PLACE RESPONCIBLE LUNG BIOPSY TO VERIFY THE DIAGNOSIS IN PATIENTS WITH TUBERCULOSIS WITH NEGATIVE RESULTS OF BACTERIOLOGICAL AND HISTOLOGICAL EXAMINATION (ICD-10, A16.0) IN THE ERA OF DRUG-RESISTANT TUBERCULOSIS
When conducting responcible gable lung biopsy (CBBL) 246 first detected patients with pulmonary tuberculosis with negative results of bacteriological and histological examination (ICD-10, A16.0) receiving anti-TB chemotherapy in the treatment regime III, in 100% of cases the resulting material is suitable for subsequent molecular, genetic, microscopic, cultural and morphological studies. Data obtained by histological and bacteriological analysis of biopsy material allowed us to verify the diagnosis of pulmonary tuberculosis in 103 (41,9%) patients, 102 (99.0%) of the of which allowed to determine the spectrum of drug resistance of tuberculosis mycobacteria (MBT) to anti-TB drugs (PTP). It is established that at the time of treatment of PTP 1st series 35 (14,2%) patients had drug-resistant form of tuberculosis. At the same time, monoresistance MBT recorded in 9 patients, polyresistance of MBT – 6 patients, 17 patients showed multiple drug resistance of mycobacteria (MDR MBT), 3 patients – extensively drug-resistant bacilli (XDR MBT). These data confirm the need and the possibility of using CBL in Dannii algorithm of examination of patients to verify the diagnosis and obtain information about drug resistance of MBT.