ABSTRACT
The article describes the clinical case reports of patients with respiratory tuberculosis who were hospitalized at the Regional Clinical Antituberculosis Center in Kursk. One of them was in the pediatric department for patients with tuberculosis of respiratory organs and the other in the 1st department for patients with multidrug-resistant tuberculosis. As pathogenetic therapy in the complex treatment of pulmonary tuberculosis, in the intensive phase of anti-tuberculosis chemotherapy, we added inhalation therapy with surfactant (medicinal product surfactant-BL lyophilisate for emulsion preparation, 75 mg, manufactured by Biosurf LLC, Russia) according to the instructions to the drug. Treatment of pulmonary tuberculosis is performed by multiple inhalations of surfactant-BL as part of complex therapy against the background of fully deployed antituberculosis drugs (ATD), i.e. when the patient empirically or based on data on drug sensitivity of the pathogen is selected 4-6 ATD that are well tolerated by the patient in the prescribed dose and combination. It should be noted that an adult patient during the intensive phase of anti-tuberculosis chemotherapy had COVID-19. Against the background of inhalation therapy with surfactant, it was possible to stabilize the clinical and radiological condition of the patients, and to improve their condition. Clinically it was expressed in reduction of coughing, increase of tolerance to physical exertion. For example, according to spirometry data on the admission of an adult patient and in dynamics, the vital capacity index (VCI) increased from an extremely sharp decrease (31.25%) to 75%, which corresponded to a very mild decrease. At the moment the patient from the children's ward is completing a course of antituberculosis therapy with small residual changes in the lungs, and the adult patient was operated on at the Russian Ministry of Health at the Federal State Budgetary Institution "National Research Center of Pulmonary Medicine” for installation of a bronchial valve. Based on the above, we can conclude about the successful, pathogenetically sound use of surfactant-BL in patients with respiratory tuberculosis in both children and adults. © 2022, Remedium Group Ltd. All rights reserved.
ABSTRACT
The article describes the clinical case reports of patients with respiratory tuberculosis who were hospitalized at the Regional Clinical Antituberculosis Center in Kursk. One of them was in the pediatric department for patients with tuberculosis of respiratory organs and the other in the 1st department for patients with multidrug-resistant tuberculosis. As pathogenetic therapy in the complex treatment of pulmonary tuberculosis, in the intensive phase of anti-tuberculosis chemotherapy, we added inhalation therapy with surfactant (medicinal product surfactant-BL lyophilisate for emulsion preparation, 75 mg, manufactured by Biosurf LLC, Russia) according to the instructions to the drug. Treatment of pulmonary tuberculosis is performed by multiple inhalations of surfactant-BL as part of complex therapy against the background of fully deployed antituberculosis drugs (ATD), i.e. when the patient empirically or based on data on drug sensitivity of the pathogen is selected 4-6 ATD that are well tolerated by the patient in the prescribed dose and combination. It should be noted that an adult patient during the intensive phase of anti-tuberculosis chemotherapy had COVID-19. Against the background of inhalation therapy with surfactant, it was possible to stabilize the clinical and radiological condition of the patients, and to improve their condition. Clinically it was expressed in reduction of coughing, increase of tolerance to physical exertion. For example, according to spirometry data on the admission of an adult patient and in dynamics, the vital capacity index (VCI) increased from an extremely sharp decrease (31.25%) to 75%, which corresponded to a very mild decrease. At the moment the patient from the children's ward is completing a course of antituberculosis therapy with small residual changes in the lungs, and the adult patient was operated on at the Russian Ministry of Health at the Federal State Budgetary Institution "National Research Center of Pulmonary Medicine” for installation of a bronchial valve. Based on the above, we can conclude about the successful, pathogenetically sound use of surfactant-BL in patients with respiratory tuberculosis in both children and adults. © 2022, Remedium Group Ltd. All rights reserved.
ABSTRACT
Tuberculosis is the second leading cause of death by infectious disease worldwide after COVID-19. Mycobacterium tuberculosis, which causes tuberculosis, is showing alarming levels of resistance to first-line antibiotics, jeopardizing efforts to eradicate the disease. Research is underway to develop new, safer drugs to treat drug resistant tuberculosis. One of these breakthrough drugs is bedaquiline, which targets the mycobacterial ATP synthase, an essential enzyme in mycobacteria. The success of bedaquiline, which has become a cornerstone of treatment for multidrug-resistant and extensively drug-resistant tuberculosis, demonstrates the importance of the mycobacterial ATP synthase as a key drug target against M. tuberculosis. Since the discovery of bedaquiline in 2005, there has been a renewed interest in developing new and improved mycobacterial ATP synthase inhibitors. We have determined electron cryomicroscopy structures of M. smegmatis ATP synthase in complex with inhibitors. We provide detailed mechanistic and structural insights into the mode of action of these compounds, which will support medicinal chemistry efforts to design new tuberculosis drugs. Our work reveals new inhibitor binding sites in the enzyme, opening the route for development of new classes of compounds and improved inhibitors. Copyright © 2022
ABSTRACT
Background: Amidst fight against COVID-19 pandemic, efforts to mitigate other communicable disease threatening public health including TB has taken a back step. Limited evidence exists about the change in prevalence of Pediatric Dr. TB post 2020. Objective: The study aimed to find out the change in prevalence of Pediatric DR TB pre and post 2020. Methods: Descriptive retrospective and prospective study. Pediatric Dr. TB was defined on the basis of Gene X pert/ line probe assay and/ or drug susceptibility testing (DST). Results: Prevalence of Pediatric Dr. TB in year 2018, 2019, 2020 and 2021 (January-September) were 17.4%, 15.1%, 18.4% and 16.6% respectively in the age group of 1-18 years. Majority (93.9%, 90.5%, 89.5%, 96.8%) had pulmonary TB. Cumulative prevalence of Pediatric Dr. TB for the 24 months of year 2018 & 2019 was 16.3% while it was 17.6% for the 21 months of year 2020 & 2021 (January-September). It reveals an increase of 4.1%. On extrapolating the prevalence rate of Dr. TB for the 9 months of year 2021, prevalence rate of Dr. TB by the end of year 2021 is expected to be 22.1%. Among Dr. TB, prevalence (%) of XDR TB;MDR TB;monoresistant TB for year 2018, 2019, 2020 & 2021 was (10.9,88.0,1.1), (5.1,92.8,2.1), (3.4,94.9,1.7) and (7.4,91.6,1.0) respectively. Conclusion: With this report of increase in prevalence of Pediatric Dr. TB, it has become the need of the hour to start focusing on TB vigorously and to take uncompromising relentless measures to achieve the country's vision to eliminate TB by 2025.