Abstract
Introduction: the clinical and epidemiological features of tuberculosis infection is not always possible to determine the exact time and place of infection, and therefore identify with certainty the source and circumstances of infection.
Aim: to establish risk factors for relapse and progression of pulmonary tuberculosis in patients with multiple admissions to TB hospital.
Material and methods: a retrospective epidemiological case-control study. Were used the data of medical records of 163 patients admitted to a TB hospital more than once in the years 2009-2013. Spoligotyping, MIRU-VNTR- and IS6110-RFLP-typing of 73 serial isolates of Mycobacterium tuberculosis 34 patients with pulmonary tuberculosis (relapse-10,progression-24).
Results: a risk factor for the relapse or the progression of the TB process was the discontinuation of the treatment,p<0,001. All cases of relapse and 79.2% of TB progression were caused by M.tuberculosis - Beijing. Variability of drug susceptibility profiles, IS6110-RFLP and MIRU-VNTR patterns were observed among serial isolates of M. tuberculosis genotypes Beijing (profiles B0,A0,A10) and LAM9 (SIT252,SIT150). The genotype variability of serial isolates from 5 (14.7%) of 34 patients was due to mixed infection and/or exogenous infection in TB hospital. The risk of exogenous infection with MDR strains of M. tuberculosis was associated with multiple admissions to TB hospital,p=0.02.
Conclusion The risk of MDR/XDR strains of exogenous infection with M. tuberculosis is associated with multiple admissions to specialized TB hospital. The risk factor of relapse or progression of the process was the failure of the treatment.
- Copyright ©the authors 2016