Objective. To study the duration of hospitalization of patients with mycobacteriosis and their need for outpatient (dispensary) observation in the year of their initial visit to the doctor and in the following 3 years.

Materials and methods. A retrospective cohort study included 397 patients with respiratory pathology, who were diagnosed with mycobacteriosis after outpatient and/or inpatient examination at the Central TB Research Institute (CTRI) in 2020–2024. Outpatient visits to patients over 3 years of observation and 404 cases of hospitalization were analyzed. Data were obtained from medical records and processed at the Federal Center for Mycobacteriosis, organized at the CTRI. NTM was identified using genotypic methods, including standardized kits.

Results. 100% of patients required outpatient follow-up at the Central Research Institute of Traumatology and Immunology within the first year of treatment, 46.9% within the second year, and 22.2% within the third year. The average number of visits per patient was 3.1; 2.9; and 2.5, respectively. 89.8% of patients required inpatient hospitalization within the current year of treatment, with repeat hospitalization within the first year being indicated for 15% of those hospitalized. 8.6% required hospitalization in the second year and 1.6% in the third year. The number of hospitalizations for chronically ill patients was 2.6 per patient. The average length of hospital stay was 27.5 days.

Objective. To classify the municipalities of Irkutsk Region based on the level of tuberculosis (TB) epidemiological situation in children and adolescents.

Materials and мethods. An assessment of clinical-epidemiological indicators of TB was conducted in 33 municipalities of Irkutsk Region in children, adolescents and adult, using data from forms No. 8 and No. 33 of the Federal Statistical Observation for 2020–2024, employing cluster analysis.

Results. A decline in TB incidence and prevalence is observed across all age groups in the Irkutsk Region, alongside uneven coverage of immunodiagnostics and fluorographic screening. Three groups of medical organizations in the Irkutsk Region were identified, differing in the incidence rates among children (p = 0.02) and the adult population (p < 0.001), including cases involving bacterial excretion (p < 0.001), lung destruction (p < 0.001), and fibro-cavernous TB (p < 0.001), as well as in TB mortality rates (p = 0.02). Differences were also noted regarding the proportion of children who completed a course of chemoprophylaxis (p = 0.04) and the average number of contacts identified at infection foci (p = 0.04).

Due to the widespread circulation of multi drug resistant (MDR) M. tuberculosis (MTB) strains it’s very important to determine MTB strains susceptibility to relatively new anti-TB drugs and repurposed antibacterial agents formed the basis of chemotherapy regimens and MTB resistance to them is a hallmark of pre-XDR and XDR.

The aim. Analysis of the results of culture-based drug susceptibility testing of clinical MDR MTB strains for bedaquiline, delamanid, linezolid, levofloxacin, and moxifloxacin in a centralized bacteriological laboratory and assessment the frequency of detection of pathogens with preand extreme drug resistance.

Materials and Methods. Our retrospective study included 171 clinical MDR MTB isolates from 171 patients with active TB. Drug susceptibility testing was performed with the help of a modified proportion method in the BactecTMMGITTM 960 automated system.

Results. The proportion of resistant strains to levofloxacin and moxifloxacin was 36.8% and 38.0%, respectively, the pathogen showed high cross-resistance (97%) to these drugs. The proportion of strains resistant to bedaquiline, delamanid, and linezolid was low: 1.2%, 4.7%, and 3.5%, respectively. 33.9% of strains were pre-XDR and 4.1% of all multidrug-resistant (MDR) strains were XDR. Conclusion. We determined high levels of resistance to fluoroquinolones, while bedaquiline delamanid, and linezolid retain high activity against MDR MTB strains. Systematic monitoring of resistance to anti-TB drugs of circulating MTB strains’ is essential for the timely detection and prevention of their potential speading.

Objective. To investigate the relationship between the prevalence of genitourinary tuberculosis and the clinical forms of respiratory tuberculosis, the presence of drug-resistant Mycobacterium tuberculosis (MBT), and HIV infection.

Materials and methods. A prospective observational study was carried out with the inclusion of 240 patients suffering from tuberculosis affecting the genitourinary system; among them, 231 had respiratory tuberculosis (27 were clinically cured); 123 patients had stage IV HIV coinfection. The disease process was classified as advanced if it was localized to two or more sites within the genitourinary tract or involved the genital organs.

Results. In the study cohort, advanced genitourinary tuberculosis predominated over localized disease (66.2% vs. 33.8%, respectively; p < 0.01). Advanced genitourinary tuberculosis was more frequently observed in patients with disseminated/miliary (89.1%) and infiltrative (81.8%) tuberculosis (compared to 10.9% and 18.2% for localized disease, respectively; p < 0.01), in cases involving drug-resistant pathogens (92.3% vs. 7.7%; p < 0.01), and in the absence of HIV infection (89.7% vs. 10.3%; p < 0.01).

Conclusion. Advanced forms of genitourinary tuberculosis most frequently often occur alongside disseminated (miliary) and infiltrative pulmonary tuberculosis, in the presence of drug-resistant Mycobacterium tuberculosis, and in HIV-negative patients.

Objective. To analyse predictors of treatment failure and their relationship with disease duration in patients with pulmonary tuberculosis caused by pre-extensively drug-resistant (pre-XDR) Mycobacterium tuberculosis.

Subjects and methods. A total of 247 HIV-negative patients with pre-XDR tuberculosis were examined and treated. Patients were divided into two groups: Group 1 – 49 individuals with newly diagnosed pulmonary tuberculosis caused by a pre-extensively drug-resistant pathogen; Group 2 – 198 previously treated patients.

Results. Significant predictors of treatment failure were identified: patient age under 40 years (OR = 4.15, 95% CI 2.78–6.42, p = 0.013), ineffective previous treatment of two or more courses (OR=3.95, 95% CI 1.68–5.21, p = 0.032), high comorbidity burden (OR = 3.45, 95% CI 1.56–5.36, p = 0.007), radiological signs of lung parenchymal destruction (OR = 4.26, 95% CI 1.86–5.72, p = 0.012), frequent development of adverse drug reactions (OR = 4.17, 95% CI 1.84–7.25, p = 0.037), low patient adherence (OR = 3.91, 95% CI 2.11–5.82, p < 0.0001), and the inability to undergo the surgical stage of treatment (OR = 11.5, 95% CI 5.6–23.8, p < 0.0001).

Conclusion. The duration of the tuberculosis process did not influence treatment effectiveness as measured by sputum conversion; however, a significant association was found between disease duration and the closure of destruction cavities. Identification of these predictors at the initial stage of chemotherapy may allow for timely adjustment of the pre-XDR TB treatment plan.

Aim. Was to study the clinical characteristics, causes of decompensation, and outcomes of hospitalizations in the intensive care unit (ICU) of tuberculosis patients without HIV infection.

Materials and methods. A retrospective cohort study was conducted of all ICU admissions of HIV-negative tuberculosis patients aged over 18 years to a specialized tuberculosis hospital between 2022 and 2025. Demographic data, clinical forms of tuberculosis, drug resistance profile of the pathogen, comorbidities, causes of critical conditions, laboratory parameters at ICU admission and transfer from the ICU, methods of intensive care, and treatment outcomes were assessed.

Results. The median age of HIV-negative patients, predominantly male (81.6%), was 44 years [33–62]. In the structure of clinical forms, disseminated (57.1%) and infiltrative (32.6%) tuberculosis were diagnosed; lung tissue destruction was detected in 75.6% of patients, bacterial excretion in 93.8%, pre-extensively drug-resistant (pre-XDR) TB was present in 28.6% of cases, and multidrug-resistant (MDR) TB in 10.1%. Diabetes mellitus was identified in 20.4% of patients. The main reason for ICU admission was acute respiratory failure (65.3%). Mechanical ventilation was required in 18.4% of patients. The median ICU length of stay was 5 days. ICU mortality was 18.4%, and overall, in-hospital mortality was 20.4%. Non-survivors had significantly higher leukocytosis at admission (median 10.6×10⁹/L vs. 8.5×10⁹/L, p=0.04). All deceased patients had destructive forms of tuberculosis with MDR/pre-XDR pathogen.

Currently, the only measure for primary specific prevention of tuberculosis is the use of the BCG vaccine. Its protective properties have been demonstrated in generalized tuberculosis in young children, but its effectiveness is low in adults. The BCG vaccine does not protect against latent infection and does not provide lifelong immunity against tuberculosis. The lack of established immune correlates of post-vaccination immunity makes it difficult to determine the duration of immunity and to justify the need for revaccination. In modern conditions, a significant group of unvaccinated children is formed due to parental refusals or medical exemptions. This cohort creates local areas of increased epidemiological risk within the population. Optimizing tuberculosis control in the context of incomplete vaccination coverage becomes a task of precision epidemiology that requires synchronization of preventive, diagnostic, and therapeutic measures.

Aim. Сomparative analysis of the effectiveness of BCG/BCG-M vaccination and revaccination in comparison with the dynamics of the epidemic process among non-BCG-M vaccinated individuals in different epidemiological conditions.

Materials and methods. Information was searched in MEDLINE/PubMed, Google Scholar, Scopus, and ELIBRARY databases, and manually in the libraries of the Moscow City Scientific and Practical Center for Tuberculosis Control; the Central Research Institute of Tuberculosis; and the State Central Scientific Medical Library. The 4,054 sources were identified, and 79 publications were selected for the review.

Results. Тhe analysis revealed inconsistencies and gaps in the data regarding the protective properties of the BCG/BCG-M vaccine. Further in-depth study of the long-term efficacy of vaccination in high-risk adults is required, as is the development of additional preventive measures for unvaccinated individuals.

The examination and treatment of patients with pulmonary tuberculosis lacking bacteriological confirmation can be challenging due to the absence of data on the pathogen species and its drug susceptibility. Since several lung diseases present with clinical and radiological features similar to tuberculosis, identifying the etiological agent is crucial.
This article discusses the utility of microbial marker mass spectrometry (MSMM) and 16S rRNA sequencing technologies for establishing disease etiology, illustrated by a clinical case of a patient diagnosed with pulmonary tuberculosis without bacteriological confirmation. During further examination using MSMM, 10-methyloctadecanoic acid, a marker of the order Mycobacteriales, was detected in the patient’s sputum and bronchial lavage samples. Subsequently, 16S rRNA sequencing revealed the DNA of Nocardia cyriacigeorgica. These results indicate the need to broaden diagnostic capabilities in cases where standard microbiological methods fail to establish the etiology of the disease.