Consideration of the results of the Xpert MTB/RIF method on the treatment outcome of patients with M\XDR pulmonary tuberculosis during the COVID-19 epidemic in Kharkiv region, Ukraine
TS Butova(1) OS Solodiankin(2,3) N Rudova(2) NM Sapelnik(3) OL Borysova(3) DO Butov(3)
1: Research Institute of Experimental and Clinical Medicine, Kharkiv National Medical University, Kharkiv, 61022, Ukraine; 2: Laboratory of Molecular Diagnostics, National Scientific Center Institute of Experimental and Clinical Veterinary Medicine, Kharkiv, 61023, Ukraine; 3: Department of Phthisiology and Pulmonology, Kharkiv National Medical University, Kharkiv, 61022, Ukraine
The aim of our study was to determine the presence or absence of the effect of the Xpert MTB/RIF method on the treatment outcome of patients with multi\extensively drug-resistant tuberculosis (M\XDR-TB) of the lungs during the COVID-19 epidemic in Kharkiv region, Ukraine.
Methods. A prospective observational cohort study was performed on registry data from the regional antituberculosis dispensary #1 in Kharkiv region, Ukraine. All microbiologically confirmed M\XDR-TB patients registered in 2020 were included. All samples of the culture of Mycobacterium tuberculosis of patients were subjected to whole genome sequencing. Diagnostic and treatment data were analyzed. The treatment outcomes of tuberculosis (TB) were assessed according to WHO recommendations for the period of the study. One of the exclusion criteria was “Lost to follow up” as an outcome of TB treatment.
Results. We observed 168 patients with M\XDR-TB. Patients were divided into two groups: group 1 - patients who did not receive Xpert MTB/RIF upon admission to the dispensary (n=44) and group 2 - received Xpert MTB/RIF (n=124). Treatment failure and death were observed in 26 (59.1%) patients in group 1 and 45 (36.3%) patients in group 2, p=0.0313. 18 (40.9 %) patients recovered and completed treatment in group 1 and 79 (63.7 %) patients in group 2, p=0.0313 against the background of treatment duration (mean (±SD)): group 1 – 611.8 ±43.1 and group 2 - 567.2±105.9 days, p=0.0001.
Conclusions. Pre-Treatment Results Xpert MTB/RIF in the early days of hospital admission provides better efficacy and shorter duration of chemotherapy for patients with M/XDR-TB.