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Characteristics of tuberculosis dispensary patients under observation for tuberculosis without confirmed bacterial excretion

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Abstract

DOI: 10.32364/2225-2282-2025-1-1

D.M. Kutuzova, T.E. Tyulkova, V.V. Tinkova

National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow

Aim: to analyze the clinical, epidemiological, and laboratory characteristics of patients presenting with limited pulmonary damage, who were monitored in tuberculosis care institutions.

Patients and Methods: a retrospective study was conducted based on medical record analysis of patients observed for tuberculosis in an antituberculosis dispensary during 2020–2021. Initial chest X-ray findings revealed limited pulmonary damage (involvement of 1–2 segments either unilaterally or bilaterally) in all patients referred for evaluation by a phthisiatrician. The cohort was divided into two groups: the main group (MG, n=95) comprised patients exhibiting positive clinical and radiological changes suggestive of tuberculosis, whereas the comparison group (CG, n=95) included individuals whose diagnosis was confirmed to be of non-tuberculosis origin. Clinical, epidemiological, laboratory, and microbiological data were systematically analyzed.

Results: patients in the MG were predominantly of working age, while older males constituted a statistically significant majority in the CG (p=0.000, p=0.003). Both groups were mostly identified during scheduled preventive examinations, although this was observed more frequently in MG patients (74.7% vs. 64.2%, p<0.05). History of contact with a known tuberculosis patient, as well as a positive immune response to the recombinant tuberculosis allergen, were reported with similar frequency in both groups. However, symptoms such as cough (p=0.006) and dyspnea (p=0.000) were more frequently reported in CG patients. Contact with an active tuberculosis case was documented in 9.5% of MG patients and 11.6% of CG patients (p>0.05). DNA of Mycobacterium tuberculosis was identified in 13.7% and 6.3% of MG and CG cases, respectively (p=0.091).

Conclusion: the study demonstrated that clinical symptoms suspicious for tuberculosis were similarly common in both groups and could not serve as definitive diagnostic criteria. Furthermore, documented history of contact with tuberculosis patients and the detection of M. tuberculosis DNA in some individuals from both groups necessitated consultation with a phthisiatrician and, in certain cases, a trial of anti-tuberculosis therapy (ex juvantibus). The findings emphasize that patients presenting with confined pulmonary lesions and an absence of pathognomonic features of tuberculosis commonly require invasive diagnostic procedures to establish a definitive diagnosis.

Keywords: tuberculosis, diagnosis, diagnostic verification, confirmed diagnosis, tuberculosis dispensary patients, bacterial excretion, non-tuberculous conditions, invasive diagnostics.

For citation: Kutuzova D.M., Tyulkova T.E., Tinkova V.V. Characteristics of tuberculosis dispensary patients under observation for tuberculosis without confirmed bacterial excretion. RMJ. 2025;1:2–6. DOI: 10.32364/2225-2282-2025-1-1

References

1. Стерликов С.А. Отраслевые и экономические показатели противотуберкулезной работы в 2019–2020 гг. Аналитический обзор основных показателей и статистические материалы. М.: РИО ЦНИИОИЗ; 2021. [Sterlikov S.A. Industry and economic indicators of anti-tuberculosis work in 2019–2020. Analytical review of key indicators and statistical materials. M.: CRIOIHC. 2021 (in Russ.)]. 2. Каканов О.Г. Особенности флюорографического выявления туберкулеза легких. ФГБОУ ВО Саратовский ГМУ им. В.И. Разумовского Минздрава России. Бюллетень медицинских интернет-конференций. 2018;8(4):159. [Kakanov O.G. Features of fluorographic detection of pulmonary tuberculosis. FSBEI HE Saratov State Medical University named after. IN AND. Razumovsky, Ministry of Health of Russia. Bulletin of Medical Internet Conferences. 2018;8(4):159 (in Russ.)]. 3. Гланц С. Медико-биологическая статистика. Пер. с англ. Ю.А. Данилова. М.: Практика; 1998. [Glants S. Medical and biological statistics. Translated from English by Yu.A. Danilova. M.: Praktika Publ.; 1998 (in Russ.)]. 4. Мордык А.В., Пузырева Л.В. Основные факторы, определяющие заболеваемость туберкулезом контактных лиц в очагах инфекции. Туберкулез и болезни легких. 2014;(1):9–13. [Mordyk A.V., Puzyreva L.V. The main factors determining the incidence of tuberculosis among contact persons in foci of infection. Tuberculosis and Lung Diseases. 2014;(1):9–13 (in Russ.)]. 5. Гудиева И.Р., Малиев Б.М., Кобесов Н.В. и др. Заболеваемость сопутствующей патологией впервые выявленных больных туберкулезом взрослых. Туберкулез и болезни легких. 2023;101(3):21–26. [Gudieva I.R., Maliev B.M., Kobesov N.V. et al. Incidence of concomitant pathology in newly diagnosed adult tuberculosis patients. Tuberculosis and Lung Diseases. 2023;101(3):21–26 (in Russ.)]. DOI: 10.58838/2075-1230-2023-101-3-21-26 6. Бяхова М.М., Минаков С.Н., Франк Г.А. Заболеваемость раком легкого в Московской области (1998–2018). Пульмонология. 2020;30(4):401–407. [Byakhova M.M., Minakov S.N., Frank G.A. The incidence of lung cancer in the Moscow region from 1998 to 2018. Pulmonologiya. 2020;30(4):401–407 (in Russ.)]. DOI: 10.18093/0869-0189-2020-30-4-401-407 7. Жуйкова Е.Л., Чойнзонов Л.Д., Ананина О.А. Заболеваемость раком легкого в различных городах мира (обзор). Вопросы онкологии. 2020;66(3):239–246. [Zhuikova E.L., Choinzonov L.D., Ananina O.A. Incidence of lung cancer in different cities of the world (review). Oncology issues. 2020;66(3):239–246 (in Russ.)]. DOI: 10.37469/0507-3758-2020-66-3-239-246 8. Ракишева А.С., Петрова О.Г. Латентная туберкулезная инфекция и ее диагностика (обзор литературы). Вестник КАЗНМУ. 2020;4:306–311. [Rakisheva A.S., Petrova O.G. Latent tuberculosis infection and its diagnosis (literature review). Vestnik Of KAZNMU. 2020;4:306–311 (in Russ.)]. 9. Старшинова А.А., Довгалюк И.Ф., Зинченко Ю.С. и др. Иммунодиагностика туберкулеза сегодня: современные иммунологические тесты и дифференцированный подход к их применению в практике. Практическая пульмонология. 2019;2:28–30. [Starshinova A.A., Dovgalyuk I.F., Zinchenko Yu.S. et al. Immunodiagnosis of tuberculosis today: modern immunological tests and a differentiated approach to their use in practice. Practical Pulmonology. 2019;2:28–30 (in Russ.)]. 10. Морозько П.Н., Алексеева А.А. Изучение и анализ заболеваемости туберкулезом среди населения Российской Федерации. Меридиан. 2022;1(63):27–29. [Morozko P.N., Alekseeva A.A. Study and analysis of tuberculosis incidence among the population of the Russian Federation. Meridian. 2022;1(63):27–29 (in Russ.)]. 11. Сысоев П.Г., Акимов М.И., Ямбаев А.В. Факторы риска заболевания туберкулеза в современных условиях. Colloquium-journal. 2019;11(35):59–60. [Sysoev P.G., Akimov M.I., Yambaev A.V. Risk factors for tuberculosis in modern conditions. Colloquium-journal. 2019;11(35):59–60 (in Russ.)]. 12. Перельман М.И. Фтизиатрия. Национальное руководство. М.: ГЭОТАР-Медиа; 2007. [Perelman M.I. Phthisiology. National leadership. M.: GEOTAR-Media; 2007 (in Russ.)]. 13. Искакова А.Ш., Нашенова Г.Б., Агзамова Р.А., Бугаков А.А. Методы выявления и клиническая структура туберкулеза органов дыхания. В кн.: Материалы VI Межрегиональной научно-практической и учебно-методической конференции с международным участием, посвященной Всемирному дню борьбы с туберкулезом, с проведением открытого конкурса студенческих работ по пропаганде здорового образа жизни, борьбе с туберкулезом и вредными привычками. Тверь; 2017:51–52. [Iskakova A.Sh., Nashenova G.B., Agzamova R.A., Bugakov A.A. Methods of detection and clinical structure of respiratory tuberculosis. Materials of the VI interregional scientific-practical and educational-methodological conference with international participation, dedicated to World Tuberculosis Day, with an open competition of student works on promoting a healthy lifestyle, combating tuberculosis and bad habits. Tver; 2017:51–52 (in Russ.)]. 14. Warria K., Nyamthimba P., Chweya A. et al. Tuberculosis disease and infection among household contacts of bacteriologically confirmed and non-confirmed tuberculosis patients. Trop Med Int Health. 2020;25(6):695–701. DOI: 10.1111/tmi.13392 15. Корецкая Н.М., Наркевич А.Н., Наркевич А.А., Гринь Е.Н. Туберкулез и табакокурение: риск развития специфического процесса и его особенности у курящих больных. Пульмонология. 2017;27(1):51–55. [Koretskaya N.M., Narkevich A.N., Narkevich A.A., Grin’ E.N. Tuberculosis and tobacco smoking: a risk of development and specific features in smoking patients. Pulmonologiya. 2017;27(1):51–55 (in Russ.)]. DOI: 10.18093/0869-0189-2017-27-1-51-55 16. Мордык А.В., Багишева Н.В., Вершинина М.В. Курение, хроническая обструктивная болезнь легких и туберкулез: составляющие проблемы. Омск: Издательский центр КАН; 2018. [Mordyk A.V., Bagisheva N.V., Vershinina M.V. Smoking, chronic obstructive pulmonary disease and tuberculosis: components of the problem. Omsk: Publishing Center KAN; 2018 (in Russ.)]. 17. Zhang Y.H., Guo L.J., Kuang T.G. et al. [Association between the erythrocyte sedimentation rate, serum C-reactive protein and risk of lung cancer]. Zhonghua Zhong Liu Za Zhi. 2010;32(1):48–51 (in Chinese). PMID: 20211068.

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