Received: 23.09.2025
Accepted: 25.12.2025
Published online: 20.03.2026
UDC: 616.24-002.5-036.87:615.33
DOI: 10.26212/2227-1937.2026.31.75.008
CLINICAL MANIFESTATIONS AND COURSE OF RECURRENT RESPIRATORY TUBERCULOSIS IN PATIENTS WITH DRUG-RESISTANT MYCOBACTERIUM TUBERCULOSIS
Dilmagambetov D.S. ¹, Tanzharykova G.N. ¹, Almagambetova A.S. ¹, YermekbayevaK.Zh. ¹, Zhalimova O.A. ¹, Ilyassov E.N. ²
¹ NJSC “West Kazakhstan Marat Ospanov Medical University”, Aktobe, Kazakhstan
² SCE on REM «Aktobe Regional Phthisiopulmonology Center», Aktobe, Kazakhstan
Introduction. Tuberculosis caused by drug-resistant Mycobacterium tuberculosis poses a serious threat to public health. Recurrent cases of respiratory tuberculosis with drug-resistant pathogens are of particular clinical importance, as they are characterized by an unfavorable course, a high rate of complications and low treatment effectiveness. Studying the clinical features of recurrent tuberculosis with drug-resistant strains of Mycobacterium tuberculosis is essential for optimizing
diagnosis and developing individualized treatment regimens.
Objective. To assess the clinical manifestations and course of recurrent respiratory tuberculosis in patients with drug resistant Mycobacterium tuberculosis.
Materials and methods. The study included 131 patients with drug-resistant respiratory tuberculosis who were treated at the Aktobe Regional Phthisiopulmonology Center from 2023 to 2025. The main group consisted of 87 patients with recurrent tuberculosis cases classified as “relapse” and “other,” while the control group included 44 patients with newly diagnosed tuberculosis (“new case”). Complaints upon hospital admission, risk factors, clinical and radiological forms, comorbidities, complications, laboratory and functional indicators were evaluated.
Results. In the main group, the majority were men (69.0%), urban residents (70.1%), and individuals without permanent employment (64.4%). Most patients were diagnosed based on self-referral (86.2%). The most common forms of tuberculosis were infiltrative (65.5%), fibrocavernous (21.8%) and disseminated (11.5%). Bilateral lung involvement was detected in 43.7% of cases, lung parenchymal destruction in 83.9% and bacteriological positivity in 90.8%. Tuberculosis
complications were observed in 90.8% of patients and comorbidities were present in 81.6%.
Discussion. The obtained results reflect an unfavorable social and clinical profile of patients with recurrent respiratory tuberculosis: predominance of working-age men, urban residents and individuals without permanent employment indicates a close association of the disease with social disadvantage. The high frequency of fibrocavernous and disseminated forms, accompanied by lung destruction and bacteriological positivity, reflects a prolonged and complicated course of the disease and poses an epidemiological threat amid the rise of drug resistance. The presence of complications and comorbidities highlights the severity of the condition and the need for a comprehensive approach. The identified features emphasize the importance of early diagnosis, prevention measures and improving treatment adherence.
Conclusion. Recurrent drug-resistant respiratory tuberculosis is characterized by a severe clinical course, a high frequency of complications and comorbid conditions.
Keywords: tuberculosis relapse, drug-resistant tuberculosis, drug resistance of the pathogen, multidrug-resistant and extensively drug-resistant tuberculosis.
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