The article describes a clinical case of viral pneumonia associated with COVID-19 of the only lung, it developed in the patient 30 days after pleuropneumonectomy which was done to manage fibrous cavernous pulmonary tuberculosis. The favorable course of COVID-19 was due to its timely detection and initiation of treatment, and possibly, it was due to using anti-tuberculosis chemotherapy containing antibacterial drugs that prevented nosocomial infections.

The patient with severe viral-bacterial pneumonia and verified COVID-19 was successfully treated with surfactant therapy in the late respiratory phase of the disease, surfactant therapy was used to reduce the degree of hypoxemia and accelerate the weaning from non-invasive mechanical ventilation (NIMV). The native surfactant was administered with inhalations at the dose of 75 mg 2times a day on the 5th day of NIMV since SpO₂ values persisted to be 92-93% and did not improve. Positive changes were observed after 4 inhalations: SpO₂ reached 95% and then remained within the range of 94-97% with FiO₂ 90%. In total, the patient received 10 inhalations, then she was gradually transferred to breathing through an oronasal mask with humidified oxygen.

The objective: to determine risk factors of lethal outcomes (predictors) in tuberculosis patients treated with chemotherapy regimens I, II, III during confinement in the Russian penitentiary system.

Subjects and Methods: data on 6,069 patients registered for treatment in 2019 and 2020 were studied. Univariate and multivariate analyses were performed.

Results. The following factors were found to have effect on mortality: age (aOR = 1.05; 95% CI 1.03-1.06), multiple localizations of tuberculosis (aOR = 11.08; 95% CI 5.12-24.20), concurrent HIV infection (aOR = 9.13; 95% CI 6.90-12.24), and positive sputum microscopy at registration (aOR = 5.18; 95% CI 3.93-6.81). The patient gender was found to have no effect (OR = 0.9; 95% CI 0.4-1.9; p = 1).

The objective: to evaluate the possibility of using the baseline activity of adenosine deaminase (ADA) to predict effectiveness of therapy in patients with new infiltrative pulmonary tuberculosis (IPTB).

Subjects and Methods. Data of 121 patients with new infiltrative pulmonary tuberculosis were analyzed; patients were divided into groups according to therapy effectiveness.

Results., The discriminant analysis of data of new infiltrative pulmonary tuberculosis patients made it possible to obtain adiscriminant function which included the activity of ADA, the concentration of haptoglobin (HP) and ceruloplasmin (CP) – parameters reflecting that severity of the disease and protective potential of the host.

Conclusion. Analysis of ADA activity in combination with level of HP and CP allows the following: predicting effectiveness of the intensive phase of therapy before it begins in patients with new infiltrative pulmonary tuberculosis (with the accuracy of 77.0%); assuming that the reduction of ADA activity and inhibition of the inflammatory response may be useful for treatment of patients with new infiltrative pulmonary tuberculosis.

The objective: to evaluate the efficacy and safety of various anti-tuberculosis therapy regimens for multiple drug resistant (MDR) and extensive drug resistant pulmonary tuberculosis in the intensive phase of treatment lasting for 8 months minimum.

Subjects and Methods. A single-center cohort prospective-retrospective clinical study was conducted, which included 166 patients aged 18 to 70 years with active pulmonary tuberculosis and proven MDR of Mycobacterium tuberculosis, who received chemotherapy according to regimens IV and V. The treatment regimen of patients in Group I (n = 96) included modern anti-tuberculosis drugs (TBdrugs) – bedaquiline, linezolid, respiratory fluoroquinolone (levofloxacin, moxifloxacin, sparfloxacin), cycloserine, pyrazinamide, and perchlozone at a dose of 8-10 mg/kg, 1 time per day after meals during the intensive phase of treatment, that was at least 8 months. Patients from Group II (n = 70) received a respiratory fluoroquinolone (levofloxacin, moxifloxacin, sparfloxacin), aminoglycoside (amikacin), cycloserine, pyrazinamide, ethambutol, and prothionamide.

Results. After 3 months of treatment, symptoms of intoxication disappeared in 22 (81.5%) patients in Group I, and only 41 (61.2%) in Group II (p = 0.04; TTF). In patients of Group I versus Group II, the body temperature returned to normal within a shorter time: 2.8 and 4.3 weeks, respectively (p < 0.05). By the end of the intensive phase of treatment (8 months), sputum conversion confirmed by culture was observed more often in patients of Group I compared to Group II (85 and 80%, pχ2 = 0.003). Adverse events (AE) caused by TB drugs in Group I were observed significantly more often versus Group II: gastroenterological adverse events (pχ2 = 0.05), cardiac adverse events (pTTP = 0.05), and endocrinological adverse events (pTTP = 0.05). Neurotoxic AEs tended to develop more often in Group I (pTTP = 0.06). Ototoxic AEs were more frequently observed in Group II where the treatment regimens included aminoglycosides (pχ2 = 0.05). To maintain adequate chemotherapy regimens IV or V over long-term treatment, MDR tuberculosis patients need continuous monitoring of AEs, intravenous administration of two or three TB drugs, and timely therapy to manage manifestations of AEs.

The objective: to study prevalence and evaluate the efficacy of therapy and prevention of nonspecific urinary tract infection (NUTI) in tuberculosis patients as well as the possibility of combining them with anti-tuberculosis therapy.

Subjects and Methods. 936 patients with various localizations of tuberculosis at the age from 18 to 96 years old were examined. Men made 447 (47.8%), and women – 489 (52.2%). NUTI was diagnosed based on the following criteria: the presence of typical symptoms, leukocyturia and bacteriuria detected by urine microscopy, positive results of urine culture for nonspecific bacterial population, and negative urine tests for tuberculous mycobacteria.

Results. The prevalence of NUTI among tuberculosis patients made 174 (18.6%) out of 936 patients, it was found among all forms of TB but most frequently in urogenital tuberculosis (74.1%). Prophylactic treatment tactic (antibacterial therapy and the herbal formulation of Kanefron N) was offered. Treatment efficacy made 94.6%, while patients received anti-tuberculosis therapy, and the combination of drugs caused no adverse reaction in any patient. When choosing a therapeutic tactic, it is necessary to take into account the presence of structural and functional changes in the urinary tract which reduce treatment efficacy.

The objective: exploring the frequency of circulation of genotypes and alleles of rs2227983 polymorphism of EGFR gene among patients with allergic bronchial asthma with various levels of control.

Subjects and Methods. The study includes adult individuals (n = 396) divided into two groups: Group 1 (main) – individuals with allergic bronchial asthma (ABA), Group 2 is a control one. ABA Group consisted of 179individuals (118 women и 61 men) aged 37.4 ± 14.2 years. Control Group consisted of 217 individuals (110 women и 107 men) aged 30.0±9.1years. All subject included in ABA Group and Control Group underwent molecular genetic tests for rs2227983 polymorphism of EGFR gene using polymerase chain reaction.

Results. The comparison of distribution of gene EGFR genotypes showed statistically significant predominance of genotype AGcarriers in the group of patients with ABA (48.6%), versus Control Group (36.9%); p < 0.05. Besides that, there is a predominance of number of carriers of heterozygote genotype АG of EGFR gene among patients with ABA (57.7%) with a controlled course of the disease versus Control Group (36.9%); p < 0.05. Also, it has been found out that rs2227983 genotype of EGFR gene was more frequent in women with controlled ABA (67.4%) compared to women from Control Group (32.7%); p < 0.05.

Conclusion. The results of the conducted study allowed analyzing the connection of single nucleotide rs2227983 polymorphism ofEGFR gene with ABA including various levels of control of the course of the disease. Genotype АG of single nucleotide polymorphism rs2227983 of EGFR gene increases the risk of developing ABA. Alongside this, АG genotype of EGFR gene is correlated with the controlled course of ABA.

The objective: to compare treatment efficacy of pulmonary tuberculosis patients with multiple (MDR) and extensive drug resistance (XDR) using a standard chemotherapy regimen and the regimen containing bedaquiline.

Subjects and Methods. A retrospective study was conducted to analyze treatment outcomes in 219 patients with pulmonary tuberculosis and MDR/XDR of Mycobacterium tuberculosis (MTB) aged 18-75 years old who were treated in in-patient and out-patient facilities of St. Petersburg from 2016 to 2019. Treatment outcomes were analyzed by subgroups formed taking into account resistance patterns and addition of bedaquiline to the treatment regimens: Ia – n = 94 (MDR TB; Bq-) and IIa ‒ n = 80 (XDR TB; Bq-); Ib ‒ n = 22 (MDR TB; Bq+) and IIb ‒ n = 23 (XDR TB; Bq+). Clinical and laboratory parameters of patients, the severity of comorbidity were assessed before the start of treatment, after 3, 6, 12-14 and 18-24 months of therapy, as well as after therapy completion and during the follow-up period. Statistical analysis was carried out using Statistica 10.0 and methods of parametric and nonparametric statistics and the SPSS 16.0 software, where p ≤ 0.05 was considered significant.

Results. XDR TB patients in Subgroup IIb were significantly more likely to have a high level of comorbidity according to Charlson index (from 5 to 6 points) – in 34.7% of cases versus 5.0% in Subgroup IIa. At all stages of treatment in MDR TB patients with Bq+ (Ib), sputum conversion was recorded significantly more often versus patients of Subgroup Ia with Bq- when examined at all stages, with maximum effectiveness achieved by 18-24 months of treatment (90.9%). Treatment efficacy of XDR TB patients (IIb, Bq+) was also significantly higher versus treatment regimen containing no bedaquiline (60.8% (IIb, Bq+) versus 25.0% (IIa, Bq-), χ2 = 4.61, p < 0.05).

Conclusions. Achieved high efficacy of therapy in Subgroups Ib and IIb containing Bq provided a positive impact on treatment default rates, that were recorded in a low percentage of cases in those subgroups. An ineffective course of treatment in MDR TB patients treated with regimens containing no Bq was observed in 42.5% in Subgroup Ia, while this rate made only 0.09% in Subgroup Ib. Treatment effectiveness was the highest in XDR TB patients of Subgroup IIb when Bq was added to the treatment regimen.

The article reviews and analyzes 63 scientific publications devoted to new classes of antituberculosis drugs – DprE1 inhibitors. Currently, compounds BTZ-043, PBTZ-169 (makozinone), TBA-7371 and OPC-167832 are tested at different stages of clinical trials. DprE1 inhibitors are promising drugs with antituberculosis activity, which requires further clinical trials.