In recent tuberculosis years is the main cause of morbidity and death among patients with HIV infection. Modern diagnostics of tuberculosis includes mass screening of the population: digital fluorography from the age of 15 and immunodiagnostics in children and adolescents. Detection of mycobacterium tuberculosis by microscopy occurs in forms of tuberculosis with the decay of lung tissue. Such patients represent a high epidemic risk. To improve the verification of diagnosis in the practice of a phthisiologist, molecular genetic methods for the search for mycobacteria are increasingly used, based on the identification of specific fragments of the DNA chain in the diagnostic material. The most widely used method is the polymerase chain reaction (PCR), which is based on directed DNA amplification. The latest innovation is fully automated systems using cartridge technology GeneXpert. The advantages of GeneXpert are high sensitivity, speed (result in 2 hours), real-time PCR detection, exclusion of sample contamination. The technique of cartridge technology is constantly being improved, various cartridges are used on its platform, which not only detect M. tuberculosis, but also determine the sensitivity to anti-tuberculosis drugs - rifampicin (MTB / RIF cartridge) or several anti-TB drugs (MTB / XDR). Cartridges have been developed that are able to detect Mycobacterium tuberculosis (MBT) at an even lower concentration in the test material - MTB / RIF (Ultra). GeneXpert technology can be used to diagnose extrapulmonary tuberculosis by examining various biological materials, which are more effective in detecting tuberculosis in children and adolescents, in HIV-positive individuals.

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Достоверным диагностическим критерием туберкулеза является обнаружение Mycobacterium tuberculosis в материале, полученном от больного. В статье дана информация о применении бактериоскопического, бактериологического, молекулярно-биологических методов выявления M. tuberculosis, представлены их характеристики с учетом преимуществ и недостатков. Для своевременной диагностики и успешного лечения туберкулеза все более широко внедряются инновационные методы выявления M. tuberculosis и определения лекарственной устойчивости. Ключевые слова:туберкулез; Mycobacterium tuberculosis; микроскопический метод; бактериологический метод; молекулярно-генетические методы; определение лекарственной чувствительности; биочипы; полимеразная цепная реакция в реальном времени Финансирование. Работа не имела финансовой поддержки. Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Currently, with the improvement of epidemic indicators for tuberculosis, the number of patients with drug-resistant forms of tuberculosis is increasing, which complicates and prolongs the treatment of such patients. The aim of the work is to study the drug resistance of Mycobacterium tuberculosis obtained from surgical material. Materials and methods: the study included 74 patients with medical and diagnostic operations on the chest organs. All patients were examined by standard methods: sputum and BAL microscopy with bronchoscopy (during the procedure), molecular genetic methods, culture on dense and liquid nutrient media. The diagnosis of tuberculosis was confirmed morphologically in all patients by histological examination of surgical material. When analyzing the results of drug resistance, it was found that among the newly identified patients, more than half (59.3%) had multiple (44.6%) p<0.005 and extensively drug resistance (14.7%) p= 0.003. At the same time, 74.5% (n= 35/47) of patients had no MBT in sputum before surgery. The frequency of development of drug resistance to first-and reserve-line antibacterial drugs, the structure of drug resistance depending on the group of dispensary registration is presented. A comparative analysis of drug sensitivity testing of MBT isolated from sputum before surgery and from surgical material was performed. The results of the study showed a high percentage of MBT drug resistance obtained in the operating material in patients with negative MBT tests. More than half of the patients who did not receive antibacterial therapy before surgery have multi drug resistance and extensively drug resistance, which suggests a high regional primary drug resistance of Mycobacterium tuberculosis.

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