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To evaluate the efficiency of chemotherapy used in patients with pulmonary tuberculosis by the results of a rapid detection of drug resistance (DR) to isoniazid and rifampicin on a "TB-Biochip" test system versus the standard treatment with its subsequent correction by the data of determination of Mycobacterium tuberculosis (MBT) resistance by the absolute concentration technique (ACT), the study included 208 patients with pulmonary tuberculosis. The patients were divided into 2 groups: 1) those in whom MBT sensitivity to antituberculous agents was determined on a "TB-Biochip" test system to detect mutations in the MBT genes rpoB, katG, inhA, ahpC that were responsible for MBT sensitivity to rifampicin and isoniazid and by ACT; 2) those in whom this was determined by only ACT. The results of a test for MBT sensitivity to rifampicin and isoniazid were obtained within 2 days before chemotherapy in Group 1 and 2 months after chemotherapy in Group 2. In Group 1, antituberculous chemotherapy was used, by taking into account MBT sensitivity to isoniazid, rifampicin, or their combination; in Group 2, the drugs were given by the standard regimens with their subsequent correction following 2 months by the results of ACT. The timely initiation of treatment with reserve drugs in the detection of drug sensitivity in MBT could achieve higher therapeutic efficiency and in a shorter space of time.

The pretreated patients who isolated drug-resistant Mycobacterium tuberculosis (MBT) were randomly divided into 2 groups. A multidrug-resistant MBT strain was isolated from 77 and 62.2% of patients in the study and control groups, respectively. Artificial pneumoperitoneum (PP) was applied to the study group patients (n = 95) during adequate chemotherapy. In the control group (n = 43), only chemotherapy was performed in accordance with the data of a MBT drug sensitivity test. The results were assessed by the trend in bacterial isolation cessation and decay cavity closure. In the group of patients treated with PP and chemotherapy, sputum inoculation abacillarity occurred in 72.6 and 95.8% by months 4 and 6, respectively; in the control group, this did in 48.8 and 65.1% in the same periods. Moreover, decay cavity closure was noted in 95.1% in the study group and in 63.7% in the control group following 6 months of treatment.

Two hundred and twenty-four patients with pulmonary tuberculosis and bacterial isolation were examined to study the efficiency of chemotherapy in patients who isolated drug-resistant strains of Mycobacterium tuberculosis (MBT) of different genotypes. According to the pattern of susceptibility to antituberculous drugs (ATDs), the patients were divided into 3 groups: 1) those who were found to have ATD-susceptible MBT; 2) those who had multiresistant MBT susceptible to all ATDs, other than isoniazid and rifampicin; 3) those with multidrug resistance. MBT genotyping in accordance with the polymorphism of the length of restriction fragments IS6110 has indicated that the strains of the families W and AI were prevalent in all the groups. However, the strains of mycobacteria of the W family were most frequently (62%) detected among the patients with tuberculosis with slight drug resistance. Treatment was performed in accordance with the data of tests of MBT for their susceptibility to chemical agents. Comparison of the efficiency of therapy failed to reveal any relationship of the genotype of the causative agent within the groups of patients with tuberculosis with different resistance of Mycobacteria, including those with slight drug resistance. At the same time, the pattern of drug susceptibility of MBT largely determined the frequency and trends of bacterial isolation cessation.

Data concerning chemotherapy of patients with multiresistant tuberculosis of the lungs by reserve antituberculous agents in combination with ofloxacin are presented. It was shown that the ofloxacin-including chemotherapy regimen applied to patients with multiresistant destructive tuberculosis of the lungs provided by the end of the 6-month treatment course elimination of multidrug resistant tubercle bacilli isolation at least in 80% of the patients and closure of the lung caverns after artificial pneumothorax and routine surgical interventions in more than half of the patients. For all this, side effects that could not be eliminated were stated merely in 8.5% of the patients.

The patients with multiresistant tuberculosis were divided into 2 groups: the sensitivity of Mycobacteria tuberculosis to antituberculous drugs was evaluated in Group 1 by the methods of absolute concentrations and in Group 2 by biological microchips determining mutations in the rpo3 gene responsible for rifampicin resistance. The results of the drug sensitivity test were obtained after 3 months of treatment in Group 1 and several days prior treatment in Group 2. By taking into account the test results, reserve drugs was used in Group 2 patients. Subsequently, the results of the drug sensitivity tests carried out by the bacteriological method in Group 2 patients showed that isoniazid resistance was simultaneously noted if there were mutations in the rpo-B gene. Timely treatment with reserve drugs exhibited higher efficiency of treatment with its shorter duration in Group 2 than in Group 1.

Two-stage standard chemotherapy was performed in 149 newly detected patients with pulmonary tuberculosis, by isolating Mycobacteria. Within the first 2 months, the patients received 4 drugs: isoniazid, rifampicin, pyrazinamide, streptomycin or ethambutol. Treatment with two agents (isoniazid and rifampicin) was continued for 4 months. Mycobacterial isolation was stopped in 104 patients after 2 months of treatment, in other 26 after 3 months, which amounts to 80.2%. Higher therapeutical results were observed in patients who had isolated Mycobacteria resistant to 1 and even 2 drugs.