The objective of the study: a comparative analysis of genome-wide sequences of seed lot (SL) 361 "sh" M. bovis BCG-1 (Russia) and its daughter isolates obtained from children with manifestations of BCG osteitis.

Subjects and methods: genotyping; bioinformational analysis of genome-wide sequences of PS 361 "sh” vaccine BCG-1 (Russia) and its daughter isolates.

Results. PS 361 "sh" BCG-1 (Russia) was heterogeneous in 7 coding sequences with different ratios of single nucleotide substitutions inherited by 2 of 6 daughter BCG isolates. At the same time, polymorphisms did not violate the genomic stability and viability of the BCG vaccine during long-term existence in vivo. In isolates of BCG 2925 and 5448, accumulation (hypothetically, under the pressure of selection in the vaccinated organism) of nonsynonymous substitutions in 4 out of 7 polymorphic genes was noted, including the genes ppsC, eccD5, and eccA5 associated with mycobacterial virulence. Evaluation of the significance of genomic variations in BCG isolates relating to the association with the development of post-vaccination osteitis requires more detailed information about the immune status of patients. Genome-wide analysis of production strains, seed lots, finished vaccine lots and daughter clinical isolates makes the contemporary approach to understanding the molecular basis of the efficacy and complications of BCG vaccination.

The objective: to analyze the frequency of genotypes and alleles of the rs6737848 polymorphism of the socs5 gene in patients with allergic bronchial asthma (BA) and to assess the association of this polymorphism with different levels of control over this disease.

Subjects and methods. 179 people of the Caucasian race were the subjects of the study, and they all had the confirmed diagnosis of allergic asthma. The diagnosis, severity, and level of disease control were assessed in accordance with the GINA recommendations. The comparison group included apparently healthy individuals (n = 217).

Results. The study of rs6737848 of the socs5 gene revealed statistically significant differences in the frequencies of genotypes and alleles in the group of patients with allergic asthma versus the group of healthy individuals. Among patients with allergic asthma, the frequency of the CC genotype and C allele was the highest. Carriers of the CG genotype and G allele prevailed among healthy individuals versus allergic asthma patients. Analysis of frequency distribution of genotypes and alleles of the rs6737848 polymorphism of the socs5 gene showed statistically significant predominance of the CC genotype and C allele in the sample of patients with allergic asthma that was fully or partially controlled.

Conclusion. In women, the CC genotype and allele C of the socs5 gene can be considered as a genetic risk factor for the development of allergic asthma and a prognostic marker of controlled and partially controlled course of the disease. The CG genotype and G allele of the socs5 gene have a conditionally protective effect on the development of allergic asthma.

The objective: to study the frequency and nature of community-acquired pneumonia (CAP) in HIV patients.

Subjects and methods: The continuous longitudinal retrospective study of all cases of respiratory diseases among HIV patients (n = 185), who received in-patient treatment in the therapy department.

Results. CAP was diagnosed in 38.4% (n = 71) of patients and it was the most frequent respiratory disease among HIV patients. The median CD4 count in CAP made 197.5 cells/μL, 9.1% of patients received antiretroviral therapy before hospital admission. 74.7% of CAP patients (n = 53) had lesions disseminated to several lobes. Laboratory parameters revealed in severe CAP (leukocytosis > 12 × 109/L, leukopenia < 4.0 × 109/L and thrombocytopenia < 100 × 1012/L) were associated with the degree of immunodeficiency and did not depend on the infiltration dissemination (p > 0.05). Bacteremia in CAP was detected in 20.8% of patients and it was associated with the failure of standard empiric antibiotic therapy (p < 0.05). 9.9% of CAP patients (n = 7) were diagnosed with polymicrobial infection. Lethal outcomes of CAP were recorded in 5.6% of cases (n = 4), all with severe immunosuppression (the median of CD4 count was 5 cells/μL), 2 cases had bilateral subtotal CAP and 2 suffered from polymicrobial infection.

The objective: to assess the elution characteristics of anti-tuberculosis drugs (isoniazid, cycloserine, rifampicin, amikacin, kanamycin, ethambutol) placed into bone cement samples and put in a liquid medium to determine the possibility of using such systems as a drug reservoir.

Subjects and methods. For in vitro studies, pure substances of the drugs were used. The spectrophotometry was used to study the elution kinetics of the drugs. Absorption spectra of the drugs in the visible and ultraviolet regions were analyzed to reveal the absorption maxima, and the resistance of the chemical structure of the drugs to heating was assessed. Further, the changes of drug release from hardened bone cement samples under static conditions were studied.

Results. It has been found that studied drugs demonstrated satisfactory parameters of thermal stability and elution which makes it possible to use them in a mixture with bone cement.

The objective: to study the effect of immunomodulators on markers of the acute inflammation phase in patients with mild community-acquired pneumonia (CAP).

Subjects and methods. Patients (n = 64) with mild CAP (39.62 ± 9.82 years, CRB – 650.15 ± 0.04 scores) were enrolled in the study. The patients were divided into 2 groups: Group 1 (control) received only standard CAP therapy; in the other two groups, immunomodulators were prescribed simultaneously with standard therapy: in Group 2 – bacterial lysate (BL), in Group 3 – azoximer bromide (AB). In the patients, the blood levels of IL-6, TNF-α, C-reactive protein (CRP), lactoferrin were tested before treatment (day 1), and on days 13 and 60 of observation.

Results. The initial levels of TNF-α, IL-6, CRP and lactoferrin in the patients were statistically significantly higher above normal ones. A significant decrease in the levels of TNF-α, IL-6, CRP was found in all patients on the 13th and 60th days of observation compared to the 1st day, the maximum reduction was observed in the patients receiving immunomodulators. The biggest decrease in the level of lactoferrin on the 60th day of observation was noted in the group of patients taking BL. The changes in the rate of TNF-α and IL-6 levels decrease on the 13th and 60th days were also statistically significantly more pronounced (compared to the control group). The changes in the rate of decreasing from the baseline on the 13th and 60th days in TNF-α in the BL Group made 44 [-64; -32]% and 85 [-89; -82]%; in the AB Group – 28 [-40; -20]% and 82 [-86; -80]%; in IL-6 in the BL group – 32 [-40; -18]% and 86 [-90; -85]%, in the AB group – 45 [-53; -38]% and 86 [-88; -84]%. In the control group, this parameter for TNF-α was 18 [-32; -8]% and 64 [-78; -56]%, for IL-6 – 11 [-20; -1]% and 75 [-81; -74]%.

Conclusion. The addition of immunomodulators (BL, AB) to the therapy of patients with mild CAP results in statistically significant decrease in the blood levels of biomarkers of the acute inflammation phase on the 13th and 60th days.

The objective of the study: detection of early preclinical manifestations of vision disorders in patients with TB/HIV co-infection using optical coherence tomography (OCT).

Subjects and methods. A prospective open-label study was carried out enrolling patients with TB/HIV co-infection (Group 1, n = 19) and patients with pulmonary and extrapulmonary tuberculosis (Group 2, n = 18). In both groups, standard ophthalmological examination and OCT were performed with measurement of the thickness of the choroid and the diameter of upper and lower temporal and nasal arteries and veins, and assessment of arteriovenous coefficient (AVC).

Results. In the patients of both groups, the thickness of the choroid in the fovea area decreased in comparison with healthy volunteers (control group, n = 20), however, the decrease in choroid thickness was statistically significantly more pronounced in the patients of Group 1, and this group was also characterized by change in the caliber of retina arteries and veins, which is expressed in a higher AVC.

Conclusion. OCT allows early preclinical diagnosis of eye disorders (in the absence of eye complaints) in patients with tuberculosis, including those with concurrent HIV infection. Detection of choroid disorders and AVC changes in such patients allows timely prescription of therapy and prevention of pathological changes from progression.

The objective of the study: monitoring the spectrum of non-tuberculous mycobacteria isolated from patients who referred for medical care to the Republican Specialized Scientific and Practical Medical Center of Phthisiology and Pulmonology.

Subjects and methods. The diagnostic procedure of ATS/IDSA was used to define if the patient suffers from mycobacteriosis. The following specimens were collected to isolate non-tuberculosis mycobacteria: sputum, bronchoalveolar lavage fluid, feces, pleural fluid, surgical and biopsy specimens, and urine. The following tests were performed: Ziehl-Nielsen microscopy, microscopy stained by auramine-O, cultures by Middlebrook 7H9 in BACTEC™ MGIT™ 960 System, Becton Dickinson, USA. Non-tuberculosis mycobateria were differentiated from mycobacterium tuberculosis complex using the sdmpt64 chromatographic test (SD Bioline TBAg MPT64 test, Korea). The non-tuberculosis species were defined by the hybridization technology of DNA* strips GenoType Mycobacterium AS/CM, version 1.0.

Results. Of 14,544 patients with suspected respiratory tuberculosis, non-tuberculous mycobacteria were detected in 38 (0.26%) of them, 17 (44.7%) patients had Mycobacterium avium complex, in them there were 26 men (68.4%) and 12 (31.6%) women. Non-tuberculosis mycobacteria were isolated mainly from sputum – in 27 (71.2%) patients and urine – in 6 (15.7%) patients. In 26 (68.4%) patients, mycobacteriosis was caused by slow-growing non-tuberculosis mycobacteria, of which Mycobacterium avium complex prevailed – in 17 people as well as Mgordonae – in 8 patients. Rapidly growing non-tuberculosis mycobacteria were identified in 12 (31.6%) patients, they included M. fortuitum (5 cases) and M. chelonae (4) prevailed.

The review considers the possible use of artificial intelligence for the interpretation of chest X-rays by analyzing 45 publications. Experimental and commercial diagnostic systems for pulmonary tuberculosis, pneumonia, neoplasms and other diseases have been analyzed.

Based on 12 publications, official data on the detection of cases of tuberculosis and other infectious diseases in England and Wales, Germany and South Korea in 2020 and 2019 were compared. The results indicate that during the COVID-19 pandemic, there is a decrease in the number of detected cases of all major infectious diseases, and the percentage of reduction in tuberculosis detection is lower versus other infections.