, microbiological parameters, treatment outcomes