Наукові праці. Кафедра інфекційних хвороб, дитячих інфекційних хвороб, фтизіатрії та пульмонології
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Item The Influence of the Background of Concomitant Pathology on the Post-Epidemic Syndrome(2024) Todoriko, L.; Lesnik, E.; Shevchenko, O.Item The Impact of External Migration on the Epidemiology of Tuberculosis in Eastern Europe(2024) Todoriko, L.; Lesnik, E.; Shevchenko, O.; Slyvka, V.Item Mycobacterium Tuberculosis Resistance - Stages of Drug Resistance Formation (Review)(2024) Todoriko, L.; Petrenko, V.; Shevchenko, O.; Noreiko, S.; Semianiv, I.; Lesnik, Е.The review contains an analysis of the latest research on molecular genetic aspects of the formation of resistance in tuberculosis patients to avoid it during use of modern treatment programs. Objective - to assess the situation with the evolution of resistance of Mycobacteria tuberculosis and the stages of drug resistance development using materials from available databases. Materials and methods. The research has been completed for the period from 2014 to 2024. The next stage with the establishment of a systemic topological and metric computer analysis of the results allowed us to see the most informative sections of the research topic that are clearly associated with the formation mechanisms of drug-resistance in pulmonary tuberculosis. The most complete database of available literary sources was obtained (about 50 out of 502 analyzed arrays). Results and discussion. Ukraine is among the thirty countries with a high burden of tuberculosis with multiple drug resistance (MDR-TB). The main threat to the effectiveness of tuberculosis treatment in Ukraine is late detection of the disease and determining the sensitivity of the pathogen, which is the main prerequisite for prescribing adequate treatment. The situation with MDR-TB in Ukraine remains difficult in the conditions of war against the background of the COVID-19 pandemic. Thus, the total number of such cases for 2023 was 1,955 patients, of which 1,326 were new cases. The number of cases of tuberculosis with extended resistance (XDR-TB) was 228, of which 136 patients were diagnosed for the first time. Conclusions. The question of studying the genetic aspects of the formation of drug resistance of M. tuberculosis with the determination of the role of polymorphic variants of genes encoding xenobiotic metabolism systems in tuberculosis infection remains relevant to understand the mechanisms of interaction in the process of implementing hereditary information at the holistic level of the organism in order to increase the effectiveness of treatment and prevent the formation of resistance.Item The Role of Microbiological and Radiological Tests in the Diagnosis of Pulmonary Tuberculosis in the Conditions of the Pandemic COVID-19(2024) Lesnic, E.; Todoriko, L.; Yeremenchuk, I.; Shevchenko, O.; Slyvka, V.The impact of the methods for diagnosis of pulmonary tuberculosis is perceived in the fastness in setting up the actions aiming to isolate the source infection and to treat it in due time. Objective - to establish the role of microbiological and radiological tests in diagnosis of pulmonary tuberculosis in actual epidemiological context of tuberculosis associated to the COVID-19 pandemics (2020—2022). Materials and methods. It was conducted a case-control study which included 172 patients diagnosed with pulmonary tuberculosis, as new case, distributed in two groups, the 1st group - 116 patients diagnosed through the radiological methods and the 2nd group — 56 patients, diagnosed through microbiological methods. Results and discussion. The main peculiarities of patients diagnosed with tuberculosis regardless of methods of investigation were male gender, low social and economic state and high prevalence of the harmful habits with impact on the health state. Patients diagnosed through the microbiological methods were residing more frequently in rural areas, with low accessibility to healthcare services, identified through a long-evolving symptomatology, late detection, expressiveness of the clinical symptomatology and a high rate of poor treatment outcome. Recommendations were established that systematic screening for tuberculosis should be performed in all social-vulnerable groups, fortified by the individualised therapeutic approach. Conclusions. The case-control study identified that the main peculiarities of patients diagnosed with tuberculosis regardless of methods of investigation were male gender, low social and economic state and high prevalence of harmful habits such as smoking and alcohol consumption. Patients diagnosed through the microbiological methods were residing more frequently in rural areas, with low accessibility to healthcare services, concluded through a long-lasting symptomatology, late detected forms of tuberculosis, high expressiveness of the clinical symptomatology and severe evolution, followed by a high rate of poor treatment outcomes, including death. Patients diagnosed through the radiological methods were more frequently from urban sectors, from tuberculosis clusters, with comorbidities with high risk for tuberculosis sickness, such as HIV infection, diabetes and mental disorders which constituted included in active screening programs. The lack of positive microbiological assay results was the consequence of the unilateral and limited forms of pulmonary and determined a higher rate of treatment success rate.Item Human-Beta-Defensin-1, Ferritin, Interleukin-6 and their Relationship with Clinical and Laboratory Parameters of the Severity of the Tuberculosis Process(2024) Shevchenko, O.; Todoriko, L.; Shevchenko, R.; Matvyeyeva, S.; Tudor, Е.; Ovcharenko, I.; Shvets, O.; Pohorielova, O.Establishing relationships between clinical and laboratory parameters, such as general patient’s state, parameters of complete blood count and blood biochemistry and markers of the course of tuberculosis in the future can be used to predict the severity of dysfunction of various organs and tissues in patients with tuberculosis and in particular in patients who receive anti-tuberculosis treatment. Objective - to investigate the relationship between biochemical markers, namely Human-beta-defensin-1, ferritin and interleukin-6, and clinical and laboratory indicators of the severity of the tuberculosis process. Materials and methods. 100 patients diagnosed with pulmonary tuberculosis were included in the study. After receiving 60 doses of anti-tuberculosis treatment, the patients were retrospectively divided into 2 groups. Group 1 (n = 77) consisted of patients in whom sputum conversion was observed after 60 doses of treatment, determined by sputum microscopy. Group 2 (n = 23) comprised patients in whom bacterial secretion was maintained after 60 doses of treatment, as detected by microscopy. In addition to the routine studies provided for the monitoring of patients with tuberculosis by the current orders of the Ministry of Health of Ukraine, the levels of Human-beta defensin-1, ferritin and interleukin-6 (IL-6) in the fasting blood were additionally measured by ELISA at the beginning of treatment and after 60 days. Statistical data processing was carried out using the Statistica 8.0 software environment. Results. A comparison of the investigated parameters between groups at the beginning of treatment showed significantly higher values of Human-beta-defensin-1 (Group 1 — (18.97 ± 2.42) pg/ml, Group 2 — (55.02 ± ± 15.69) pg/ml), ferritin (Group 1 — (94.86 ± 6.02) ng/ml, Group 2 — (141.61 ± 24.66) ng/ml) and IL-6 (Group 1 — (80.33 ± 5.03) pg/ml, Group 2 — (110.13 ± 10.35) pg/ml) in patients with positive sputum micros copy after 60 doses of treatment, p < 0.05. All studied markers demonstrated a reliable positive relationship with the massiveness of bacterial excretion, a conditional indicator of the severity of clinical symptoms and signs, ESR and urea level, as well as reliable negative correlations with creatinine level. In addition, patients with a lower body mass index were found to have higher levels of Human-beta-defensin-1 and ferritin. Higher levels of Human-beta defensin-1 and ferritin are associated with lower hemoglobin levels (Human-beta-defensin-1 was also negatively correlated with erythrocyte count). An increase in the leukocytes level is accompanied by a significant increase in the level of Human-beta-defensin-1 and IL-6. Additionally, a significant negative correlation was found between the level of glucose and ferritin, as well as between the level of bilirubin and ferritin and IL-6. Conclusions. The determined significantly higher levels of Human-beta-defensin-1, ferritin and interleukin-6 in patients in whom sputum microscopy was positive after 60 doses of treatment allow considering the investigated biochemical parameters as markers of the ineffectiveness of anti-tuberculosis therapy. The identified positive relationships with the severity of clinical symptoms indicate the possibility of using the studied parameters as markers of the severity of the tuberculosis course. The possibility of using Human-beta-defensin-1 and ferritin as markers of anemia was also found. Correlations with parameters of blood biochemistry allow us to talk about increased levels of Human-beta-defensin-1, ferritin and interleukin-6 against the background of kidney damage.