Efficacy of treatment of MDR/XDR TB patients based on rapid diagnostics of M. tuberculosis drug resistance by GenoType MTBDRplus and GenoType MTBDRsl (Hain Lifescience GmbH, Germany)

Objective : Assess efficacy of treatment of MDR/XDR TB patients at an early diagnostics of drug resistance (DR) by rapid method GenoType MTBDRplus and GenoType MTBDRsl. Materials and methods: It was conducted analysis of 69 case histories of MDR TB patients diagnosed by rapid method. Patients were divided into 3 groups: MDR TB – 33, pre-XDR TB – 28, XDR TB – 8. Efficacy of therapy in groups was assessed in 6 months by frequency of negativation of M. tuberculosis by culture. Results: Treatment regimens were assigned from the beginning which included all sensitive to M. Tuberculosis drugs. Patients from 1st group received aminoglycosides, levofloxacin, cycloserine, PAS, protionamide, pyrazinamide and ethambutol (if MBT were sensitive to ethambutol by GenoType MTBDRsl). The regimen for patients from 2nd group consists of aminoglycosides or polypeptide, fluoroquinolones - levofloxacin or moxifloxacin, cycloserine, PAS, protionamide, pyrazinamide and sometimes ethambutol. Patients with XDR TB from 3rd group received polypeptide, moxifloxacin, cycloserine, PAS, pyrazinamide, linezolide, sometimes ethambutol or protionamide and also amoxicillin/clavulanate or clarithromycin. In 6 months 93,9% (31 from 33) MDR TB patients from 1st group, 75% (21 from 28) MDR TB patients from 2nd group and 6 from 8 XDR TB patients from 3rd group became non-bacillary. Conclusion: Regimens based on rapid method, which allow to diagnose MDR and XDR TB cases in several hours after sputum collection, have high efficacy for the most complicated category of TB patients.