We examined 137 patients with suspicion of renal TB. Based on the complex examination renal TB diagnosed in 53 patients, chronic nonspecific pyelonephritis – in 84 patients. Mycobacterium tuberculosis detected in 43.4% of patients with renal tuberculosis. Analysis of diagnostic efficiency proved that MBT in urine were detected more often by molecular and genetic method – 22.6%. The least sensitive method for detection of MBT in urine has been proved microscopy – 5.7% of cases. Sensitivity of cultural method was as much as 15.1%. Comparison of efficiency of molecular and genetic methods with traditional methods showed that Xpert MTB/RIF detected MBT in 52.2% of cases, which 4 times more often than microscopy and 1.5 times more often than cultural method (52.2%, 34.8% and 13%, respectively).

The problems of the combined administration of the third-line antituberculosis drugs – thioureidoiminomethylpyridinii perchloras (Perchlozon®), bedaquiline (Sirturo®), linezolid – in routine clinical practice in MDR/XDR TB patients. Based on the current clinical observation (totally 81 patients, in treatment effectiveness analysis included 74, among them 61 – sputum and/or culture positive at the treatment beginning), the clinical structure and followed-up groups of third-line TB-drugs users are evaluated. The high rate of the social disadaptation and seriously concomitant diseases (HIV, HVC) in these patients was obtained. The treatment results of the different drugs combinations are presented

After 5-year experience of pneumonectomy (2011–2015), we have analyzed the cases of complicated postoperative period and the ways to do with complications. We have performed 136 pneumonectomies. Complications were registered in 30 cases (22%). The main complications were empyema of post-operative thoracic cavity, insolvency of the mane bronchial tubes suture, which in some cases formed a bronchial fistula. Post-operation bleeding was rare (two cases); there was one case of hylothorax. In 28 complicated cases of pneumonectomy, we had to re-operate the patients but there were only two cases when the rethoracotomy itself was enough. The main method of treatment was thoracostomy followed by thoracomyoplastics, or thoracoplastics with drainage of postoperative thoracic cavity. Most of the patients operated (average age 30–35 years) had TB. For the young people whose aim is to socialize in society it is very important not only to preserve life and health but to avoid the post-operative deformation of thorax caused by 8–9 ribsthoracoplastics. This kind of operation performed in 25 cases. The new method of osteoplastic thoracomyoplastics makes it possible to minimize the defect of thorax and create the conditions for liquidation of the post-operative thoracic cavity. During the period described we have managed to perform one operation, one more was done in 2016 with no recidive of empyema.

The article discusses the results of the comparative of treatment effectiveness of HIV-positive patients with tuberculosis (TB/HIV+) and HIV-negative TB patients (TB/HIV–), based on cohort analysis for new pulmonary TB cases, and based on dispensary follow up data of TB/HIV+ and TB/HIV– patients.
It was showed a significant effect of HIV infection on the TB treatment effectiveness. Treatment effectiveness of new pulmonary TB patients registered in 2013-2014 in the TB/HIV+ cohort was only 56.0% at 84.2% in TB/HIV– cohort. The effectiveness of chemotherapy for TB relapse in TB/HIV+ cohort were also significantly lower than in TB/HIV– cohort of TB relapses – 47.4% against 68.4%. Methods of calculating used in the study allowed to compensate the negative impact of mortality from HIV infection to the cure and to evaluate a clinical component of treatment effectiveness. The difference in the successfully outcomes of treatment of new pulmonary TB patients cohorts of 2013-2014, calculated based on this approach, remained a major and statistically significant: 73.2% for TB/HIV+ cohort and 88.4% - for the TB/HIV– cohort.
Evaluation of TB treatment outcomes for MDR-TB patients showed better efficacy of treatment in TB/HIV+ cohort compared with the TB/HIV– cohort: 56.4% and 52.0% of the successfully rate of treatment.
On the basis of dispensary follow-up data for new respiratory TB patients, registered in 2014, the rate of bacteriological conversion data were significantly lower for TB/HIV+ patients in comparison with TB/HIV– patients: 78.2% and 93,8%, accordingly, as well as the rate of closure of lung cavities: 67.3% and 81.8% accordingly.

Pregnant women and women after childbirth are at risk of the tuberculosis. Tuberculosis among these patients is more severe, has its own features. For example, tuberculosis pleurisy among pregnant women is 4 times more often. The availability of specialized obstetrical Department in the structure of the leading TB institutions in Moscow increases the effectiveness of TB control among this important risk group.

Aims. To determine the incidence and clinical characteristics of tuberculosis medication-associated Clostridium difficile infection.
Methods. This single center study included patients from one hospital enrolled from 2013 to 2015. A retrospective analysis was conducted to identify the clinical features of C. difficile infection in patients who received TB medication.
Results. C. difficile infection developed in 36 of the 10675 patients prescribed TB medication, representing a total incidence of infection of 3.37 cases per 1,000 adults. 25 (69,4%) patients were treated with rifampin. The patients were usually treated with oral metronidazole, which produced improvement in 8 of the 12 (75,0%), combined treatment with oral vancomycin led to improvement in 7 of the 8 (87,5%). Rifampin was discontinued during CDI treatment for all patients. There were no significant differences in improvement between patients treated continuously (n=10) and patients in whom treatment was discontinued (n = 6).
Conclusion. The incidence of C. difficile infection after TB medication was not low considering the relatively low TB medication dosage compared to other antibiotics. It may not be always necessary to discontinue TB medication. Instead, decisions concerning discontinuation of TB medication should be based on TB status.

The article present the base principles of the health education in phthisiology and consider the historical aspects, definitions, background, aims and subjects of it. The different forms of the health education are detailed and defined approaches to this work in various population groups, such as: TB patients and their relatives, contacts, various groups of the healthy persons. Especially attention paid for difference and specific features in methods and procedures of the health education as the part of the tuberculosis control system for general population, tuberculosis patients and their contacts. The special section assigned for work in children and adolescents with tuberculosis and their parents. In conclusion, presented the typical peculiarities of the most demonstrative method of the education – the thematic leaflet and brochures, аnd the important role of the health education in the package of measures of the tuberculosis control.