Mycobacterium Tuberculosis Resistance — Stages of Drug Resistance Formation (Review)

Abstract

The review contains an analysis of the latest research on molecular genetic aspects of the formation of resistance in tuberculosis patients to avoid it during use of modern treatment programs. Objective — to assess the situation with the evolution of resistance of Mycobacteria tuberculosis and the stages of drug resistance development using materials from available databases. Materials and methods. The research has been completed for the period from 2014 to 2024. The next stage with the establishment of a systemic topological and metric computer analysis of the results allowed us to see the most informative sections of the research topic that are clearly associated with the formation mechanisms of drug-resistance in pulmonary tuberculosis. The most complete database of available literary sources was obtained (about 50 out of 502 analyzed arrays). Results and discussion. Ukraine is among the thirty countries with a high burden of tuberculosis with multiple drug resistance (MDR-TB). The main threat to the effectiveness of tuberculosis treatment in Ukraine is late detection of the disease and determining the sensitivity of the pathogen, which is the main prerequisite for prescribing adequate treatment. The situation with MDR-TB in Ukraine remains difficult in the conditions of war against the background of the COVID-19 pandemic. Thus, the total number of such cases for 2023 was 1,955 patients, of which 1,326 were new cases. The number of cases of tuberculosis with extended resistance (XDR-TB) was 228, of which 136 patients were diagnosed for the first time. Conclusions. The question of studying the genetic aspects of the formation of drug resistance of M. tuberculosis with the determination of the role of polymorphic variants of genes encoding xenobiotic metabolism systems in tuberculosis infection remains relevant to understand the mechanisms of interaction in the process of implementing hereditary information at the holistic level of the organism in order to increase the effectiveness of treatment and prevent the formation of resistance.