The objective: to assess the efficacy of tuberculosis preventive treatment (TPT) in children with latent tuberculosis infection (LTBI) and without risk of multidrug-resistant tuberculosis (MDR-TB), and to identify the advantages of video-observed therapy.

Materials and Methods. A cohort of 572 children aged 0 to 17 years (inclusive) with LTBI and positive recombinant tuberculosis allergen (RTA) tests was analyzed. Children with exposure to multi-drug resistant tuberculosis (MDR-TB) were excluded from the study. TPT was administered to 480 (83.9%) children: Group I (no known TB exposure) – n=295, Group II (known TB exposure) – n=163, Group III (video-observed TPT) – n=22 children (no known TB exposure). Parents of 92 (16.1%) children (Group IV) refused TPT. Video-observed therapy was conducted via the Yandex Telemost platform. Statistical analysis was performed using the SPSS 17.0 software package.

Results. Within two years after TPT, 13.04% of children in Group IV developed TB compared with 0.34% in Group I and 1.8% in Group II, no cases were observed in Group III. No adverse reactions (ARs) were reported in children receiving video-observed therapy (Group III), whereas in Groups I and II ARs were reported in 20.0% and 39.9% of children, respectively (p<0.05). Reported ARs were mild. A reduction in local response to the recombinant tuberculosis allergen test (Diaskintest) was observed among children who received TB preventive treatment: 87.5% in Group I, 79.1% in group II, and 86.4% in group III, compared with only 26.1% in those who did not receive TB preventive treatment (Group IV) (p < 0.05). Conclusions were drawn regarding the efficacy and safety of video-observed TPT.

The objective: to evaluate the toxicity of bedaquiline and delamanid combined with linezolid or sutezolid (Szd) in a rat model.

Materials and methods: Rats in the experimental groups (EG) were orally administered Bdq+Dlm+Lzd (EG1) or Bdq+Dlm+Szd (EG2). Rats in the control group (CG) orally received 1% starch gel. For all groups, the administration period lasted 14 days. Subsequently, functional, hematological, biochemical, and pathomorphological tests were conducted, with results compared between the experimental groups and the control group.

Results: Prolongation of QT and RR intervals on ECG and similar signs of toxic cardiomyopathy development were observed in rats of both experimental groups, driven by the effects of delamanid and bedaquiline on the cardiac conduction system. Based on functional and morphological criteria, the hepatotoxic properties of the combination containing sutezolid were less pronounced. Evidence of tubulointerstitial nephritis was detected exclusively in EG1 rats. Hematological changes were similar in both experimental groups and transient in nature; however, granulocytopenia, lymphocytopenia, and thrombocytopenia occurred at earlier stages when linezolid was used.

The objective: to investigate the diversity and distribution of antibiotic resistance genes within the fecal microbial community of patients with pulmonary tuberculosis (TB) compared to controls, and to analyze the impact of long-term multicomponent chemotherapy on the fecal resistome structure in TB patients.

Materials and methods. Metagenomic DNA samples obtained from fecal specimens of pulmonary TB patients and healthy individuals were used in this study. The matagenomic data analysis was performed using the microbiome R package and the Comprehensive Antibiotic Resistance Gene Annotation Database (CARD)

Results. The fecal microbial community of TB patients demonstrates high diversity of antibiotic resistance genes compared to healthy controls. TB therapy slightly reduces the diversity of resistance genes. Tetracycline resistance genes are the most abundant in the gut microbiome, followed by genes conferring resistance to lincosamides, macrolides, and aminoglycosides. The fecal microbial community of TB patients additionally harbors genes conferring resistance to fluoroquinolones, aminocoumarins, beta-lactam, and peptide antibiotics. In the healthy microbiome, the main reservoir of resistance genes is comprised of members of Bacteroidota and Bacillota phyla. In contrast, the fecal resistome of TB patients is primarily driven by genes annotated within Pseudomonadota (Escherichia, Klebsiella, Campylobacter, Citrobacter, Enterobacter, Shigella, Vibrio) and Bacillota (Staphylococcus, Streptococcus, Blautia, Lactobacillus, Eubacterium, Enterococcus). A pairwise comparison of metagenomic data of TB patients before and after chemotherapy identified four genes (pmrA, Bado_rpoB_RIF, npmA and AAC(6')-Ib7) whose abundance increased during TB treatment.

The objective: to evaluate the efficacy of incorporating thioureidoiminomethylpyridinium perchlorate (Tpp) into the chemotherapy regimen for multidrug-resistant, pre-extensively drug-resistant and extensively drug-resistant (MDR, pre-XDR, and XDR) tuberculosis (TB) in patients with comorbidities.

Materials and Methods. This retrospective study included 108 patients aged 18 years and older who received Tpp during the intensive phase of chemotherapy for pulmonary MDR-TB, pre-XDR, and XDR-TB. The second group consisted of 63 patients who started the intensive phase of anti-tuberculosis therapy without the inclusion of thioureidoiminomethylpyridinium perchlorate. Treatment efficacy was evaluated at 2, 4, and 6 months after initiation of chemotherapy based on three criteria: resolution of clinical symptoms, positive radiological dynamics, and cessation of bacterial excretion. Comorbidity was assessed using the Charlson Comorbidity Index.

Results. Subgroup analysis based on the comorbidity index demonstrated that TB treatment efficacy assessed by standard criteria depended on the index value. Patients with a higher comorbidity index score achieved clinical improvement at a later stage. Persistent bacterial excretion was typical for patients with multimorbidity, substance and alcohol use, as well as diabetes mellitus.

Conclusion. Evaluating the efficacy of TB drugs in patients with comorbidities remains a challenging task; therefore, it is essential to predict potential drug-to-drug interaction. This study investigated the specific aspects of using thioureidoiminomethylpyridinium perchlorate for TB treatment in this complex patient population. While this drug is already successfully used in real-world clinical practice, the data obtained in this study further demonstrate high efficacy of Tpp-containing regimens, even in the presence of comorbidities.

The objective: to identify factors contributing to dysglycemia in patients with pulmonary tuberculosis and comorbid diabetes mellitus, and to assess the effectiveness of dysglycemia management based on the 24-hour glycemic variability.

Materials and methods. The study included 51 HIV-negative patients with advanced tuberculosis (TB) and decompensated type 1 or type 2 diabetes.

Results. Infection-induced dysglycemia driven by active TB was found to be the leading cause of glycemic decompensation in 98.0% of patients; this condition was frequently compounded by dietary non-compliance, poor self-monitoring, and drug-drug interactions. The introduction of the 24-hour glycemic variability as an additional clinical parameter enabled careful monitoring of glucose-lowering therapy resulting in glycemic profile stabilization within 3–8 weeks. Against this background, combined with the optimization of TB therapy, this approach yielded favorable TB treatment outcomes demonstrated by the radiographic improvements in 66.7% of patients, with the median time to sputum conversion of 2.2 months. Joint management by phthisiologists and endocrinologists combined with management of dysglycemia represents a strategic approach to enhancing TB treatment efficacy in this patient population.

The objective: to evaluate long-term outcomes of extrapleural thoracoplasty (ET) in HIV-positive patients with destructive pulmonary tuberculosis (TB) and to identify socio-medical factors influencing these outcomes.

Materials and methods. The outcomes of 55 HIV-positive patients with destructive pulmonary tuberculosis were evaluated across two follow-up periods: from 6 months to 2 years, and from 2 to 5 years after the discharge from the surgical department. When evaluating the ET results, the following outcomes were reported: cured of TB, discharged from dispensary follow-up, transferred to dispensary follow-up group III, and continuing treatment (including TB relapses after ET). Concurrently, the course of HIV-infection was evaluated based on the viral load and CD4+ T-lymphocyte levels. Cases of loss to follow-up for TB chemotherapy and ART, TB relapses, HIV progression and fatalities (due to HIV infection, TB, or other causes) were recorded.

Results. Among 55 patients with destructive pulmonary TB and HIV infection, the 5-year post-operative follow-up outcomes after extrapleural thoracoplasty were as follows: 29 (52.7%) patients were cured of TB and discharged from the follow-up group; 3 (5.5%) remained in the follow-up group III; 4 (7.3%) continued TB treatment (all of whom had pre-XDR and a history of treatment interruption); 2 (3.6%) were lost to follow-up. Fatal outcomes due to various causes were reported in 17 (30,9%) patients.

The objective: to compare attitudes toward illness (ATIs) based on the psychological status of inpatients with pulmonary tuberculosis (TB).

Materials and methods. ATIs and psychological statuses were evaluated in 189 patients with pulmonary tuberculosis: 143/189 (76%) women and 46/189 (24%) men; mean age: 33.9 ± 10.5 years.

Results. The most prevalent ATIs were ergopathic (39.2%), sensitive (36.5%), anxious (27.0%), and anosognosic (25.9%). Ergopathic and anosognosic ATIs were significantly more frequent in men, while women predominantly demonstrated the anxious type. In patients with psychological distress, ATIs indicative of psychological maladjustment were significantly more frequent. Conversely, ATIs associated with preserved psychological adjustment were more common in patients without psychological distress. After two months of inpatient treatment, positive shifts were observed in most psychological status indicators, with a significant decrease in anxiety-related ATIs and an increase in the frequency of the anosognosic type. In some patients, the observed changes in ATIs were facilitated by psychological interventions aimed at enhancing their coping resources.

The risk of developing tuberculosis (TB) increases in rheumatology patients receiving tumor necrosis factor-alfa (TNF- α) inhibitor therapy. This paper presents two clinical case reports demonstrating the difficulties in diagnosing and treating generalized TB that occurred during TNF-α inhibitor therapy in patients with ankylosing spondylitis. In both patients, the time to TB detection exceeded three months due to the pronounced clinical manifestations of the multiorgan inflammation (fever, polyserositis, generalized lymphadenopathy), the lack of regular TB monitoring during biologic therapy, and initial focus on oncology screening. Atypical clinical and radiological manifestations prompted an escalation of the baseline glucocorticoid therapy, which further contributed to TB progression and generalization. In both cases, TB was successfully cured following prolonged treatment.

Clinical manifestations of abdominal tuberculosis (TB) include diverse symptoms of intoxication and specific local lesions of the gastrointestinal tract and/or other abdominal organs, complicating its timely diagnosis. The article presents a clinical case of delayed diagnosis of abdominal TB in an HIV-negative 14-year-old girl. According to the final diagnosis, the patient had abdominal TB (TB of the intestines, peritoneum, and mesenteric lymph nodes) complicated by abscess formation and, subsequently, by the respiratory TB (TB of the intrathoracic lymph nodes of all groups with single foci in the left S1–2 and right S4). The lack of TB vigilance among clinicians of various medical specialties combined with clinical manifestations similar to non-specific gastrointestinal diseases resulted in several months of observation without effective treatment. A detailed analysis of the diagnostic errors is presented.

The objective: to analyze preclinical and clinical studies on the mechanisms of action, efficacy and safety of the antituberculosis drug pretomanid (PA-824/ F₄₂₀- Pa).

Materials and methods: This review presents the results of 48 publications, including clinical trials evaluating the activity and efficacy of pretomanid (PA-824/ F₄₂₀- Pa) – a member of the nitroimidazopyran class developed for treatment of tuberculosis (TB). This drug is effective against both replicating and persistent Mycobacterium tuberculosis (Mtb), particularly under hypoxic conditions. Preclinical studies demonstrated high activity of Pa against both drug-susceptible and drug-resistant M. tuberculosis. Pa became a key component of the short-term, all-oral regimens, such as BPaL (bedaquiline, pretomanid, and linezolid), for treatment of multidrug-resistant and pre-extensively drug-resistant TB Phase III clinical trials (Nix-TB, ZeNix-TB, and TB-PRACTECAL) confirmed that these regimens achieve cure in just 6 months with a favorable safety profile. Consequently, the duration of effective treatment for drug-resistant TB becomes comparable to that for drug-susceptible TB.

This review summarizes the results of research on preventive treatment for multidrug-resistant tuberculosis (MDR-TB) contacts. A systematic literature search was conducted in the Google Scholar, PubMed and eLibrary databases to identify publications on the epidemiology and preventive treatment of MDR-TB contacts. The search covered the period from 2018 to 2025 using the following Medical Subject Headings (MeSH) keywords: “Tuberculosis, Multidrug-Resistant” / “Epidemiology”, “Transmission”, and “Prevention & Control”. Following the selection process, 41 publications were included in this literature review

Results. The literature review demonstrated that the development and implementation of new, highly effective and safe antituberculosis drugs in preventive treatment regimens for MDR-TB contacts represents a promising approach to reducing the incidence of multidrug-resistant tuberculosis.

Fluoroquinolones are essential drugs for the treatment of drug-resistant tuberculosis; however, the rise in resistance to these agents significantly reduces treatment efficacy. This review summarizes current data on the molecular genetic and phenotypic mechanisms of Mycobacterium tuberculosis resistance to fluoroquinolones. Particular attention is focused on mutations in the gyrA and gyrB genes encoding DNA gyrase, the primary target of fluoroquinolones. Mutations within the QRDR of gyrA are the major determinants of resistance and are associated with an increase in the minimum inhibitory concentrations of fluoroquinolones. This review examines the role of alternative resistance mechanisms, including efflux pump systems and glpK-associated adaptations, as well as the importance of the WHO Catalogue of Mutations for variant interpretation. The integration of phenotypic and molecular diagnostic approaches is essential for the effective detection and control of drug-resistant tuberculosis.

We reviewed the available literature on the spectrum of bone and joint infection (BJI) pathogens and their drug resistance. A systematic search of publications was performed in the international PubMed database and the Russian scientific electronic library eLIBRARY.RU for the period of 2006-2026. The review included 79 studies containing data on the microbiological structure of BJI pathogens and antibacterial drug resistance rates in osteomyelitis, prosthetic joint infection, septic arthritis, and spondylodiscitis. The selection was performed in line with the PRISMA 2020 guidelines.

Results. Staphylococcus aureus and coagulase-negative staphylococci, primarily Staphylococcus epidermidis, remain the leading BJIs pathogens, particularly in implant-associated infections. Gram-negative microorganisms, including Pseudomonas aeruginosa, members of the order Enterobacterales, and polymicrobial associations, also play a significant role. An increasing prevalence of methicillin-resistant staphylococci, ESBL-producing, and carbapenem-resistant gram-negative bacteria has been noted which substantially limits the options for empirical antibacterial therapy. The structure of BJI pathogens and their resistance profiles vary depending on the clinical forms of infection, geographical region, and diagnostic approach used. In some regions, a high prevalence of bone and joint tuberculosis caused by Mycobacterium tuberculosis persists. This pathology is characterized by delayed diagnosis and high rates of drug resistance.