Objective: to analyze approaches to coding latent tuberculosis infection in children and adults in the Russian Federation, including coding under the International Classification of Diseases (ICD-10), and to outline pathways toward a unified approach in the Russian Federation.

Materials and methods. Analysis of historical and current tuberculosis classifications in the Russian Federation. Identification of outdated approaches and emerging challenges.

Results. In the Russian Federation, there is a pressing need to introduce a unified approach to coding LTBI in both adults and children. This is primarily driven by the implementation of preventive treatment and the expansion of its indications for new target populations, including patients receiving biologic therapies and transplant recipients. Adopting a standardized approach to coding LTBI as Z22.7 under ICD-10 will help harmonize statistical data and accurately determine the demand for preventive chemotherapy drugs. Reducing the miscoding of LTBI as R76.1, a practice that still occasionally occurs in the Russian Federation, will lower the overall pediatric morbidity rates reported by Rosstat, which currently relies on the R76.1 code. Furthermore, consideration should be given to amending Order No. 127n of the Ministry of Health of the Russian Federation, dated March 13, 2019, regarding adults with LTBI. A specific dispensary follow-up group needs to be established for adults undergoing preventive TB treatment; this issue has already been resolved for children and adolescents with LTBI.

Objective: to evaluate the impact of employment in the coal mining industry on tuberculosis (TB) incidence amid the implementation of preventive measures for dust-induced lung diseases and TB.

Materials and methods. We analyzed data from a patient-level TB registry that allows for the identification of coal mining industry workers, employees of other industries, and the general population between 2014 and 2022. When comparing TB incidence rates, we evaluated age groups comparable to coal miners (21-68 years) and performed sex-stratification and sex-standardization of TB incidence rates.

Results. Between 2015 and 2022, TB incidence rates among coal mining industry workers ranged from 37.3 to 51.6 per 100,000 population, including from 40.7 to 70.2 per 100,000 among men. Their incidence rates did not differ statistically significantly from those in workers of other industries (p > 0.2) and were statistically significantly lower than the TB incidence in the general population of the Kemerovo region of comparable age (21–68 years) (p < 0.0001).

Conclusion. Employment in the coal mining industry does not constitute a TB risk factor amid advanced labor legislation, provision of personal and collective protective equipment, and regular preventive medical examinations.

Objective: to evaluate the efficacy and safety of a rifapentine-containing regimen in treatment of patients with drug-susceptible respiratory tuberculosis and gastrointestinal comorbidities, compared to the standard 6-8 month regimen.

Materials and Methods. An analysis of treatment efficacy and safety was performed in 204 patients with drug-susceptible respiratory tuberculosis who completed a full course of therapy. Inclusion criteria: male and female patients aged 18 years and older, newly diagnosed with respiratory tuberculosis with preserved susceptibility of Mycobacterium tuberculosis to the first line drugs, and concomitant gastrointestinal diseases. Exclusion criteria: HIV infection, acute liver diseases of various etiologies, decompensated liver cirrhosis, grade II–III pulmonary heart failure, and chronic renal failure. Patients in the main group (MG, n=77) received a modified chemotherapy regimen for drug-susceptible tuberculosis, where rifapentine replaced rifampicin in both the intensive and continuation phases. The comparison group (CG, n= 127) received standard chemotherapy regimens.

Results. By the end of month 4, sputum culture conversion was achieved in 77.8% of patients in the main group and 46.5% of patients in the comparison group. Lung cavity scarring within 6 months of chemotherapy was observed in 84.4% of patients in the main group, versus 51.5% in the comparison group. Adverse events were reported in 2.6% of patients in the main group and 14.2% in the comparison group (p < 0.05).

Conclusion. A modified rifapentine-containing regimen for treatment of drug susceptible tuberculosis is effective and safe in patients with gastrointestinal comorbidities.

Objective: to identify latent tuberculosis infection (LTBI) in patients with rheumatic diseases receiving immunosuppressive therapy using modern methods of immunodiagnostics.

Materials and methods. A combined retrospective-prospective controlled study was conducted. The study group included 79 patients with rheumatic diseases receiving immunosuppressive therapy and having no documented contact with tuberculosis (TB) patients. The control group consisted of 69 healthy individuals with no history of TB contact and no signs of exacerbated chronic diseases. All study participants underwent an interferon-gamma release assay (IGRA) and/or a skin test with a recombinant tuberculosis antigen (RTA).

Results: LTBI was detected in 13.9% (11/79) of participants in the study group, which was significantly higher than in the control group (4.4% (3/69); χ²=3.944, p=0.048). During follow-up, positive RTA test results in the study group were observed in 16.1% (9/56) of cases at the second assessment and in 16.7% (6/36) of cases at the third assessment. These rates were higher than at the first (χ²=0.148, p = 0.701) and second assessments (χ²=0.006, p = 0.940), showing no statistically significant differences, although an upward trend was observed.

Objective: to develop a reproducible model of tuberculous enterocolitis in laboratory animals comparable in its pathomorphological characteristics to intestinal tuberculosis in humans.

Materials and methods. The experiment was conducted on 10 male Soviet Chinchilla rabbits. One day before infection, the animals were administered infliximab (16 mg/kg) intravenously to simulate immunosuppression. Laparotomy was performed under general anesthesia, followed by the introduction of a suspension of the international reference virulent Mycobacterium tuberculosis H₃₇Rv strain (10⁶ CFU in 0.5 ml of normal saline) into the cranial mesenteric artery and the fiber of the mesentery of the small intestine. During the 72–90–day observation, behavioral patterns and body weight were monitored, and an intradermal test with recombinant tuberculosis allergen (RTA, Diaskintest®) was performed. At the end of the experiment, pathomorphological (hematoxylin and eosin staining and Ziehl-Neelsen staining) and molecular genetic (PCR) studies of the abdominal and thoracic organs were conducted.

Results. A positive RTA skin test on day 30 confirmed the development of a specific immune response. All infected animals (100%) exhibited specific granulomatous changes in the intestinal wall, mesentery and omentum (80%), with the formation of epithelial cellular granulomas, caseous necrosis and the presence of acid-fast mycobacteria (AFB). Specific lung lesions were detected in 90% of rabbits, 70% had enlarged intraabdominal lymph nodes, with caseous necrosis observed in 40% of the animals. PCR analysis detected MBT DNA in 80% of intestinal samples and 90% of lung samples.

Conclusion. A reproducible model of tuberculous enterocolitis was established, characterized by the development of specific granulomatous inflammation within the intestine and mesentery.

Objective: to evaluate the in vitro anti-tuberculosis activity of the active pharmaceutical ingredient (API) of Gratiola officinalis dry extract using BACTEC MGIT 960 system.

Materials and Methods. In vitro studies were conducted at the Department of Microbiology of the Central Tuberculosis Research Institute using seven M. tuberculosis strains: one laboratory M. tuberculosis H37Rv strain, one clinical drug-susceptible strain, three multidrug-resistant (MDR) clinical strains, and two clinical extensively drug-resistant (XDR) strains.

Results. The active pharmaceutical ingredient (API) of Gratiola officinalis dry extract demonstrated in vitro bacteriostatic activity against M. tuberculosis, including MDR and XDR clinical isolates, with a minimum inhibitory concentration (MIC) of 128 mg/mL. The API of Gratiola officinalis dry extract showed no bactericidal activity against M. tuberculosis at the tested concentrations.

Objective: to determin vitamin D status in children with active tuberculosis (TB) and latent tuberculosis infection (LTBI.)

Materials and methods. A total of 88 children aged 1 to 14 years were examined in the Tuberculosis Department of St. Petersburg City Children's Hospital No. 3 from 2022 to 2024. The inclusion criterion was a positive result of RTA and/or IGRA tests, while the exclusion criterion was the presence of immunodeficiency conditions. These children were then divided into two groups: Group 1 included 54 (61.4%) children with TB, and Group 2 consisted of 34 (38.6%) children with LTBI. All participants underwent phthisiatric evaluation and measurement of serum calcidiol levels.

Results. A decrease in vitamin D level was identified in 98.1±1.68% of children with active TB, compared to 79.4 ± 6.94% in those with LTBI (p = 0.011). The average calcidiol level in children with active TB was lower (11.70±0.86 ng/ml) than in children with LTBI (21.28±1.53 ng/ml, p = 0.000). Patients with TB infection and calcidiol levels below 20 ng/ml had a higher likelihood of being diagnosed with TB rather than LTBI, compared to children with higher calcidiol levels (OR=12.923 CI [4.324-38.624] SE=0.559; RR=3.541 CI [1.728-7.258] SE=0.367; _χ2yates =22,845, F=0.000, φ=0.535), as well as a higher frequency of hyperergic reactions to RTA test (OR=2.952 CI [1.090-7.997] SE=0.508; RR=1.960 CI [0.989-3.883] SE=0.339; _χ2yates =3.767; F=0.000; φ=0.232).

Objective: to evaluate the efficacy and phthisiatric safety of BCG therapy in bladder cancer patients provided with appropriate phthisiatric follow-up.

Materials and Methods. The study included 95 bladder cancer patients with indications for intravesical BCG vaccine therapy monitored between 2023 and 2025.

Study Results. Before initiating intravesical BCG therapy, chest X-ray lung abnormalities were detected in 18 (18.9%) of the 95 patients. Following evaluation by a phthisiologist, tuberculosis (TB) was ruled out in all cases. A hyperergic reaction to the Mantoux test with 2 TU was observed in 6.3% of patients, and latent tuberculosis infection (LTBI) diagnosed via a recombinant tuberculosis allergen (RTA) test was observed in 12.6% of patients. Seven (6.3%) patients were not eligible for BCG therapy: six due to a hyperergic reaction to the Mantoux test and one due to a history of TB. Non-specific adverse events occurred in 20.0% of 88 patients who underwent intravesical BCG therapy (Imuron-Vac vaccine), with no BCG-specific adverse events reported. During the follow-up period, no TB cases were reported among these 88 patients.

Objective: to identify risk factors associated with the development of acute progressive tuberculosis (TB) in HIV-negative patients.

Materials and methods: A case-control study included 342 HIV-negative patients with newly diagnosed TB, who were hospitalized at the I.F. Kopylova Kuzbass Clinical Phthisiopulmonology Medical Center (Kemerovo, Russia) in 2022–2025. Group 1 (n=135) comprised patients with acute progressive forms of TB (disseminated TB, caseous pneumonia), whereas Group 2 (n=207) consisted of patients with non-acute forms of TB (focal, infiltrative, cavernous TB, tuberculoma). A total of 66 variables were analyzed, encompassing sociodemographic, anamnestic, clinical, and genetic factors (38 polymorphic variants in genes of the vitamin D system and the NF-kB1 – 20S proteasome system). Genotyping was performed using real-time polymerase chain reaction (PCR).

Results: Medical and social risk factors associated with the development of acute progressive forms of TB included unemployment among working-age individuals (p = 0.01; OR = 1.8), alcohol dependence syndrome (p = 0.03; OR = 1.8), rural residence (p = 0.01; OR = 2.0), and the presence of chronic non-communicable diseases (p = 0.005; OR = 1.9). Among comorbid conditions, diabetes mellitus was identified as the most significant risk factor (p = 0.01; OR = 3.35). The risk of acute progressive TB was particularly associated with decompensation of carbohydrate metabolism (HbA1c >9%, p=0.02; OR=5.33) and poor patient adherence to regular medical follow-up (p =0.01; OR = 7.19). In patients with acute progressive TB, pre-XDR and XDR strains of Mycobacterium tuberculosis were detected more frequently (p = 0.001; OR = 3.63). Molecular genetic analysis revealed that the risk of acute progression of TB is associated with polymorphisms in genes involved in vitamin D transport and binding (GC rs3755967-CT genotype, OR=2.12; rs7041-AC genotype, OR=2.17), primary activation (CYP2R1 rs10741657-AA genotype, OR=0.43), degradation of active forms (CYP24A1 rs2209314-TT genotype, OR=0.54; rs2296241-AA genotype, OR=0.51), as well as with the pro-inflammatory factor gene NFKB1 (rs4648050-TC genotype, OR=1.81).

Objective: to evaluate the impact of Gln27Glu polymorphism in the β₂-adrenergic receptor gene on immune status parameters and lipid metabolism in patients with asthma stratified by obesity phenotype.

Materials and methods. The study included 156 Uzbek patients with bronchial asthma (BA) aged 18-65 years. Group 1 comprised patients with obesity (n = 71), Group 2 included patients without obesity (n = 85). The control group consisted of 47 healthy individuals. Genotyping of the Gln27Glu polymorphism in the β₂-adrenergic receptor gene was performed. Serum levels of total immunoglobulin E (IgE), interleukin-4 (IL-4), and interferon-γ (IFN-γ) were measured, along with the lipid profile parameters, including total cholesterol, triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and the atherogenic index.

Results: Patients with BA exhibited a shift in the immune response toward a Th2 phenotype: IgE and interleukin-4 levels were significantly increased, while IFN-γ was decreased compared to the control group (p < 0.01). The most pronounced alterations were observed in Group 1, particularly in patients carrying the Gln27Gln genotype, who exhibited the highest levels of IgE and IL-4, reduced IFN-γ levels, and atherogenic lipid profile abnormalities. In the absence of obesity (Group 2), the Gln27Gln polymorphism was not associated with significant differences in immunological or lipid parameters among the genotypes, suggesting that the effect of this genetic variant is primarily manifested in the presence of obesity.

Objective: to evaluate the impact of specific residual changes at the lung resection margin on the early postoperative course and treatment outcomes in patients surgically treated for pulmonary tuberculoma.

Materials and Methods. This study included 275 patients who underwent surgical treatment for pulmonary tuberculoma at the Ural Institute of Phthisiopulmonology (URIP) clinic between 2017 and 2019. Patients were stratified into two groups according to the presence (Group I) or absence (Group II) of specific changes at the resection margin. Long-term treatment outcomes were evaluated 3 years after surgery.

Results. Residual findings at the resection margin were identified in 84 of 275 patients (30.5%). Long-term treatment outcomes were available for 247 (89.8%) of 275 patients, all of whom completed postoperative courses of anti-tuberculosis treatment. No exacerbation of tuberculosis (TB) process was observed during the early postoperative period. Within the 3-year follow-up, pulmonary TB relapse occurred in 8 of 80 patients in Group I (10.0%; 95% CI 4.42–18.76) and in 16 of 167 patients in Group II (9.6%; 95% CI 5.58–15.09); the differences were not statistically significant (p = 1.000).

Conclusion. The presence of specific residual findings at the resection margin in patients surgically treated for pulmonary tuberculomas did not significantly affect the early postoperative course or outcomes of TB treatment during the 3-year follow-up, provided that the comprehensive anti-tuberculosis treatment was tailored to the drug-resistance profile of the pathogen.

Objective: to evaluate the efficacy and complications of pneumoperitoneum combined with other methods of collapse therapy in the comprehensive treatment of destructive pulmonary tuberculosis.

Materials and methods. A retrospective analysis was conducted on the medical records of 147 patients with destructive pulmonary tuberculosis who received comprehensive treatment, including pneumoperitoneum, at the Ural Research Institute of Tuberculosis, a branch of the National Medical Research Center for Tuberculosis and Lung Diseases of the Ministry of Health of the Russian Federation, between 2017 and 2021. During therapy, pneumoperitoneum was supplemented with endobronchial valve therapy in 94 (63.9%) patients, artificial pneumothorax in 2 (1.4%) patients, and a combination of valve endobronchial valve therapy and artificial pneumothorax in 25 (17.0%) patients.

Results. A complete course of comprehensive treatment involving pneumoperitoneum combined with other collapse therapies was performed in 65/147 patients (Group 1), while 82/147 patients (Group 2) discontinued pneumoperitoneum due to various reasons. Treatment efficacy based on closure of cavitary lesions in Group 1 was 75.4% (49/65 patients) compared to 36.6% (30/82 patients) in Group 2 (p = 0,0001). Sputum culture conversion was achieved in 82.9% (34/41 patients) in Group 1 and 62.2% (23/37 patients) in Group 2 (p < 0.05). Complications associated with pneumoperitoneum occurred in 43/147 (29.3%) patients, necessitating premature discontinuation of the procedure in 32/147 (21.8%) patients.

I.N. Ulyanov Chuvash State University, Cheboksary, Russia A clinical case of acute interstitial pneumonia and disseminated intravascular coagulation (DIC) syndrome with a fatal outcome in a patient with underlying idiopathic pulmonary hemosiderosis is presented. Morphological examination revealed the absence of right ventricular hypertrophy and comorbid conditions, along with a pronounced destructive component in the lungs with diffuse cellular infiltration and marked hemorrhagic exudate within the alveolar spaces. 

A comparative analysis of the efficacy and safety of short-course (4 –6 months) versus long-term (9 months or more) treatment regimens and preoperative courses was performed in patients with tuberculous spondylitis. A systematic literature search was conducted in the PubMed and eLibrary databases for the period from January 1, 2024, to December 1, 2024. The analysis included 6 publications: 2 randomized controlled trials (RCTs), 2 meta-analyses, and 2 studies focused on the optimization of preoperative therapy. Short-course regimens demonstrated efficacy comparable to long-term course (94.2% vs. 97.0%; [14]), with a pooled relative risk (RR) of treatment failure of 0.98 (95% CI, 0.92–1.04). Meanwhile, short-course regimens were characterized by a statistically significantly more favorable safety profile: the pooled odds ratio (OR) for adverse drug reactions was 0.37 (95% CI, 0.24–0.58) [14]. In patients with preserved drug susceptibility of the pathogen, shortening the preoperative treatment for tuberculosis spondylitis to 1–7 days using the HRZS regimen did not reduce the efficacy of surgical treatment compared to the prolonged 2–4 weeks preparations [11, 15].