Lecture topic:

Mycobacterium nontuberculosis mycobacteria (NTMBs) are among the most abundantly represented genera of soil bacteria, are natural inhabitants of natural water bodies, colonize water distribution systems, are parasitic in animals, birds and fish, and are found in food foods.

Interest in the problem of differentiation of non- tuberculous mycobacterial infections and tuberculosis arose in the 1930s, when there were reports of mycobacteria not belonging to the Mycobacterium tuberculosis complex, but causing disease in humans. At the present time, about 190 species of NTMB have been discovered. about 190 species of NTMB, more than 60 of which can to be an etiologic agent of respiratory respiratory infection.

Since the early 1980s, diseases caused by NTMBs, mycobacterioses (MB), have been considered a new pathology. Since the beginning of the 21st century, most countries with developed health care systems have noted a steady increase in IB with damage to almost all organs and systems. The obviousness of IB as a clinical problem was demonstrated at the time of the beginning of the epidemic of HIV infection and high mortality from generalized opportunistic infection caused by M.avium. The growing interest in MB is related to the inverse relationship between the growth of MB and tuberculosis (TB), as well as to the improvement of microbiological diagnostic methods, the development of methods of lesion imaging, the spread of clinical experience and knowledge.

In Russia, since the middle of the last century, NTMBs have been considered as agents of mycobacteriosis mainly in animals. Due to the improvement of species identification of mycobacteria and the introduction of modern methods of microbiologicalIn recent years, there has been a growing interest in NTMB as a clinical problem in humans. Thus, IB patients have been diagnosed in St. Petersburg and the Leningrad Region, in the North-West of the country, in the Far North, in the Arkhangelsk 4 Region, the Republic of Mari El, the Central Region, Republic of Mari El in the central region, the former union republic of Belarus. Frequency of detection of clinically significant NTMBs in the The Russian Federation is not known due to the absence of national registries of IB patients, and data on The data on patients in the territory of the country are non-systematic .

Despite a steady increase in the incidence of IB in economically developed countries and the unanimous opinion about the predominant pulmonary localization of the infection, there is disagreement among experts:First, there is a significant variability in some epidemiological and clinical characteristics of NTMBs: the prevalence of various NTMB species as pathogens of MB significantly differs in the world; the drug sensitivity (DST) of clinically significant NTMB of one species in different countries and continents turned out to be rather heterogeneous, which calls into question the application of foreign recommendations for treatment of patients.Secondly, due to the natural resistance of NTMB to many antibiotics, the success of conservative therapy is quite controversial.therapy is highly controversial; there is information about possible differences in vivo drug concentrations, the minimum inhibitoryconcentration (MIC) for a particular type of NTMB and the dose, therapeutic effect.

Clinical guidelines for the diagnosis of IB have been developed in a number of economically developed countries, these are first of all, national guidelines of the USA [D.E. Griffith, 2007], Germany [N. Schoenfeld, 2016], United Kingdom [C.S. Haworth, 2017]. Since similar clinical studies on the territory of the Russian Federation and in the metropolitan area have not were conducted, the clinical problem of mycobacteriosis is evident. There is a lack of domestic instructional and The problem of mycobacteriosis is evident. There is no domestic regulatory and instructional base for Mycobacteriosis. The clinical, radiological and other characteristics of infection have not been determined. The clinical and radiological characteristics of the course of infection have not been determined. The principles of treatment and patient care have not been developed for specific epidemiological, organizational and epidemiological, organizational and organizational and administrative conditions have not been elaborated. The provision of medical the provision of medical care to patients with mycobacteriosis in these conditions presents certain difficulties

Mycobacterial infections

atypical (health condition)

A very rare group of diseases in which A person without immunodeficiency is susceptible to infection by weak mycobacterial organisms, non-tuberculous mycobacteria and environmental mycobacteria, such as, Calmette-Guerin Bacillus (BCG) bacteria

Mycobacteriosis (NTMB)

an infectious disease caused by non- tuberculous mycobacteria with the formation of affected organs and tissues granulomatous inflammation

SYMPTOMS OF LUNG NTMB

IN HUMANS

Mycobacteriosis is often a comorbid disease. Vulnerable groups include people living with HIV or tuberculosis, patients after internal organ transplantation, people with bronchopulmonary diseases (COPD, bronchial asthma, cystic fibrosis), the elderly, and people with a number of other diseases that may be associated with a weakened immune system.

The first signs of the disease are respiratorymanifestations: difficulty in breathing, coughing, spitting up sputum.As the mycobacteriosis pathogen spreads through the mucosa of the esophagus and intestines, mycobacteria enter the blood, causing bacteremia (presence of bacteria in the blood), which subsequently causes secondary damage to the bone marrow and spleen.

If the disease is not recognized early, caverns (voids) begin to form in the lungs. This causes bleeding and hemoptysis. Severe respiratory failure can develop in parallel.

In addition, it has been found that non-tuberculous or atypical, mycobacteriosis of the lungs and other organs can cause lymphadenopathy - enlargement of lymph nodes.

THOSE MOST AT RISK OF INFECTION ARE:

1.patients with AIDS and other immunodeficiencies;

2.persons after internal organ transplants;

3.patients with thermal injuries;

4.patients with pneumoconiosis;

5.Patients with chronic obstructive pulmonary disease;

6.Patients with bronchial asthma;

7.Patients with cystic fibrosis;

8.Patients with bronchiectasias;

9.patients with sarcoidosis;1

0.Patients with pulmonary fibrosis of different nature; 11.Patients with oncologic diseases;

12. Patients who have been treated with glucocorticosteroids orimmunosuppressive therapy;

13.persons of elderly age;

14. patients with tuberculosis, as well as persons treated for this disease