Epidemiology and Infectious DiseasesEpidemiology and Infectious Diseases1560-95292411-3026Eco-Vector4043610.17816/EID40436Pulmonary tuberculosis with multidrug resistance in its pathogen to essential and reserve drugsKononetsAleksandr Semenovich-KhoroshilovaN E-GolubevaL I-KononetsA SFederal Penitentiary Service, Ministry of Justice of Russia-KhoroshilovaN EFederal Penitentiary Service, Ministry of Justice of Russia-GolubevaL IFederal Penitentiary Service, Ministry of Justice of Russia-Federal Penitentiary Service, Ministry of Justice of Russia15022010151242923072020Copyright © 2010, Eco-vector2010The course of destructive pulmonary tuberculosis and the efficiency of its treatment were studied in 249 patients with this condition who excreted Mycobacterium tuberculosis (MBT) resistant to at least isoniazid and rifampicin in combination with essential and reserve antituberculous drugs (ATD). The investigators identified 2 groups of patients with multidrug resistance (MDR) to a combination of essential ATD (isoniazid and rifampicin with pyrazinamide, ethambutol, and streptomycin) and extensive drug resistance (EDR) to a combination of essential (isoniazid and rifampicin) and reserve (prothionamide, canamycin, capreomycin, cyclosein, and fluoroquinolones) drugs. The chronic course of the disease with severe clinical manifestations and more common infiltrative-destructive lesions of the lung was more frequently noted in patients with EDR in MBT to a combination of essential and reserve drugs. The chemotherapy using a combination of reserve drugs proved to be effective only in patients with MDR in MBT to a combination of essential drugs while in EDR these regimens were little effective or ineffective.pulmonary tuberculosispathogen drug resistanceantituberculous drugsтуберкулез легкихлекарственная устойчивость возбудителяпротивотуберкулезные препараты[Богуш Л. К. Хирургическое лечение туберкулеза легких. - М., 1979.][Мишин В. Ю., Чуканов В. И. // X Национальный конгресс по болезням органов дыхания: Сборник резюме. - СПб., 2000. - С. 293.][Мишин В. Ю. // Пульмонология. - 2001. - № 4. - С. 40- 46.][Мишин В. Ю., Чуканов В. И., Васильева И. А. // Пробл. туб. - 2002. - № 12. - С. 18-23.][Мишин В. Ю. Лекарственно-устойчивый туберкулез легких: Учеб. пособие для врачей. - М., 2005.][Мишин В. Ю. Медикаментозные осложнения комбинированной химиотерапии туберкулеза легких. - М., 2007.][Приказ МЗ РФ от 21 марта 2003 г. № 109 "О совершенствовании противотуберкулезных мероприятий в Российской Федерации". - М., 2003.][Рабухин А. Е. Химиотерапия больных туберкулезом легких. - М., 1970.][Хоменко А. Г. Химиотерапия туберкулеза легких. - М., 1980.][Centers for Disease Control and Prevention. Emergence of Mycobacterium tuberculosis with extensive resistance to second-line drugs-world-wide // Morbid. Mortal. Wkly Rep. - 2006. - Vol. 55. - P. 301-305.][Guidelines for Establishing DOTS-PLUS Pilot Projects for the Management of Multidrug Resistance Tuberculosis (MDR-TB). - Geneva, 2000.][Guidelines for the Management of Drug-resistant Tuberculosis. - Geneva, 1997.][Migliori G. B., Loddenkemper R., Blasi F., Raviglione M. C. // Eur. Respir. J. - 2007. - Vol. 29, N 3. - P. 423-427.][Mishin V. // Clin.Microbiol. Infect. - 2000. - Vol. 5, Suppl. - P. 67-68.][Mishin V. Yu., Vasilieva I. A. // Abstracts 13-th European Respiratory Society Annual Congress. - London, 2003. - P. 556.][Mishin V. Y. // Abstracts 15-th European Respiratory Society Annual Congress. - Copenhagen, 2005. - P. 648.]