Phthisiology

doi: 10.25005/2074-0581-2018-20-2-3-198-201
PECULIARITIES OF THE CLINICAL COURSE OF THE MULTI-DRUG RESISTANT FORM OF TUBERCULOUS SPONDYLITIS IN THE KYRGYZ REPUBLIC

M.D. Abdiev, M.K. Kubatbekov, D.A. Kushubakov, О.R. Botobekov, E.A. Baynazarov

Department of Bones and Joints Tuberculosis Surgery, National Center for Phthisiology, Bishkek, Kyrgyz Republic

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.

Conclusions: 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.

Keywords: Multiple drug resistance, spinal tuberculosis, bacteriological study of the pathological material.

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References
  1. Lavrov VN. Diagnostika i lechenie bol’nykh tuberkulyoznym spondilitom [Diagnosis and treatment of patients with tuberculous spondylitis]. Problemy tuberkulyoza i bolezney lyogkikh. 2001;4:30-2.
  2. Sterlikov SA, Testov VV. Effektivnost' lecheniya bol'nykh tuberkulyozom s mnozhestvennoy lekarstvennoy ustoychivost'yu vozbuditelya, zaregistrirovannykh v 2010 g [The effectiveness of treatment of patients with multidrug-resistant tuberculosis, registered in 2010]. Tuberkulyoz i bolezni lyogkikh. 2014;3:12-7.
  3. Vyazovaya AA, Solovyova NS, Zhuravlyov VYu, Mokrousov IV, Manicheva OA, Vishnevsky BI. Molekulyarno-geneticheskaya kharakteristika shtammov M. tuberculosis, vydelennykh ot bol’nykh tuberkulyoznym spondilitom [Molecular-genetic characteristics of Mycobacterium tuberculosis strains isolated from patients with tuberculous spondylitis]. Zhurnal mikrobiologii, epidemiologii i immunobiologii. 2013;5:20-7.
  4. Sovetova NA, Vasilyeva GYu, Solovyova NS, Zhuravlyov VYu, Baulin IF. Tuberkulyoznyy spondilit u vzroslykh (kliniko-luchevye proyavleniya) [Tuberculous spondylitis in adults (clinical and radiological manifestations)]. Tuberkulyoz i bolezni lyogkikh. 2014;2:10-4.
  5. Stakhanov VA, Batyrov FA, Borisova MI. Vnelyogochnyy tuberkulyoz v programmakh obucheniya na razlichnykh etapakh meditsinskogo obrazovaniya [Extrapulmonary tuberculosis in training programs at various stages of medical education]. Tuberkulyoz i bolezni lyogkikh. 2011;5:172-3.
  6. Adambekova AD, Adambekov DA, Litvinov VI. Test XPERT MTB/RIF dlya diagnostiki tuberkulyoza i ustoychivosti k rifampitsinu – rezul'taty vnedreniya v Kyrgyzskoy Respublike [XPERT MTB / RIF TEST for diagnosis of tuberculosis and resistance to rifampicin – results of introduction in the Kyrgyz Republic]. Tuberkulyoz i bolezni lyogkikh. 2014;1:34-6.
  7. Sikalengo G, Ramirez A, Faini D. Tuberculous spondylitis diagnosed through Xpert MTB/RIF. BMC Infect Dis. 2016;16:514.
  8. Tortoli E, Russo C, Piersimoni C. Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis. European Respiratory Journal. 2012;40(2):442-7.
  9. Gu Y, Wang G, Dong W. Xpert MTB/RIF and GenoType MTBDRplus assays for the rapid diagnosis of bone and joint tuberculosis. International Journal of Infectious Diseases. 2015;36:27-30.
  10. Smerdin SV, Tsybulskaya YuA, Shutikhina IV, Ratobylskiy GV, Selyukova NV, Baturin OV. Vozmozhnosti luchevoy diagnostiki tuberkulyoznogo spondilita [Possibilities of radiation diagnosis of tuberculosis spondylitis]. Tuberkulyoz i bolezni lyogkikh. 2014;7:65-70.
  11. Burlakov SV, Oleynik VV, Vishnevskiy AA. Vliyanie dlitel'nosti zabolevaniya tuberkulyoznym spondilitom na razvitie oslozhneniy [Influence of duration of tuberculous spondylitis on the development of postoperative complication]. Travmatologiya i ortopediya Rossii. 2013;1:61-6.
  12. Colmenero JD, Ruiz-Mesa JD, Sanjuan-Jimenez R, Sobrino B, Morata P. Establishing the diagnosis of tuberculous vertebral osteomyelitis. European Spine Journal. 2013;22(4):579-86.
  13. De Backer AI, Mortelé KJ, Vanschoubroeck IJ, Deeren D, Vanhoenacker FM, De Keulenaer BL, et al. Tuberculosis of the spine: CT and MR imaging features. JBR-BTR. 2009;88:92-7.
  14. Trecarichi EM, Di Meco E, Mazzotta V, Fantoni M. Tuberculous spondylodiscitis: epidemiology, clinical features, treatment, and outcome. Eur Rev Med Pharmacol Sci. 2012;16 (Suppl 2):58-72.
  15. Shen Y, Zhong W, Peng D, Lu C, Xiong G, Li D, Deng Y, Tan L. Atypical, multilevel and noncontiguous tuberculous spondylitis that affected the vertebrae of thoracic, lumbar and sacrum: a case report. Int J Clin Exp Med. 2015;8:3006-9.
  16. López-Sánchez MC, Calvo Arrojo G, Vázquez-Rodríguez TR. Tuberculous spondylodiskitis with lumbar tumor. Reumatol Clin. 2012;8:292-3. Available from: http://dx.doi.org/10.1016/j.reuma.2011.10.011.
  17. Kandwal P, Jayaswal A. Management of tuberculous infection of the spine. Asian Spine J. 2016;10:792-800. Available from: http://dx.doi.org/10.4184/asj.2016.10.4.792.

Authors informations:

Abdiev Marat Dzhumadylovich, Candidate of Medical Sciences, Deputy Director for Science of the National Center for Phthisiology

Kubatbekov Munarbek Kubatbekovich, Head of the Department of Bones and Joints Tuberculosis Surgery, National Center for Phthisiology

Kushubakov Danil Amankulovich, Phthisiatrician of the Department of Bones and Joints Tuberculosis Surgery, National Center for Phthisiology

Baynazarov Elchibek Abdulakhatovich, Researcher, Department of Bones and Joints Tuberculosis Surgery, National Center for Phthisiology

Botobekov Oskon Rakhmatzhanovich, Researcher, Department of Bones and Joints Tuberculosis Surgery, National Center for Phthisiology

Address for correspondence:

Abdiev Marat Dzhumadylovich

Candidate of Medical Sciences, Deputy Director for Science of the National Center for Phthisiology

720020, Kyrgyz Republic, Bishkek, Akhunbaev str., 90a

Tel.: (+996) 312 570925

E-mail: marat.abdievtbc@gmail.com

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