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CNAA / Theses / 2018 / July /

Contemporary aspects of pulmonary tuberculosis in dependence of Mycobacteria Sensitivity

Author: Malic Alina
Degree:doctor of medicine
Speciality: 14.00.26 - Phtisiopneumology
Scientific adviser: Aurelia Ustian
doctor, associate professor (docent)
Scientific consultant: Valeriu Crudu
doctor, associate professor (docent)
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova


The thesis was presented on the 5 July, 2018
Approved by NCAA on the 23 November, 2018


Adobe PDF document0.89 Mb / in romanian


CZU 616.24-002.5+616-097

Adobe PDF document 4.84 Mb / in romanian
155 pages


pulmonary tuberculosis, Xpert MTB/RIF test, conventional cultural method (Lowenstein-Jenssen), treatment efficacy


Field of study: Medical sciences; General medicine; 321.07 - Phthisiopneumology.

Aim: Studying of the clinical aspects and the treatment efficacy patients with pulmonary tuberculosis in dependence on the microbiological and molecular-genetic methods results.

Objectives: 1) Determination of the favorable factors (epidemiological, social, medical-biological) in the development of resistant forms of tuberculosis; 2) Analysis of clinical- radiological particularities and paraclinical examinations results in patients with susceptible and resistant tuberculosis; 3) Evaluation of molecular - genetic and microbiological methods results in patients with pulmonary tuberculosis; 4) Evaluation of the treatment efficacy in dependence of molecular-genetic and cultural methods results; 5) Developing of practical recommendations for early detection and shortening of the resistant tuberculosis treatment duration.

Scientific novelty and originality: clinical and radiological particularities and favorable factors in the development of resistant forms in patients with pulmonary tuberculosis examined by Xpert MTB/RIF and the cultural method will be studied. The importance of the molecular-genetic method compared with conventional microbiological methods will be appreciated. The effectiveness of treatment in patients with sensitive and resistant tuberculosis in dependence of the microbiological and molecular-genetic methods results will be analyzed.

The important scientific problem was solved in this research.Consists in establishing of the clinical-microbiological particularities and treatment efficacy that differentiate the resistant tuberculosis patients detected by the Xpert MTB/RIF test and the resistant tuberculosis patients identified by the cultural method, allows identification of measures to improve the early detection of resistant tuberculosis and prompt administration of treatment with second line drugs.

Theoretical significance of this researchconsist in introduction of the molecular-genetic method and comparative analysis with conventional bacteriological methods, which will contribute to the early detection of resistance mycobacteria for the one of the most important anti-tuberculous drug - Rifampicin. The data obtained in this study will give us possibility to initiat appropriate treatment immediately after the detection of resistant mycobacteria, which will help to improve treatment outcomes and will shorten the duration of resistant tuberculosis treatment.

The value of the research.The results obtained from the study will give us the opportunity to improve the algorithm of the diagnosis of suspects TB MDR persons and the antituberculous treatment of TB MDR patients.

Implementation of scientific results.The results of the study will be applied in the practical activity of the departments of pneumophthysiology of the medical institutions in the country and will provide a methodological support in the individualized assessment of the sensitive and resistant pulmonary tuberculosis. At the same time, the practical recommendations will be implemented in the work of family doctors and phthysiopneumologists, didactic process for medical students and doctors