Modern algorithms of geno-phenotypic diagnosis of tuberculosis in Ukraine


BACKGROUND. To ensure timely and accurate detection of tuberculosis (TB), including TB with multiple drug resistance in Ukraine, the document “Health Standards for TB” (Order of the Ministry of Health of Ukraine № 2161 of 06.10.2021), which the basis of laboratory diagnosis of TB is the use of modern molecular genetic methods and tested in the Central Reference Laboratory of Ukraine for microbiological diagnosis of TB.

RESULTS AND DISCUSSION. The article presents complex algorithms for the diagnosis and monitoring treatment of pulmonary TB using rapid molecular genetic methods. The basic principles and approaches to the diagnostic process, on which the domestic normative document is based, corresponds to those recommended by World Health Organization experts for the countries of the European region. When testing for TB, a molecular genetic test must be performed to detect the presence of Mycobacterium tuberculosis DNA in the diagnostic sample. Then (depending on the capabilities of the laboratory) one or another technology is used to detect mutations associated with the resistance of M. tuberculosis to the maximum possible range of AMBP I and II lines. After receiving the results of seeding in the automated system BACTEC MGIT, which is currently the gold standard for the study of drug sensitivity of M. tuberculosis to AMBP I and II lines, the treatment regimen is adjusted if necessary according to the phenotypic test of drug sensitivity.

CONCLUSIONS. According to the latest international guidelines for the diagnosis of TB, preference should be given to molecular genetic diagnostic tests and culture studies in liquid nutrient media. Microscopic and cultural studies are important and remain necessary to monitor treatment.

Keywords: algorithm for microbiological diagnosis of tuberculosis, rapid molecular genetic tests


Barbova A.I., Gemkova G.A., Zhurylo O.A. ta in. Zastosuvannya avtomatyzovanoi systemy MGIT dlya diagnostyky tuberculosu legen i vyznachennya medykamentoznoi stiykosti mycobacteriy. Metodychni rekomendacii. Кyiv, 2007. 24 p.

Zhurylo O.A., Barbova А.І., Glushkevych T.G. ta in. Systema zabezpechenna yakosti bacteriologichnych doslidgen u zakladach, sho zdisnuut microbiologichnu diagnostyku tuberculosu na riznych rivnach nadannya medychnoi dopomogy. Kirovograd, 2013. 71 p.

Zhurylo O.A., Barbova А.І., Gerebko N.M. ta in. Vykorystannya alternatyvnych zrazkiv u kartrydgach GeneXpert MTB/RIF і GeneXpert MTB/RIF Ultra dlya diagnostyky legenevogo i pozalegenevogo tuberculosu ta tuberculosu v doroslych i ditey Ukraini. Metodychni rekomendacii. Кyiv, 2021. 19 p.

Nakaz MOZ Ukrainy vid 27.06.2019 № 1462 “Instruktiya z mikrobiologichnoi diagnostyky tuberculoznoi infekcii”.

Nakaz MOZ Ukrainy vid 06.10.2021 № 2161 “Standarty okhorony zdorovya pry tuberculosi».

Feschenko Yu.I., Zhurylo O.A., Barbova А.І. ta in. Strategichni napryamy rozvytku laboratornoi diagnostyky tuberculosu v Ukraini. Кyiv, 2017. 120 p.

Feschenko Yu.I., Zhurylo O.A., Barbova А.І. Laboratorna diagnostyka tuberculosnoi infekcii. Кyiv, 2019. 304 p.

Ciftci I.H., Karakece E. Comparative evaluation of TK SLC-L, a rapid liquid mycobacterial culture medium, with the MGIT system. BMC Infect. Dis. 2014; 14: 130. doi: 10.1186/1471-2334-14-130.

Cruciani M., Scarparo C., Malena M., et al. Meta-analysis of BACTEC MGIT 960 and BACTEC 460 TB, with or without solid media, for detection of mycobacteria. J. Clin. Microbiol. 2004; 42 (5): 2321-2325. doi: 10.1128/jcm.42.5.2321-2325.2004.

Dara M., Ehsani S., Drobniewski F., et al. Algoritm laboratornoi diagnostiki i monitoringa lecheniya tuberculosa legkich i tuberculosa s lekarstvennoi ustoichivoctu na osnove primeneniya sovremennich bistrich molecularnich metodov. Available at:

Kovalenko O.P., Volynets G.P, Rybak M.Y., et al. Dual-target inhibitors of mycobacterial aminoacyl-tRNA synthetases among N-benzylidene-N’-thiazol-2-yl-hydrazines. Medchemcomm. 2019; 10 (12): 2161-2169. doi: 10.1039/c9md00347a.

Pfyffer G.E., Wittwer F. Incubation time of mycobacterial cultures: how long is long enough to issue a final negative report to the clinician? J. Clin. Microbiol. 2012; 50 (12): 4188-4189. doi: 10.1128/JCM.02283-12.

Said H.M., Ismail N., Osman C., Hoosen A.A. Evaluation of TBc identification Immunochromatographic assay for rapid identification of Mycobacterium tuberculosis complex in samples from broth cultures. J. Clin. Microbiol. 2011; 49 (5): 1939-1942. doi: 10.1128/JCM.01906-10.

Yang S., Wang F., Yang D., et al. Case report of false rifampin resistance with Xpert® MTB/RIF from an HIV infected patient. Clin. Lab. 2020; 66 (11). doi: 10.7754/Clin.Lab.2020.200409.

Werngren J., Klintz L., Hoffner S.E. Evaluation of a novel kit for use with the BacT/ALERT 3D system for drug susceptibility testing of Mycobacterium tuberculosis. J. Clin. Microbiol. 2006; 44 (6): 2130-2132. doi: 10.1128/JCM.02218-05.

World Health Organization. WHO sets up an Advisory Group on TB Diagnostics and Laboratory Strengthening. 2021. Available at:

World Health Organization. Implementing tuberculosis diagnostics: policy framework. 2015. Available at:

World Health Organization. Catalogue of mutations in Mycobacterium tuberculosis complex and their association with drug resistance. 2021. Licence: CC BY-NC-SA 3.0 IGO.

How to Cite
Zhurylo, O., & Barbova, A. (2022). Modern algorithms of geno-phenotypic diagnosis of tuberculosis in Ukraine. Infusion & Chemotherapy, (3), 13-20.

Author Biographies

O.A. Zhurylo, National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky of the NAMS of Ukraine, Kyiv, Ukraine

Zhurylo Oleksandr Anatoliiovych
Chief of the laboratory of microbiology and biochemistry of tuberculosis
MD, professor.
10, M. Amosova st., Kyiv, 03038, Ukraine.
Тел: +38 (044) 275 54 30.

A.I. Barbova, National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky of the NAMS of Ukraine, Kyiv, Ukraine

Barbova Anna Ivanivna
S.R. of the laboratory of microbiology and biochemistry of tuberculosis; head of the Reference laboratory for microbiological diagnosis of tuberculosis of the NAMS and the Ministry of Health of Ukraine.
10, M. Amosova st., Kyiv, 03038, Ukraine.