Drug resistance of Mycobacterium tuberculosis in the Ural region of Russian Federation

<b>Introduction:</b> Study of Regional mycobacterium tuberculosis (MBT) Drug Resistance (DR) allows to adopt treatment strategy in regions with high burden of XDR-TB. <b>Aims and Objectives:</b> To assess the frequency and spectrum of DR to first and second line drugs in the Ural regions. <b>Methods:</b> Multicenter trial in the six regions (Kurgan, Sverdlovsk, Tyumen, Chelyabinsk, Khanty-Mansiysk and Yamalo-Nenets) of the Ural was conducted in 2018. Totally 3.953 new TB cases patients and 1650 retreatment TB cases were registered. 1931 new TB cases and 1650 retreatment (relapse and chronic TB patients) have culture confirmation of TB. DST results for H; R; E; Z, Ofx, Lfx, Mfx, Km, Am, Cm were available for 1,852 new TB cases and 943 retreatment TB cases. <b>Results:</b> Among new TB cases: DR-TB was detected in 56.6% [95%CI 53.6-59.5], including Z and E resistance respectively in 9.1% [95%CI 7.5-9.8] and 25.0% [95%CI 22.5-27.6]. MDR-TB in 30.6% [95%CI 27.9-33.4] cases. Pre-XDR-TB with resistance to SLD injectable was found in 6.5% [95%CI 4.1-9.5] and pre-XDR-TB with resistance to Fq in 9.0% [95%CI 6.2-12.3] out of new MDR-TB cases. XDR TB was found in 12.2% [95%CI 8.9-15.9] out of MDR-TB cases. Among retreatment cases: DR-TB was detected in 83.5% [95%CI 80.2-86.5], MDR-TB in 45.6%, [95% CI 41.4-49.8]. Pre-XDR-TB with resistance to SLD injectable was found in 9.1% [95%CI 5.8-12.9] and with resistance to Fq in 7.4% [95%CI 4.5-11.0] out of new MDR-TB cases. XDR TB was found in 19.0% [95% CI 909-18.5] out of MDR-TB cases. <b>Conclusions:</b> In the Ural regions there is distribution of MDR strains with high level DR to first and second line drugs including XDR TB among new TB cases and retreatment cases in 12.2% and 19.0% respectively.