For the successful operation of the tuberculosis infection foci monitoring system implemented in the city of Moscow since 2021, a quality assessment and control system was developed and implemented, which is a methodology that includes internal and external information control, separate quality control for household and ‘manufactory’ (not household) TB foci, and the functionality of joint assessment of the data from the «TB Foci» registry with information on indicator patients who created foci from other registries of the city’s tuberculosis monitoring system.
The implementation of this system significantly improved the quality of data in the «TB Foci» registry, which is a key element in the successful operation of the monitoring system. As a result of the implementation of the quality control system, in 2023–2024 the number of household TB foci, information about which in the register was recognized as problematic, decreased from 326 to 115; the number of cases of lack of information on an «manufactory» TB foci decreased from 232 to 172; the number of suspected TB foci that were taken under monitoring control increased from 161 to 206; the proportion of newly diagnosed tuberculosis patients registered during the year, in whom TB foci were identified, increased from 69.6 to 72.6% (p < 0.05), and the same proportion of newly diagnosed patients from the permanent population – from 85.9 to 89.8% (p = 0.016). One of the indirect results of the introduction of this system was that, with an overall decrease in the number of patients, district TB doctors registered and checked 146 more addresses (TB foci) in 2024 than in the previous year (3,559 addresses).
An analysis of the quality control of primary documentation showed that it is critically important for effective monitoring of tuberculosis infection. Periodic monitoring compatible with methodological support provided feedback for rapid problem solving and included training for employees in record keeping.

Introduction. The incidence of tuberculosis among health care workers belonging to a high-risk group is one of the most important indicators of the effectiveness of infection control measures.
The aim was to study the dynamics of tuberculosis incidence among medical workers of medical organisations in the city of Moscow.
Methodology. An analysis of the incidence of tuberculosis was conducted among 415 health care workers working in Moscow medical institutions for 2015–2023. We considered cases of tuberculosis among doctors, mid-level and junior medical personnel, in particular for two periods 2015–2019 and 2020–2023 to assess the effectiveness of measures taken for the early detection of tuberculosis among this population group.
Results and discussion. From 30 to 56 cases of tuberculosis were registered annually among health care workers. The majority were women – 72.5%, people aged 20 to 40 years (53.4%), doctors (46.2%) or mid-level medical personnel (44.1%), permanent residents (60.7%); 85.1% were identified using active methods (screening). In 2020–2023 compared to the period 2015-2019, there was an improvement in the structure of clinical forms: the proportion of focal TB increased from 23.7 to 36.8% (p < 0.01), pulmonary TB with decay decreased from 22.9 to 10.5% (p < 0.01). When compared with the general population, limited forms of tuberculosis predominated in health care workers: the proportion of focal pulmonary tuberculosis was 40.6% compared with 11.9% in the general population, the proportion of disseminated tuberculosis was lower – 3.1% and 20.4% (p < 0.01). The incidence of tuberculosis among physicians (23.7 and 33.5 per 100,000) and nursing staff (24.1 and 16.2 per 100,000) in 2015–2019 and 2020–2023, respectively, was comparable to that of the adult population of Moscow during the same periods: 30.3 and 20.2 per 100 000, respectively, which confirmed the fulfilment of the WHO indicator target value reflecting the effectiveness of infection control.
Conclusion. The study showed the high efficiency of anti-epidemic measures in medical institutions and demonstrated a significant improvement in their effectiveness during the study period.

The aim of the study was evaluation of the diagnostic efficiency of the Xpert MTB/RIF Ultra test for detection of M. tuberculosis DNA and determination of drug susceptibility to rifampicin in various diagnostic samples of patients examined for disease verification.
Materials and methods. We analyzed 427 respiratory and extrapulmonary diagnostic samples obtained from 378 patients (including HIV-infected ones) requiring rapid TB diagnostics. The study was conducted from one portion of the sediment of the diagnostic sample using bacteriological methods (luminescent microscopy, cultivation on Middlebrook 7H9 medium in the Bactec MGIT 960 system and on a Lowenstein-Jensen medium) and Xpert MTB/RIF Ultra test.
Results. High efficiency of the Xpert MTB/RIF Ultra test-system was demonstrated in verifying of TB in HIV-positive and HIV-negative patients with suspected disease or relapse. Xpert MTB/RIF Ultra demonstrated high efficiency of M. tuberculosis DNA detection (39.2%, 95%CI 32.6–46.2%) in various diagnostic samples that were smear-negative and had no growth on nutrient media and obtained from TB patients. The use of the WHO-recommended QC of 0.5 μg/ml for M. tuberculosis drug susceptibility testing to rifampicin in the Bactec MGIT 960 system would improve the estimated concordance of 97.4% (95% CI: 86.8 – 99.5) with Xpert MTB/Rif Ultra.

With the annual increase in the prevalence of multidrug-resistant (MDR) pathogen, the effectiveness of etiotropic chemotherapy of tuberculosis is decreasing; the demand for surgical treatment, the use of which remains limited in the world and in the Russian Federation, is increasing.
The aim of the study is to evaluate the effectiveness of the strategy of treatment of first detected destructive pulmonary tuberculosis based on early and wide application of surgical treatment, including minimally invasive techniques.
Materials and methods. A retrospective cohort multicenter study included patients of tuberculosis institutions in 51 regions of the Russian Federation, analyzed the performance of phthisiosurgical departments for the period 2007–2016. The long-term results of treatment were evaluated in 1090 patients operated for MDR/XDR tuberculosis (Group 1) and in 888 patients who refused surgery (Group 2).
Results. In Penza region, 92.8% of patients were abacilliated one year after application of the developed strategy, lethality decreased 3 times compared to the results of treatment in the previous 2 years; in 3 years clinical cure was registered in 94% of operated patients. During 4 years of active surgery in Chuvashia the contingent of patients with fibrotic cavernous tuberculosis was reduced 2.3 times, in Tambov region “bacillary core” in the region was reduced 3.6 times. Effective course of treatment was noted in 92,6% of patients of group 1 (operated) and only in 17,1% of patients of group 2 (refused surgery), р < 0,001. Clinical cure in 3 years was achieved in 85.7% of group 1 patients and only 5.2% of group 2 patients (р < 0,001).
Conclusion. Wide application of surgical treatment and collapse therapy is a prerequisite for achieving the target indicators of treatment efficiency in tuberculosis patients.

The aim of the study was to evaluate the influence of surgical treatment on the long-term results of complex treatment of patients with pulmonary tuberculoma.
Materials and methods. The retrospective cohort study analyzed the long-term outcomes of treatment in patients with pulmonary tuberculoma: without surgical treatment – 25 patients, and those who underwent surgical intervention during the study period (2017–2018) – 50 patients. The method of pair matching (2:1) was used to form the groups. The target variable was the frequency and structure of unfavorable treatment outcomes registered within 5 years from the beginning of treatment
Results. Successful treatment outcome (clinical cure, deregistration due to recovery) at the end of the five-year follow-up period was recorded in 49 of 50 patients after surgical treatment (98.0%, 95% CI 88.5–100%) and in 19 of 25 patients in the control cohort (without surgical treatment) (76.0%, 95% CI 56.3–88.8%), p = 0.008 by χ² test. When only TB-related adverse outcomes (without mortality from other causes) were considered, the group differences remained significant: 16.0% (95%CI 5.8–35.3%) and 0% adverse outcomes in the cohorts with and without surgical treatment, respectively, p = 0.004 by χ².
Conclusion. Surgical treatment for tuberculomas significantly reduced the likelihood of an adverse outcome by 11.8 times (OR = 0.07, 95%CI 0.007–0.614) and improved the prognosis of patients within 5 years of registration for treatment.

Purpose of the study. To conduct a comparative analysis of the results of laparoscopic and open combined nephroureterectomy with transurethral resection of the orifice (distal part) of the ureter.
Materials and methods. The results of surgical treatment of 61 patients for renal tuberculosis were analyzed. 30 patients underwent nephrectomy using laparoscopic access (main group), 31 patients underwent nephrectomy using open access (control group).
Results. Removal of a kidney affected by tuberculosis along with the ureter, regardless of the chosen access, leads to a significant leveling of dysuria. The advantages of the laparoscopic method are: reduction in the volume of intraoperative blood loss, a more significant impact on all components of quality of life in comparison with the open technique.

The aim was to assess the efficacy and tolerability of treatment of respiratory tuberculosis with the inclusion of glutamyl-cysteinyl-glycine sodium (Glutoxim) as part of pathogenetic therapy in children and adolescents.
Materials and methods. In retrospective non-comparative study, we studied the the medical records of 33 children and adolescents (aged 8-18 yrs, average age 14.8 yrs) who received complex antituberculosis treatment including of Glutoxim in the inpatient department of the Children’s branch of the Moscow Research and Clinical Center of TB control in the period from 2020 to 2023.
Results. On the background of complex treatment with inclusion of Glutoxime early clinical and radiological positive dynamics was noted in the form of disappearance of symptoms of intoxication (in 2 months in 48,5%, 95% CI 31,9 - 65,3%), reduction of infiltration and closure of decay cavities (in 33,3% of patients in 2 months), normalisation of laboratory parameters in the development of adverse reactions (leukopenia in 51,5% of children).
Conclusion. Treatment of children with Glutoxim contributed to improved patient tolerance of anti-tuberculosis drugs and a more favorable course of the tuberculosis process. The drug can be recommended as a pathogenetic therapy for children with tuberculosis.

Genetically engineered biological therapy has been widely introduced in the treatment of rheumatic diseases, lasting for decades until stable remission is achieved. Inhibitors of tumor necrosis factor alpha (TNF-α), a key cytokine, or its receptors are used to block autoimmune inflammation.
Interruption of cytokine cascade reactions can lead to defects in immune defense, inadequacy of new or destabilization of previously existing granulomas, and development of tuberculosis infection. Without screening procedures, the risks of tuberculosis increase significantly. In this regard, regular phthisiatric support is required for the entire period of therapy with TNF-α inhibitors.
The review examines in detail the role of TNF-α in the immunological response to tuberculosis, the effect of drugs that block this cytokine, the risks of developing tuberculosis when taking them in patients with rheumatological pathology, and the possibilities of reducing this risk through screening, monitoring, and preventive therapy.

A clinical observation of retroperitoneal abscess simulating extrapulmonary tuberculosis is described. Medical imaging methods (ultrasound, MSCT) determined the presence of purulent process in the retroperitoneum with the presence of a dense round-shaped mass (calcified lymph node?) and ureterohydronephrosis on the right side, which raised suspicion of extrapulmonary tuberculosis. In the history, appendectomy was performed 16 years ago. The patient underwent surgery, opening and drainage of retroperitoneal space on the right side. After histopathologic examination, tuberculous etiology was rejected. Intraoperative picture, conversation with the patient already in the postoperative period, detailed analysis of the disease history before the patient’s admission to the clinic allowed us to assume that during the operation of appendectomy, a stone – fecolith – was probably left in the retroperitoneal space, which 16 years later became the cause of abscess formation. The patient did not report any pain or discomfort for a prolonged period of more than 16 years. This rare clinical observation showed the difficulty of diagnosis and insidiousness of the disease, which mimicked extrapulmonary tuberculosis. Surgical treatment with drainage of the abscess was the key to a favorable outcome.

Fournier’s gangrene (GF) is a specific form of necrotising fasciitis localised on the external genitalia as well as in the perianal region.
The pathogenesis is based on arterial thrombosis leading to necrosis of the skin and subcutaneous fat, intoxication and multi-organ failure.
The aim is to demonstrate a clinical case of HF, the background process for which was tuberculosis infection.
We present a clinical case of a patient with fibrotic cavernous pulmonary tuberculosis treated in the tuberculosis extrapulmonary department of the Moscow Research and Clinical Center for Tuberculosis Control for advanced HF. Correctly selected complex treatment of HF consisting of wide dissection of necrotic tissues, adequate drainage, antibacterial and infusion therapy in combination with delayed corporoplasty with scrotal flaps prevented the development of a severe septic condition that could lead to death, and also preserved the patient’s quality of life.
Conclusion. Mycobacterium tuberculosis may serve as both an etiological and predisposing factor in the development of HF (due to immunosuppression). Caution in relation to HF in patients with tuberculosis anamnesis, timely emergency care reduces the risk of fatal outcomes.