THE DYNAMICS ANALYSIS OF MYCOBACTERIUM TUBERCULOSIS CULTURES DRUG RESISTANCE FORMATION, ALLOCATED IN FIRST IDENTIFIED PATIENTS IN THE REPUBLIC OF MORDOVIA
At present, the problem of tuberculosis in the Russian Federation is of a priority nature: despite a slight improvement in the epidemic situation, the problem of increasing the proportion of patients with multiple (MDR) and extensive drug resistance (XDR) mycobacterium tuberculosis (MBT) is of particular importance. The object of the study was 534 M. tuberculosis strains isolated from newly diagnosed pulmonary tuberculosis patients in the Republic of Mordovia from 2014 to 2018. It was found that the proportion of MDR-MBT for the five-year period was 17.9% without significant dynamics, but an increase in the share of pre-XDR from 7.1% to 13.3% and XDR from 0% to 2.2%. It has been shown that with MDR MBT, the most common combinations of anti-TB drugs are the combination of isoniazid, rifampicin, streptomycin, pre-XDR - isoniazid, rifampicin, ofloxacin, kanamycin and / or amikacin and / or capremicin, and with XDR, the combination of drug resistance to isoniazid, rif ofloxacin, kanamycin and / or capremicin. Also, an expansion of the MDR spectrum to four drugs is noted. It was noted that resistance to reserve anti-TB drugs with a predominance of resistance to injectable antibiotics, protionamide and ethambutol is observed in almost half of MDR MBT cultures.