title: Epidemiological analyses of tuberculosis in Archangelsk, Russia and implementation of a rapid assay for detection of resistance in this high burden setting.
abstract: BACKGROUND
  Tuberculosis (TB) is a major problem in Russia, particularly regarding multidrug-resistant tuberculosis (MDR-TB). Rapid drug susceptibility testing methods are therefore needed.
  
  
  OBJECTIVE
  To perform epidemiological analyses of TB in the Archangelsk region and to evaluate the molecular method GenoType®MTBDRplus in this type of setting.
  
  
  METHODS
  Clinical and microbiological data of all TB patients in Archangelsk were collected in 2010. Smear-positive sputa were analysed by MTBDRplus and Bactec MGIT 960.
  
  
  RESULTS
  The number of TB cases was 812 (incidence 65/105) and among these patients, 151 cases were registered in the penitentiary system (incidence 1162/105). Most patients were men, 94% had pulmonary TB and 22% were relapses. Out of all cases, 341 (42%) were smear positive and thus contagious and 176 (22%) had MDR-TB, among which one had extensively drug resistant tuberculosis (XDR-TB). Furthermore, two TB patients had strains being resistant to rifampicin, but susceptible to isoniazid. The number of cases being both contagious and MDR-TB was 128 representing 15.8% of all TB cases (incidence 10.2/105). Among these 128 TB patients 37 were relapses representing 25.7% of all the relapse cases. The results of MTBDRplus and Bactec MGIT analyses corresponded in 98.8%.
  
  
  CONCLUSIONS
  In Archangelsk many TB patients had contagious MDR-TB thus being hazardous in society and relapsing pulmonary TB was common. The TB situation in the prisons was particularly severe. The analyses showed furthermore that MTBDRplus is of major value in this setting.
authors.affiliation: Northern State Medical University, Archangelsk, Russia.
authors.forename: Platon I
authors.initials: PI
authors.lastname: Eliseev
authors.affiliation: Northern State Medical University, Archangelsk, Russia.
authors.forename: Andrey O
authors.initials: AO
authors.lastname: Maryandyshev
authors.affiliation: Northern State Medical University, Archangelsk, Russia.
authors.forename: Elena I
authors.initials: EI
authors.lastname: Nikishova
authors.affiliation: Regional Clinical Antituberculosis Dispensary, Archangelsk, Russia.
authors.forename: Irina V
authors.initials: IV
authors.lastname: Tarasova
authors.affiliation: Regional Clinical Antituberculosis Dispensary, Archangelsk, Russia.
authors.forename: Galina P
authors.initials: GP
authors.lastname: Gorina
authors.affiliation: Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Erja
authors.initials: E
authors.lastname: Chryssanthou
authors.affiliation: Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Göteborg, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Ridell
authors.affiliation: Department of Medicine, Division of Respiratory Medicine, Karolinska University Hospital, Stockholm, Sweden. Electronic address: lars-olof.larsson@karolinska.se.
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Larsson
keywords: Method evaluation; Rapid detection of MDR-TB; Russia; Tuberculosis epidemiology