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Objective: To study the role of the implantable port system (IPS) in the treatment of pulmonary tuberculosis with multiple and extensively drug resistance (MDR TB, XDR TB). Methods: Since September 2017, IPS (POLYSITE 4008 ECHO) implanted in seven patients (4 men and 3 women) with MDR and XDR forms of pulmonary tuberculosis in the age of 30 to 60 years. All IPS implanted under the local anesthesia in the operation room. Port system installed with catheterization of the subclavian vein, mainly on the right. All these patients at the time of IPS installation received a short course of chemotherapy with new and before profiled preparations after having passed through a Consultation on drug-resistant tuberculosis. Results: The use of IPS for patients with MDR TB and XDR TB pulmonary tuberculosis demonstrated a high level of commitment to treatment. Only in one case, the infection and suppuration of punction area took place in short-term period. This complication was corrected by secondary surgical treatment and overlay of secondary seams. Conclusion: The preliminary results of the IPS application for seven patients with MDR TB and XDR TB demonstrated high safety and effectiveness of the technique, which allows recommending it, be for further expanded use in the treatment of this patients.

Objective: To study the incidence of tuberculosis (TB) among employees of medical organizations (EMO) of the Kyrgyz Republic (KR) in 2015-2017. Methods: The analysis is subject to the state reporting forms № 17 "On medical personnel" and № 8 "About diseases with active tuberculosis" for 2015-2017, the electronic database of new cases of TB in EMO in 2015-2017. The data processing was used the SPSS-16. Results: Morbidity rates of TB in EMO in the KR in 2015 and 2016 years exceeded the epidemic dangerous threshold for TB (50.0 per 100,000 people) by 37.4% and 13.4%, respectively. The incidence of TB in the EMO of the tuberculosis-care service in 2015 was 3.3 times higher than that of the EMO of the general treatment network, and in 2016 – 1.5 times. More commonly infected with TB the EMO, professionally closely contacting patients in the provision of medical care or in the care of them, or working in epidemically dysfunctional regions. The highest rates of TB morbidity were registered in Osh (2015 – 123.5, 2016 – 125.0 and 2017 – 92.6 per 100 thousand EMOs, respectively). Conclusion: The high rate of TB morbidity among RMS is due to: the unfavorable situation of TB in the Kyrgyz Republic, the high degree of risk of infection in the performance of their professional duties and the lack of adequate levels of alertness among employees, the insufficient level of their TB awareness, errors in compliance with the rules of infectious control regulations in medical organizations.

Objective: To study the clinical course of multiple drug resistance in patients with tuberculous spondylitis in the Kyrgyz Republic. Methods: Analyzed 877 medical histories of patients with tuberculous spondylitis of the cervical, thoracic, lumbar and lumbosacral spine, which was on treatment in the Department of Bones and Joints Tuberculosis Surgery from 2013 to 2017. Results: It is established that 715 patients (81.5%) had a sensitive form of tuberculous spondylitis; 153 (17.4%) is primarily resistant and 9 (0.8%) is a secondarily resistant form. In the group of patients in the sensitive form of tuberculosis men were 370, women 345, and among the patients with the resistant form of tuberculous spondylitis of men and women were 86 and 76 people respectively. Conclusion: Over the period of 2013-2017 y., the Kyrgyz Republic marked the growth in multi-drug resistant forms of tuberculous spondylitis with the rapid development of formidable neurological complications, such as meningitis, paresis, paraparesis, paralysis, and dysfunctions of pelvic organs.