The objective: to determine the effectiveness and safety (tolerability) of non-injection chemotherapy regimens containing bedaquiline in pediatric patients with multiple drug resistant respiratory tuberculosis.Subjects and Methods. Effectiveness and safety of treatment regimens containing non-injection drugs and Bdq were studied in 45 children from Main Group (MG) aged from 5 to 17 years old inclusive who were ill with multiple drug resistant tuberculosis. Control Group (CG) included patients of the same age with MDR TB who were treated with chemotherapy regimens containing injectable drugs (a retrospective study).Results. After 24 weeks (the period during which patients took bedaquiline), clinical effectiveness of chemotherapy regimens was achieved in all patients. By the end of week 24 of treatment, significant positive radiographic changes were noted in 84.4% of patients in MG and in 75.7% in CG (OR 1.741; 95% CI 0.658–4.611), healing of cavities was achieved in 42 (93.3%) and 66 (94.3%) patients, respectively (OR 0.848, 95% CI 0.181-3.982). No tuberculous mycobacteria were not detected in 100% of cases in both groups by month 6 of chemotherapy. The number of adverse reactions (AR) per patient averaged 1.25 and 1.26 in MG and CG. ARs occurred in patients receiving aminoglycosides in 41.4%: in MG – in 33.3%; 4/70 (5.7%) children from CG receiving injectable drugs developed adverse reactions requiring replacement of anti-tuberculosis drugs. No irreversible ARs were observed in MG.

Introduction . Currently, there is sustained high interest in screening for and treating latent tuberculosis infection as a potential measure for controlling the global tuberculosis epidemic, especially in children and adolescents at risk of developing tuberculosis. Aim . To evaluate the informative value of immunodiagnostic tests for the detection and diagnosis of tuberculosis in children and adolescents with oncological diseases. Materials and methods . A review was conducted of the medical documentation of 105 children with tuberculosis, aged 6 months to 17 years inclusive, who were examined at the National Medical Research Center for Phthisiopulmonology and Infectious Diseases and the Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology between 2018 and 2025. Two groups were identified: 52 patients – children with tuberculosis and oncological diseases (study group), and 53 patients – children with tuberculosis but without oncological diseases (control group). All patients in both groups underwent immunodiagnostic testing. The results of skin tests were assessed dynamically: 1 year prior to the development of tuberculosis (for children older than 1 year), 6 months prior to the diagnosis of tuberculosis, during the active phase of tuberculous, at the time of clinical cure of tuberculosis, and 6 months after clinical cure of tuberculosis. Results . In children in the main group, а decrease in the sensitivity of intradermal tests was observed: the sensitivity of the Mantoux test (MT) with 2 TU was 53.85% (p < 0.01); the test with recombinant tuberculosis allergen (RTA) showed a sensitivity of 63.46% (p < 0.01). Positive reactions were more frequently recorded with IGRA tests (ELISPOT и ELISA), which demonstrated sensitivities of 69.23% (p < 0.01) and 65.38% (p < 0.01), respectively. Negative anergy was typical for children with hemoblastosis, malignant diseases of the central nervous system and bones, and disseminated (generalized) tuberculosis. Conclusion . In children and adolescents with cancer, there is a decrease in the informative value of all immunodiagnostic tests, and intradermal samples (PM with 2 TE) in these patients are characterized by a lower sensitivity in detecting tuberculosis compared with IGRA tests.

Use of Bedaquiline in children is studied relatively rarely therefore, according to the WHO experts, it is necessary to further conduct the research on the effectiveness and safety of including of the Bedaquiline drug in chemotherapy regimens in children as well as to obtain the new data on the characteristics of its metabolism in routine clinical practice. The purpose of this research was to evaluate the therapeutic monitoring performance of the Bedaquiline drug use in treatment of pediatric patients with multidrug-resistant tuberculosis (TB). Materials and methods used: pharmacokinetic (PK) parameters were determined in 10 patients of both genders aged 6 to 17 y/o who had received Bedaquiline drug as part of complex therapy in the treatment regimen for multidrug-resistant TB (MDR-TB). All patients had not received anti-tuberculosis drugs previously. Results: during the period of initial daily administration (saturation) of the Bedaquiline drug, Cmax was 3901 ng/ml, Cmin 165 ng/ml, Me 1672 (781.7-2562.3; 95% CI) ng/ml. During the period of maintenance dose intake (3 times per week) prior to taking the drug, Cmax was 987 ng/ml, Cmin 251 ng/ml, Me 504 (340.2-667.7; 95% CI) ng/ml, two hours after Bedaquiline intake Cmax was 2387 ng/ml, Cmin 576 ng/ml, Me 1429 (1005.9-1852.1; 95% CI) ng/ml. Conclusion: the data obtained coincide with the bibliographical data on the Bedaquiline PK in children aged 5 to 8 y/o issues.

The objective: to study detection and clinical and radiological characteristics of tuberculosis in children and adolescents with malignant diseases. Subjects and Methods. Medical records of 105 children with respiratory tuberculosis (RTB) aged from 6 months to 17 years inclusive, examined in 2018–2025, were analyzed. Children were divided into two groups: Main Group (MG) – children with respiratory tuberculosis (RTB) and malignant neoplasms (MN) (52 patients) and Control Group (CG) – children with RTB and no MN (53 patients). Demographic characteristics, features of clinical manifestations and forms of respiratory tuberculosis of the patients were retrospectively analyzed. Results. In 73.1% (38/52) of cases, respiratory tuberculosis in children from MG was detected during the onset of malignant neoplasms or their treatment, in 17.3% (9/52) – at the stage of malignant neoplasm remission, in 9.6% – at the stage of post-tuberculosis changes in the form of calcifications in the intrathoracic lymph nodes prior to development of malignant neoplasms. In MG, tuberculosis was detected in 59.6% (31/52) of patients with hemoblastoses and 40.4% (21/52) of patients with malignant neoplasms of solid organs. In children from MG, tuberculosis was detected in 21.2% (11/52) of cases based on the results of immunodiagnostics and in 78.8% (41/52) when they referred for help with complaints. In children from MG, the course of respiratory tuberculosis was characterized by a widespread disease (78.8%, 41/52) and development of bronchopulmonary complications (80.8%, 42/52). Among children with hemoblastoses, generalized or disseminated forms of tuberculosis were in 32.3% (10/31) of cases, in children with malignant neoplasms of solid organs – in 9.5% (2/21). The incidence of lesions of central nervous system in children from MG made 7.7% (4/52).

Parasitic infections are widespread throughout the world and are especially common in childhood. The absence of pathognomonic symptoms in liver diseases is characteristic. We presented clinical observation with asymptomatic echinococcosis with damage to the respiratory organs and liver. During the fluorographic examination, changes in the lungs were revealed, in connection with which she was sent for a consultation with a phthisiatrician. In the TB hospital, with the help of a comprehensive examination and modern telemedicine technologies, changes were identified in lungs and in the liver. This clinical observation showed that it is necessary to conduct a comprehensive examination before prescribing specific anti-tuberculosis treatment. Increasing physicians' knowledge of parasitic diseases could increase the early detection.

Introduction. Tuberculosis is among the most dangerous infectious diseases. Its high social significance is due to the severity of its clinical manifestations and the risk of developing multidrug resistance. Aim. To evaluate the effect of a skin test with a recombinant tuberculosis allergen in young individuals not at risk for developing tuberculosis on the results of tests that determine the secretion of interferon-gamma by blood cells in response to Mycobacterium tuberculosis antigens. Materials and methods. Design: a prospective, open-label study involving a cohort of healthy adults of both sexes (aged 18 to 30 years) not belonging to risk groups for tuberculosis development, without clinical symptoms of the disease, who underwent a preventive examination for tuberculosis within the prescribed time frame. The study included 30 volunteers: 24 women and 6 men; the median age was 26.0 years (Q1 – 23.9 years; Q3 – 28.0 years). All participants underwent Diaskintest® (JSC Generium, Russia), TB-Feron IGRA (RU No. RZN 2021/14954, SD Biosensor, Inc., Republic of Korea), and TigraTest® TB (RU No. RZN 2024/22462, JSC Generium, Russia). The study included five visits to the center. At each visit, the presence of complaints was recorded, as well as adverse events, if they occurred during the observation period. Results and discussion. The Diaskintest showed no reaction to the administered antigens (recombinant proteins CFP10, ESAT6) in all patients throughout the entire observation period (day of administration, days 3, 10, and 30). Positive and borderline results of laboratory tests after a skin test with ATP (Diaskintest) are not statistically significant, which allows us to conclude that there is no booster effect in the form of false-positive reactions of laboratory tests to the introduction of ATP. Conclusion. The obtained results indicate that there is no need to establish a diagnostically significant time interval between skin screening and subsequent laboratory analysis of the specific immune response.