Genotypes of extensively drug-resistant Mycobacterium tuberculosis strains: clinical and epidemiological features of pulmonary tuberculosis
Here, we present clinical and epidemiological analysis of 85 Russian cases of pulmonary tuberculosis caused by an extensively drug-resistant M. tuberculosis strains. As defined by spoligotyping, M. tuberculosis strains belonged to the following genetic families: Beijing - 81.2%, which significantly exceeds the prevalence rate of this genotype (50%) in M. tuberculosis population across Russia; LAM - 14.1% and Ural - 4.7%. Among patients infected with Beijing strains prevailed alcohol and tobacco abused males; the main source of infection were family and penitentiary contacts. This group of patients has been characterized by a variety of clinical forms of lung disease with the prevalence of fibro-cavernous tuberculosis and a significant proportion of patients with interrupted treatment. Regardless of the M. tuberculosis strain genotype, the extensively drug-resistant pulmonary tuberculosis is characterized by severe course leading to the chronic disease with the relapses and poor response to anti-tuberculosis treatment, requiring repeated hospitalizations and surgical treatments.