PATHOMORPHOSIS OF TUBERCULOSIS IN TODAY'S CONDITIONS: THE PROBLEM OF RESISTANCE AND MOLECULAR-GENETIC METHODS FOR DETERMINATION OF SENSITIVITY OF STABLES MATTERS

Abstract

Abstract. Since the early 1990s, there has been an increase in drug resistance of Mycobacterium tuberculosis (MBT) to the most active anti-TB drugs (AMBs) worldwide, which has reduced the effectiveness of treatment and contributed to the growth of key epidemiological indicators. The aim of the study was to identify mutations in M. tuberculosis associated with AMBP resistance using the molecular genetic method of linear probe analysis Nain Lifesciences (Geno-Typ MTBDRplus). The strains of the Office, isolated in newly diagnosed patients and in relapses for the detection of chemoresistance of strains in patients who were treated in 2017-2021 in the ENT "Lviv Regional Phthisiopulmonology Clinical Medical and Diagnostic Center" were analyzed. The sensitivity of MBT strains to AMBP of the first series - isoniazid and rifampicin and the second series - fluoroquinolones and injectable drugs (kanamycin, capriomycin and amikacin) was determined. A high percentage of matches to the rpoB gene was found. Mutations associated with isoniazid resistance were most common in the katG gene. They retain complete virulence to isoniazid and are often multidrug-resistant strains. Molecular genetic resistance of MBT strains to fluoroquinolones is associated with the gyrA and gyrB genes, to injectables (kanamycin, amikacin, capriomycin) is associated with the rrs gene, and to kanamycin is associated with the eis gene. The need for further research will identify MBT mutations associated with AMP resistance and use them in real time for effective and timely treatment, which will further improve the epidemiological situation of chemoresistant tuberculosis.