The aim of our study was to features of the treatment outcome of patients with multidrug-resistant tuberculosis (TB) and Beijing lineage 2 (BL2) of MTB.

Methods. This is a prospective, cohort study of all patients with culture-confirmed pulmonary TB and MTB resistance to at least isoniazid and rifampicin. Bacterial DNA of MTB was isolated from 201 TB patients. Isolates were sequenced on Illumina platforms using a paired-end library design. Following the complete genome sequencing, we analyzed reads using the TB Profiler (version 3.0.6) software to compile detailed information about drug resistance variants.

Results. According to the results of treatment during the study period: cured - 81 (40.3%), completed - 17 (8.5%), died - 48 (23.9%), failure - 22 (10.9%), lost to follow-up - 33 (16.4%). Severe comorbid pathology was observed in 97 (48.3%) patients. It was first of all: Anemia - 48 (23.9%), HIV - 33 (16.4%), hepatitis of various etiologies - 26 (12.9%), diabetes - 8 (4%) and others. Most of the samples are from the BL2 (sub-lineage 2.2.1) (N=173, 86.1%). Euro-American lineage 4 (EA4) include 23 patients (11.4%). We also observed a combination of lines 2 and 4 (N=5, 2.5%). We observed that 39 (22.5%) patients with BL2 experienced death and treatment failure in the presence of severe comorbid pathology, while 17 (9.8%) patients recovered in the presence of other diseases (p=0.0013). 

Conclusions. For Kharkiv region, there is a characteristic high prevalence of BL2 in patients. In the presence of severe comorbid pathology and BL2, an unfavorable prognosis is observed in the form of failure or death from TB.