Development of extensively drug-resistant tuberculosis during multidrug-resistant tuberculosis treatment.

Rationale: Extensively drug-resistant (XDR) tuberculosis (TB) may arise in individuals on treatment for multidrug-resistant (MDR) TB. Preventing this amplification of resistance will likely improve clinical outcomes and delay the secondary spread of XDR-TB.

Objectives: To measure the proportion of individuals that develops XDR-TB during the course of MDR-TB treatment, and to identify those factors associated with the development of XDR.

Adverse reactions among patients being treated for MDR-TB in Tomsk, Russia.

Background And Significance: Treatment of multidrug-resistant tuberculosis (MDR-TB) is challenging because of the toxicity of second-line medications. Little is known about whether adverse events impact treatment outcome.

Methods: We conducted a retrospective case series of 244 MDR-TB patients enrolled in Tomsk between 10 September 2000 and 10 September 2002.

Treatment outcomes in an integrated civilian and prison MDR-TB treatment program in Russia.

Setting: Multidrug-resistant tuberculosis (MDR-TB) is a major problem in countries of the former Soviet Union in both the civilian and prison sectors.

Objective: To evaluate outcomes of the MDR-TB treatment program (DOTS-Plus) in Tomsk, Russia.

Design: Retrospective case series of all patients enrolled in this program between 10 September 2000 and 10 September 2002.

[Laboratory service optimization in the implementation of a complex programme for detection and treatment patients with tuberculosis].

The paper presents a model of laboratory service in implementing a complex program aimed at detecting and treating patients with tuberculosis in the Tomsk Region. Organizational, methodological, and managerial measures to set up bacteriological stations and a main (reference) laboratory for microbiological sputum study in Tomsk, intensification of this work at all clinical-and-diagnostic laboratories of general health care facilities have improved the quality of the whole system detecting bacterial isolators and ensured a close organizational and methodological interaction between the therapeutic-and-diagnostic institutions of the general medical system and tuberculosis-controlling service.