Background: Russia, together with other former Soviet Union countries, is characterized by one of the highest burdens of drug-resistant tuberculosis. Published data on the drug-resistant tuberculosis for these countries are limited, and it is not clear whether current treatment regimens remain effective against constantly evolving drug-resistant strains. Objectives: The aim of the study was to evaluate treatment efficacy of patients with multidrug-resistant (MDR), extensively drug-resistant (XDR) and drug-susceptible (DSTB) tuberculosis in the most populous region of Russia (Bashkortostan) that borders with Central Asia. Methods: A retrospective cohort study was performed on 436 patients with pulmonary tuberculosis who were enrolled between January 1, 2016, and February 28, 2018, and received treatment according to WHO recommendations. Altogether, 369 patients completed the full course of chemotherapy. Clinical characteristics and treatment outcomes of DSTB, MDR, and XDR-TB patients were analyzed. Results: Of 436 patients, 169 (39%) had XDR-TB, 94 (22%) had MDR-TB and 173 (40%) had DSTB. Half of the MDR-TB patients (44%) and 82% of XDR-TB patients failed treatment. Patients with DSTB had unexpectedly poor treatment efficacy: only 67% had treatment success. We found that most of the MDR isolates from our patients were resistant to all first-line drugs, and a majority of the XDR isolates were resistant to more than 6-7 anti-TB drugs. While this can explain poor treatment efficacy in drug-resistant cases, causes of poor treatment efficacy in DSTB patients remain unclear. Finally, a considerable fraction (46%) of newly diagnosed patients had MDR-TB (27%) and XDR-TB (19%), suggesting that drug-resistant Mtb is being transmitted in the general population. To our best knowledge, this study is the first one to report XDR-TB prevalence in Russia in recent years (2016)(2017)(2018). Conclusions: MDR and XDR-TB became more common in recent years and treatment efficacy is declining at the face of more extensive drug resistance. There is evidence for the transmission of resistant strains in the general population, which calls for urgent changes not only in clinical practice but also in measures to prevent spread in the general population.

The objective of the study: to assess changes in the incidence and prevalence of multiple drug resistant tuberculosis (MDR TB) and TB/HIV coinfection (TB/HIV) in Volga Federal District (VFD) and its regions during 2016-2020.Subjects and Methods. Data from FGSN Forms No. 8, 33, and 61, and analytical reviews of main statistical TB rates in the Russian Federation have been studied. The number of those died is presented as per the Rosstat data.Results. An increase in the incidence and prevalence of MDR TB and TB/HIV coinfection has been detected in certain region of Volga Federal District. Perm Region, the Republic of Bashkortostan, the Republic of Udmurtia, and Orenburg and Samara Regions have the highest prevalence of MDR TB and TB/HIV coinfection. In 2020, the Republic of Bashkortostan was the only region where the incidence and prevalence of MDR TB were growing (164.7% and 47.3%, respectively). The highest incidence and prevalence of TB/HIV coinfection was reported in the Republic of Bashkortostan, Perm Kray, Orenburg Region, the Chuvash and Udmurt Republics. Over the last 5 years, the maximum increase in TB/HIV incidence and prevalence was observed in the Republic of Bashkortostan (38.8% and 41.3%, respectively).

The review presents data from 55 publications describing the relationship between the gut microbiome and tuberculosis. It presents possible mechanisms by which the intestinal microbiota can influence various parts of the immune system.It describes the effect of anti-tuberculosis drugs on the intestinal microbiome as well as possible prospects for the use of probiotics in the treatment and prevention of tuberculosis.

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Всероссийской научно-практической конференции с международным участием «Актуальные вопросы противотуберкулезной помощи в Российской Федерации: консолидация усилий в борьбе с туберкулезом»