The data on patients referred to the TB in-patient from general practice hospital in Moscow, 2016-2017, evaluated; include 861 immunocompetent patients and 431 HIV-positive. Demography and social status were analyzed, and the exact follow up the Russian guidelines in TB suspected patients management was checked.
The examination before TB-physician consultation was insufficient in the most part of patients: chest CT performed in less than 50%, sputum microscopy and/or DNA-tests in 30% HIV-positive and in 20% of HIV-negative. The immunological tests for TB diagnostic used less than 4% cases. As the result – the hyperdiagnosis of TB in general practice hospitals up to 40% in immunocompetent patients and 12% in HIV-infected.
In patients transmitted in TB hospital from other in-patient clinics for diagnosis confirmation the death rate was 9.5% (72% due to the TB progression) in HIV-negative and 23,5% in HIV-positive (73% due to the HIV-infection).
The essential wide implementation of the etiological confirmation of TB diagnosis pointed out.

The article is devoted to the analysis of the structure of the incidence, features of diagnosis, the clinical course of tuberculosis and the level of Mycobacterium infection with tuberculosis of foreign and Belarusian students of Belarusian universities. A complete retrospective study was conducted to analyze the characteristics of tuberculosis in 22 Belarusian and 22 foreign students of Belarusian universities in 2010–2016 and the results of tests for latent tuberculosis infection in practically healthy students (35 Belarusian and 24 foreign) were evaluated. In 22.8% of cases, tuberculosis in students developed as a result of family contact and was often accompanied by multiple drug resistance of the pathogen. Among foreign students, tuberculosis is an always diagnosed during preventive examinations mainly in the first two years of stay in the country (63.1%), which is explained by the stressful situation in the initial period of study and adaptation problems. In all cases, secondary tuberculosis is a diagnosed with a relatively rare multidrug-resistant pathogen.

Recently, the quantitative of drug susceptibility testing (DST) has become essential in mycobacteriology as the more informative method. We established MIC of linezolid against 219 strains of Mycobacterium tuberculosis most of them were MDR-MTB strains. It was found that 85.8% of strains were inhibited by linezolid concentrations limited from 0.25 to 1.0 μg/ml; values of MIC50 and MIC90 were 0.5 μg/ml, and 1.0 μg/ml consequently. We revealed a strong correlation (95,0%) between the results of DST performed by the serial microdilution method and BD BD ВACTECTMMGITTM 960 used as a reference method. Most of the investigated strains (90.4%) were susceptible and only 4.6% were resistant to linezolid.
In case of spreading of linezolid-resistant MTB strains, detection of the level of susceptibility/resistance of MTB by the serial microdilution method will have essential practical importance in mycobacteriology and treatment of TB.

The broth microdilution method (Sensititre® SlowMyco) allows to obtain quantitative data of the degree of susceptibility/resistance of mycobacteria strains. In the study of the drug sensitivity of M. kansasii and M. xenopi, most cultures of these species were found to be resistant to antituberculosis and to other antibacterial drugs used for the treatment of diseases caused by these non-tuberculosis mycobacteria. However, M. kansasii was more resistant to trimetho-Prim/ sulfamethoxazole and ciprofloxacin, and M. xenopi to ethambutol and ethionamide. It should be emphasized that a significant part (> 10%) of the strains of M. kansasii and M. кopi with intermediate sensitivity to many studied antibacterial drugs, which creates a certain reserve for the use of these drugs in the treatment of mycobacteriosis with a high degree of drug resistance of the pathogen.

We determined the levels of drug susceptibility of clinical strains of yeasts of the genera Cryptococcus (two species), Geotrichum (one species), Hanseniaspora (one species), Saccharomyces (one species), Saprochaete (one species), Rhodotorula (two species), isolated at diagnosing bronchopulmonary mycoses and central nervous system cryptococcosis. We established that amphotericin B and voriconazole were most active against fungi, which caused advanced mycoses. Susceptibility to triazoles correlated with strain species; low susceptibility to all triazoles was typical for Rhodotorula spp. Echinocandins activity was high against the ascomycetes (Geotrichum, Hanseniaspora, Saccharomyces, Saprochaete) and low against the basidiomycetes (Cryptococcus, Rhodotorula). We recommend performing in vitro susceptibility tests to major antimycotics for causative agents of cryptococcosis and rare yeast infections based on the established levels of initial susceptibility.

45 patients with pulmonary multidrug-resistant pulmonary tuberculosis who had pulmonectomy in the early postoperative period, in combination with the continuation of chemotherapy and antibiotic therapy, administered intravenous immunoglobulin pentaglobin to prevent broncho-pulmonary complications. Complications in the form of empyema of the pleural cavity without fistula formation were observed in two people (4.4%), who successfully performed step-bystep operations of thoracostomy and thoracomyoplasty.
In 45 patients from the comparison group, who were not administered in the early postoperative period, complications occurred more often (28.8%) and were more severe. The largest proportion among complications was attributed to the inconsistency of the stump of the main bronchus and the development of pleural empyema (46.7%), for the elimination of which stage operations were required. In 2 (13.3%) patients’ progression of the tuberculosis process in a single lung started, which led to their death. The fatal outcome within the first week after the operation resulted in the postoperative pneumonia of the single lung in 3 of 4 patients. As a result, one third of patients (33.3%) with the most severe complications died within 1 month after the operation.
Thus, the use of pentaglobin in the complex surgical treatment of patients with tuberculosis in the early postoperative period after pneumonectomy allowed significantly reducing the incidence of complications and avoiding deaths.

The scale for assessing the level of adherence of tuberculosis patients to treatment for individual assessment in the early stages of treatment was developed. A five-point scale was used, followed by division into two groups: patients with a high degree of adherence to treatment and patients with a low degree of adherence.
The scale was validated in 185 patients with tuberculosis in accordance with the criteria: 1. early discharge from the hospital due to a violation of the regimen; 2. The conversion rate of culture. An assessment was made of the sensitivity, specificity and prognostic value of assessing adherence based on a scale. The results of sensitivity and specificity at the level of 70-75% for both criteria indicate the desirability of further research.
It is assumed that the assessment scale of the patient’s adherence to treatment allows to predict the cases with low effectiveness of treatment and develop an individual program to improve it.

With the aim to study, the spread of HIV/TB coinfection in the North-West Federal Region, a descriptive epidemiological analysis was provided according to the Rosstat reporting forms from 2007–2017. Despite the decline in key indicators in recent years, the HIV/TB situation in North-West of Russia remains complicated with the uneven territorial co-infection prevalence. The least favorable regions are the Leningrad oblast and Saint Petersburg, where the most of HIV/TB cases are concentrated. The accelerated growth rates of tuberculosis incidence among HIV-positive population in the Arkhangelsk, Murmansk, Novgorod oblasts and the Komi Republic are alarming. Favorable regions includes the Nenets Autonomous Region, where during the survey period was not notified a single coinfection case and the Kaliningrad oblast, which came out of the high HIV/TB burden territories in survey period.
To improve the HIV/TB epidemic in the North-West of Russia, it is necessary to strengthen tuberculosis control measures among people living with HIV, and to strengthen intersectoral interactions.

The purpose of the article is to demonstrate the case of a disseminated process in the lungs of a patient suffering from systemic lupus erythematosus, which histologically was regarded as tuberculosis. Further differential diagnostic search made it possible to establish that pathological changes were caused by a pathogen of deep mycosis, endemic for the countries of the Western Hemisphere. In recent years, the frequency of sporadic cases of dangerous deep mycoses has increased beyond endemic areas. This is associated with the growth of tourists’ flows and migration to epidemically problem regions. The article reflects the difficulties of differential diagnosis in disseminated lung processes and provides basic data on the causative agents of deep endemic mycoses.

Laser (quantum) therapy is a new course in modern medicine. It based on the quantum – electromagnetic basis of nature. The laser medicine develops very fast. The first devices were bulky and, in the treatment, only one radiation source was used. With the advent of
semiconductor lasers they have become compact. Now they can add other sources to the laser radiation. There are some names to divide monolaser therapy from multifactorial – magneto-infrared-laser, polyfactor and quantum therapy. The article describes the history of the use of quantum therapy in phthisiology. The possibilities of laser therapy are analyzed when various forms of pulmonary tuberculosis are included in the complex treatment regimen.