"CTRI Bulletin"
#1,(6),2019.

CTRI BULLETIN №1 (6) 2019

Journal Information: Read
Chief Editor: Ergeshov A.E.
Year of foundation: 2017
ISSN (Print): Browse
Publisher site: http://critub.ru
http://tb-bulletin.ru

CONTENT

1)

Challenges in immunodiagnosis of tuberculosis

Gergert V.Ya., Yeremeev V.V., Lyadova I.V., Averbakh M.M., Ergeshov A.E.

5 READ MORE
2)

Age, gender, clinical and microbiological peculiarities of TB patients with extensive drug resistance

Galkin V.B., Rusakova L.I., Sterlikov S.A., Maliev B.M., Yarullina R.Kh.4, Yukhnova E.A., Frolov E.G., Tinkova V.V., Strelkov A.N., Smerdin S.V., Svicharskaya A.K., Podgainaya O.A., Pirogova N.D., Ovsyankina O.V., Milyutina P.A., Lechleider M.V., Kustova I.V., Kononenko Yu.S., Komkova M.A., Zyryanova O.G., Zelenina A.E., Beltyukov M.V., Ashenova G.Zh.

15 READ MORE
3)

Clinical and morphological manifestations of TB in HIV-infected patients in Orenburg region

Mikhailovsky A.M., Komissarova O.G., Lepekha L.N.

32 READ MORE
4)

Nutritional status of tb/hiv co-infected patients

Gerasimov L.N., Abdullaev R.Yu., Komissarova O.G.

41 READ MORE
5)

Clinical experience and advancements in the application of confocal laser endomicroscopy of the respiratory tract (a literature review and our data)

Danilevskaya O.V., Averyanov A.V.

50 READ MORE
6)

Allergic reactions during treatment of new pulmonary TB patients

Ivanova D.A., Borisov S.E.

59 READ MORE
7)

Evaluation of blood microcirculation in the lungs of patients with tuberculomas in the pre- and post-operative period

Sigaev A.T., Amansakhedov R.B., Kazho R.M., Krasnikova E.V., Berezovsky Yu.S., Ergeshov A.E.

68 READ MORE
8)

The effect of human immunoglobulin on the course of the early postoperative period after pneumonectomy and the incidence of complications in patients with progressive destructive pulmonary tuberculosis with multidrug resistance

Penagi S.N., Bagirov M.A., Mozhokina G.N., Krasnikova E.V., Penagi R.N.

77 READ MORE
9)

Pulmonary tuberculosis co-infection with pulmonary mycobacteriosis: the peculiarities of diagnosis and treatment

Stepanyan I.E., Bagdasaryan T.R., Larionova E.E., Smirnova T.G., Andreevskaya S.N., Zaytseva A.S., Chernousova L.N., Ergehov A.E.

84 READ MORE
10)

Diagnosis and management of pulmonary and extrapulmonary TB with extensive drug resistance in a patient with comorbidities

Bagdasaryan T.R., Polyakova A.S.,  Tikhonov A.M., Romanov V.V., Shabalina I.Yu.,  Larionova E.E., Ergeshov A.E.

91 READ MORE
11)

Microscopic detection of mycobacteria by Ziehl-Neelsen staining technique

Part 1. Smear preparation and staining procedure

Sevastyanova E.V., Larionova E.E., Andrievskaya I.Yu.

100 READ MORE

Challenges in immunodiagnosis of tuberculosis

Article 1.Page 5.
ARTICLE TITLE:Challenges in immunodiagnosis of tuberculosis
AUTORS:

Gergert V.Ya., Yeremeev V.V., Lyadova I.V., Averbakh M.M., Ergeshov A.E.

Central TB Research Institute, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 04.12.2018

The review discusses the issues of immunodiagnosis of tuberculosis infection and disease; causes, why a host organism responds or doesn’t respond to immunological tests, associated with individual sensitivity to mycobacterial antigens, antigenic load, genetically determined resistance to disease, or severity of process.

KEYWORDS:

tuberculosis, immunodiagnostics, tuberculin, recombinant tuberculosis antigen, immunological tests in vitro.

FOR CORRESPONDENCE:

Central ТВ Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

Vladislav Ya. Gergert, Doctor of Medical Sciences, Professor, Head of Immunology Department

Tel.: +7 (499) 785-90-72

E-mail: hergertv@mail.ru

Age, gender, clinical and microbiological peculiarities of TB patients with extensive drug resistance

Article 2.Page 15.
ARTICLE TITLE:Age, gender, clinical and microbiological peculiarities of TB patients with extensive drug resistance
AUTORS:

Galkin V.B.1, Rusakova L.I.2, Sterlikov S.A.2,3, Maliev B.M.15, Yarullina R.Kh.4, Yukhnova E.A.5, Frolov E.G.13, Tinkova V.V.16, Strelkov A.N.14, Smerdin S.V.13, Svicharskaya A.K.6, Podgainaya O.A.7, Pirogova N.D.8, Ovsyankina O.V.8, Milyutina P.A.10, Lechleider M.V.16, Kustova I.V.9, Kononenko Yu.S.10, Komkova M.A.17, Zyryanova O.G.11, Zelenina A.E.12, Beltyukov M.V.1, Ashenova G.Zh.18

1St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russia

2Central TB Research Institute, Moscow, Russia

3Federal Research Institute for Health Organization and Informatics, Moscow, Russia

4Republican Clinical TB Dispensary, Kazan, Russia

5Novgorod Clinical Specialized Center for Phthisiopulmonology, Novgorod, Russia

6Sevastopol TB Dispensary, Sevastopol, Russia

7Crimea Republican Clinical Center for Phthisiology and Pulmonology, Simferopol, Russia

8Oblast TB Dispensary, Tyumen, Russia

9Kostroma TB Dispensary, Kostroma, Russia

10Republican TB Dispensary, Petrozavodsk, Russia  

11Irkutsk Oblast Clinical TB Hospital, Irkutsk, Russia

 12Lipetsk Oblast TB Dispensary, Lipetsk, Russia

13Moscow Oblast Clinical TB Dispensary, Moscow, Russia

14Smolensk Oblast Clinical TB Dispensary, Smolensk, Russia

 15North Ossetia State Medical Academy, Vladikavkaz, Russia

16Chelyabinsk Oblast Clinical TB Dispensary, Chelyabinsk, Russia

 17Kamchatka Krai TB Dispensary, Petropavlovsk-Kamchatsky, Russia

18Yamalo-Nenetsky Okrug TB Dispensary, Salekhard, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 28.11.2018

We investigated factors associated with the development of extensively drug resistant (XDR) TB and treatment options. Materials and methods. We analyzed TB treatment cases in 14 regions of the Russian Federation notified in 2015 and 2016. The main group: 708 XDR TB cases. Control group 1 included 4,369 multidrug resistant (MDR) TB cases. Control group 2 included 4,320 cases with drug sensitive TB. The data were stratified by notification and gender. Results. In the main group prevailed TB cases after treatment failure (67.5% vs. 48.9% in group 1 and 5.6% in group 2; p<0.001) due to a decreased share of new TB cases (13.4% vs. 29.7% and 77.3%, respectively) and relapses (7.2% vs. 9.8% and 10.7%). The median age of all patients was 39. The share of female patients was higher among new TB cases of the main group (37.9% vs. 28.9% and 28.1%, respectively; p<0.05). The share of HIV-positives in the main group (15.8%) was somewhat lower than in control group 1 (19.7%; p<0.01) but did not differ from this rate in control group 2 (16.3%; p>0.05). The share of rural population was 31.0%, 28.5% and 31.1%, respectively, p>0.05. The frequency of lung cavities was 73.7%, 64.9% and 59.2%, respectively, p<0.001. The frequency of sputum positivity confirmed by microscopy was 64.7% vs. 57.5% and 56.8%, respectively, p<0.001. The established resistance to drugs in the main group and control group 1 was as follows: ethambutol – 76.8% and 58.1%, respectively, ethionamide – 48.5% and 11.9%, cycloserine – 24.4% and 4.4%, amino-salicylic acid – 19.8% and 3.4%. Discussion. The structure of XDR TB cases confirms that treatment failure is the major risk factor for XDR TB development, while treatment interruption is not an essential risk factor. We did not establish influence of HIV-infection or place of residence on the frequency of primary or acquired XDR TB. More massive bacterioexcretion and lung cavities in XDR TB cases are associated with higher epidemic danger. Administration of ethambutol, ethionamide or protionamide is not effective for XDR TB cases. Conclusions. The treatment outcome defined as “treatment failure” is the major risk factor for XDR TB. The influence of treatment interruption, HIV-infection or place of residence on the frequency of XDR TB is not proved. The hypothesis about higher epidemic danger of XDR TB is confirmed. It is advisable to widely use collapse therapy and novel TB drugs to treat XDR TB.

KEYWORDS:

extensive drug resistance (XDR), TB, clinical characteristics of XDR TB cases, risk factors for XDR TB, drug resistance pattern.

FOR CORRESPONDENCE:

St. Petersburg Research Institute of Phthisiopulmonology

2-4, Ligovsky Pr., 191036, St. Petersburg, Russia

Vladimir B. Galkin, Candidate of Medical Sciences, Leading Researcher

Tel.: +7 (812) 579-24-23

E-mail: vbgalkin@gmail.com

Clinical and morphological manifestations of TB in HIV-infected patients in Orenburg region

Article 3.Page 32.
ARTICLE TITLE:Clinical and morphological manifestations of TB in HIV-infected patients in Orenburg region
AUTORS:

Mikhailovsky A.M.1, Komissarova O.G.2, Lepekha L.N.2

 1Orenburg Oblast Clinical TB Dispensary, Orenburg, Russia

2Central TB Research Institute, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 06.12.2018

The objective of our research was to determine pathomorphological and clinical manifestations of acute progressive TB in patients, who died from TB in Orenburg region. Based on the autopsy and the retrospective analysis of medical documents, we studied clinical and pathomorphological manifestations of acute progressive disseminated forms of TB in 562 patients with the late stage HIV-infection (the TB/HIV group). The comparison group included 134 HIV-negative patients with similar manifestations of TB (the TB group). We established that clinical and morphological manifestations of progressive TB associated with HIV infection differed from those of TB without HIV and depended on the priority of TB or HIV infection. Clinical signs of TB/HIV co-infection mainly manifested as newly detected disseminated forms of TB with massive bacterioexcretion, expressed respiration disorders, intoxication and the systemic inflammation response. Morphological changes due to TB/HIV co-infection displayed the progressive nature of inflammation with prevailing exudative-alterative changes, absence of delimitation signs and organization of purulent necrotic inflammatory focuses without specific signs in the lungs and other organs. Spread of TB inflammation was predominantly due to hematogenic dissemination, rapid generalization of the disease. TB progress was influenced by a concomitant infection, which might become the major cause of death. Bacterial pneumonias, mycoses and viral infections of bronchopulmonary system were more common in TB/HIV patients.

KEYWORDS:

TB, HIV-infection, exudative-necrotic changes, intoxication, hematogenic dissemination.

FOR CORRESPONDENCE:

Orenburg Oblast Clinical TB Dispensary

6, Nezhinskoe shosse, 460041, Orenburg, Russia

Alexander M. Mikhailovsky, Candidate of Medical Sciences, Head of Pathological Anatomy Department, Assistant of Phthisiology and Pulmonology Department of Orenburg State Medical University

Tel.: +7 (922) 627-75-22

E-mail: michailovsky2007@yandex.ru

NUTRITIONAL STATUS OF TB/HIV CO-INFECTED PATIENTS

Article 4.Page 41.
ARTICLE TITLE:Nutritional status of tb/hiv co-infected patients
AUTORS:

Gerasimov L.N.1,3, Abdullaev R.Yu.1, Komissarova O.G.1,2

 1Central TB Research Institute, Moscow, Russia

2Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia

3Tuberculosis Hospital named after A.E. Rabukhin, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 14.11.2018

We examined 347 TB patients, which were divided in two groups. Group 1 included 224 TB/HIV co-infected patients, group 2 – 123 TB patients without HIV. The nutritional status was determined based on body mass index (BMI), levels of transthyretin (TTR), albumin (A) and total protein (TP) in the blood serum. Nutritional deficiencies were established in the both groups. However, nutritional deficiencies were more severe in TB/HIV co-infected patients, as demonstrated by more essential decrease in TTR and A levels. Severity of protein-energy deficiencies in TB/HIV co-infected patients correlated, on one hand, with TB course, and, on the other hand, with HIV-infection course. The worst indicators of nutritional status were observed in patients with fibrocavitary pulmonary TB, lesions of multiple anatomical sites, lesions of more than two lung lobes, lung cavities and sputum positivity caused by extensively drug resistant M. tuberculosis. We established that the most essential decrease in protein-energy support was observed in patients with CD4 counts less than 0.35х109/L and HIV viral loads more than 500,000 copies/ml.

KEYWORDS:

TB, nutritional deficiency, body mass index, albumin, transthyretin.

FOR CORRESPONDENCE:

Tuberculosis Hospital named after A.E. Rabukhin, Moscow Health Department

7, Rabukhin St., 141504, Solneshnogorsk, Moscow region, Russia

Lev N. Gerasimov, phthisiologist  

Tel.: +7 (495) 780-69-08

E-mail: 1968berserc@mail.ru

Clinical experience and advancements in the application of confocal laser endomicroscopy of the respiratory tract (a literature review and our data)

Article 5.Page 50.
ARTICLE TITLE:Clinical experience and advancements in the application of confocal laser endomicroscopy of the respiratory tract (a literature review and our data)
AUTORS:

Danilevskaya O.V., Averyanov A.V.

Federal Pulmonology Research Institute of Federal Medical and Biological Agency, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 22.11.2018

Probe-based confocal laser endomicroscopy (pCLE) was introduced in 2007. Presently, it is the unique technology, which allows real-time in vivo visualization of intraacinar structures. In this review we have shown the potentials of pCLE in diagnosis of different lung diseases based on our own experience and the data from other researchers involved in the development of alveoloscopy worldwide. The main advantages of the method are: ability to evaluate intraalveolar autofluorescent structures, containing yellow fibers, proteins, lipids, phosphorus or resin; possible determination of signs of neoplastic processes. However, there is a number of limitations for the method application in broad clinical practice.

KEYWORDS:

confocal laser endomicroscopy, distal respiratory tract, alveoloscopy, diagnosis, lung diseases, bronchoscopy.

FOR CORRESPONDENCE:

Federal Pulmonology Research Institute of Federal Medical and Biological Agency

28, Orekhovy boulevard, 115682, Moscow, Russia

Olesia V. Danilevskaya, Candidate of Medical Sciences, Senior Researcher, Laboratory of Pathological Anatomy

Tel.: +7 (916) 981-98-53

E-mail: danless@mail.ru

Allergic reactions during treatment of new pulmonary TB patients

Article 6.Page 59.
ARTICLE TITLE:Allergic reactions during treatment of new pulmonary TB patients
AUTORS:

Ivanova D.A., Borisov S.E.

Moscow Research and Clinical Center for Tuberculosis Control of Moscow Government Health Department, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 12.11.2018

A prospective study of frequency, spectrum and risk factors of allergic reactions during antituberculosis chemotherapy included 435 new pulmonary tuberculosis patients. The frequency of allergic reactions during intensive phase of treatment was 50.6% (95% CI 45.9-55.2%) with predominated isolated drug eosinophilia (43.1%); severe allergic reactions (3-4 degrees) developed in 17.9% (95% CI 13.8-20.8%). Blood eosinophilia more than 5% (300 cells per ml) before treatment (OR 3.51, 95% CI 1,69-7,29), fungal infection (OR 2.09, 95% CI 1.28-3.40) and use of aminoglycosides or capreomycin (OR 2.34, 95% CI 1.56-3.52) were independent risk factors of allergic reactions. The effectiveness of prolonged use of antihistamines for the prevention of allergic reactions was not confirmed.

KEYWORDS:

antituberculosis chemotherapy, allergic reactions, risk factors, drug eosinophilia, antihistamines.

FOR CORRESPONDENCE:

Moscow Research and Clinical Center for Tuberculosis Control of Moscow Government Health Department

10, Stromynka St., 107014, Moscow, Russia

Diana A. Ivanova, Candidate of Medical Sciences, Scientist Secretary

Тel.: +7 (499) 269-14-10

E-mail: d-ivanova@list.ru

Evaluation of blood microcirculation in the lungs of patients with tuberculomas in the pre- and post-operative period

Article 7.Page 68.
ARTICLE TITLE:Evaluation of blood microcirculation in the lungs of patients with tuberculomas in the pre- and post-operative period
AUTORS:

Sigaev A.T., Amansakhedov R.B., Kazho R.M., Krasnikova E.V., Berezovsky Yu.S., Ergeshov A.E.

Central TB Research Institute, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 13.07.2018

Lung scintigraphy is a valuable diagnostic method, which enables to evaluate dissemination, anatomical site and activity of the pathological process in patients with lung tuberculomas. The article represents an objective evaluation of data on regional blood flow disturbances in the lungs of 35 surgery patients obtained using scintigraphy with 99mTc-MAA. We compared scintigraphy and morphology data to investigate causes of capillary flow reduction in the lungs of patients with tuberculomas; compared pulmonary microcirculation before and after surgery.

KEYWORDS:

perfusion scintigraphy, 99mTc-MAA, lung tuberculoma, pulmonary microcirculation.

FOR CORRESPONDENCE:

Central TB Research Institute

2, Yauzskaya alley, 107564, Moscow

Anatoly T. Sigaev, Doctor of Medical Sciences, Professor, Head of Radiology Department

Tel.: +7 (962) 908-10-61

E-mail: sigaev.1938@mail.ru

The effect of human immunoglobulin on the course of the early postoperative period after pneumonectomy and the incidence of complications in patients with progressive destructive pulmonary tuberculosis with multidrug resistance

Article 8.Page 77.
ARTICLE TITLE:The effect of human immunoglobulin on the course of the early postoperative period after pneumonectomy and the incidence of complications in patients with progressive destructive pulmonary tuberculosis with multidrug resistance
AUTORS:

Penagi S.N.1, Bagirov M.A.1, Mozhokina G.N.2, Krasnikova E.V.1, Penagi R.N.1

1Central TB Research Institute, Moscow, Russia   

2National Medical Research Centre of Phthisiopulmonology and Infectious Diseases, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 30.11.2018 г.

Forty-five patients with destructive multidrug-resistant pulmonary tuberculosis (TB) after pneumonectomy were administered human immunoglobulin (HI – Pentaglobin®) in the early postoperative period to prevent early bronchopulmonary complications. The comparison group also consisted of 45 patients, who did not receive HI in the early postoperative period.

In the main group the postoperative period was smooth, with rapid rehabilitation. An empyema without fistula in the pleural space was observed in the early postoperative period in two patients (4.4%), who successfully underwent a damage control thoracostomy and thoracomyoplasty. In the comparison group complications were more common and severer (28.9%, р<0.01).  The most common complications were bronchial stump dehiscence and pleural empyema (46.7%), which required additional operations. Two patients (13.3%) died from TB progression in a single lung.  Three out of 4 patients died from postoperative pneumonia in a single lung in the first week after surgery. Totally, one third of the patients with the severest complications died during the first month after surgery.

Thus, administration of HI in the early postoperative period after pneumonectomy allowed a six-fold reduction of complications and prevention of lethal outcomes.

KEYWORDS:

drug-resistant tuberculosis, surgical treatment, pneumonectomy, bronchopulmonary complications, prevention of complications, human immunoglobulin.

FOR CORRESPONDENCE:

Central ТВ Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

Buinaksk TB Dispensary, the Ministry of Health of the Republic of Dagestan

77, Lomonosov St., Buinaksk, 368222, the Republic of Dagestan, Russia

Surkhab Nidzhat A. Penagi, Postgraduate, Head of Surgery Unit No. 3

Tel.: +7 (87237) 2-21-30

E-mail: penagi79@gmail.com

Pulmonary tuberculosis co-infection with pulmonary mycobacteriosis: the peculiarities of diagnosis and treatment

Article 9.Page 84.
ARTICLE TITLE:Pulmonary tuberculosis co-infection with pulmonary mycobacteriosis: the peculiarities of diagnosis and treatment
AUTORS:

Stepanyan I.E., Bagdasaryan T.R., Larionova E.E., Smirnova T.G., Andreevskaya S.N., Zaytseva A.S., Chernousova L.N., Ergehov A.E.

Central TB Research Institute, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 14.12.2018

We carried out a retrospective analysis of simultaneous detection of Mycobacterium tuberculosis (MTB) and nontuberculous mycobacteria (NTM) in the sputum from patients with established pulmonary tuberculosis. The co-infections were diagnosed in 19 out of 34,567 examinees (0.55%). Co-infection with NTM was found in patients with different clinical forms of tuberculosis. Among isolated NTM we detected 7 species of rapidly- and slowly-growing mycobacteria; however, M. avium was found in none of the cases. In the most cases (14 out of 19) NTM were detected after sputum conversion due to TB treatment; in 3 cases NTM were detected earlier than MTB; in two cases MTB and NTM were detected at the same time. Antibacterial therapy for pulmonary mycobacteriosis was administered based on drug susceptibility of NTM and patients’ tolerance; in all the cases it was effective.

KEYWORDS:

pulmonary tuberculosis, pulmonary mycobacteriosis, mycobacterial co-infection.

FOR CORRESPONDENCE:

Central TB Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

Igor E. Stepanyan, MD, Doctor of Medical Sciences, Professor, Leading Researcher

Теl. +7 (499)169-99-51

E-mail: drstepanyan@mail.ru

Diagnosis and management of pulmonary and extrapulmonary TB with extensive drug resistance in a patient with comorbidities

Article 10.Page 91.
ARTICLE TITLE:Diagnosis and management of pulmonary and extrapulmonary TB with extensive drug resistance in a patient with comorbidities
AUTORS:

Bagdasaryan T.R., Polyakova A.S.,  Tikhonov A.M., Romanov V.V., Shabalina I.Yu.,  Larionova E.E., Ergeshov A.E.

Central TB Research Institute, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 29.11.2018.

Primary TB is most commonly diagnosed in children and adolescents, less commonly – in adults. Primary TB often affects organs other than lungs. The proportion of extrapulmonary TB is not large, but such cases are diagnostic challenges. We have represented a clinical example, which demonstrates that even patients with generalized TB, extensive drug resistance (XDR) and comorbidities can be effectively treated. What they need is an adequate chemotherapy regimen based on drug susceptibility data, uninterrupted treatment, maintenance treatment to prevent adverse reactions, careful monitoring and timely treatment correction due to adverse reactions.

KEYWORDS:

primary TB, extrapulmonary TB, extensive drug resistance, chemotherapy.

FOR CORRESPONDENCE:

Central TB Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

Tatevick R. Bagdasaryan, MD, Candidate of Medical Sciences, 1st Division for Phthysioiology, Head

Теl.: +7 (967) 182-90-04  

Е-mail: norair04@mail.ru

MICROSCOPIC DETECTION OF MYCOBACTERIA BY ZIEHL-NEELSEN STAINING TECHNIQUE

PART 1. SMEAR PREPARATION AND STAINING PROCEDURE

Article 11.Page 100.
ARTICLE TITLE:

Microscopic detection of mycobacteria by ziehl-neelsen staining technique

Part 1. Smear preparation and staining procedure

AUTORS:

Sevastyanova E.V., Larionova E.E., Andrievskaya I.Yu.

Central TB Research Institute, Moscow, Russia

DESCRIPTION OF ARTICLE:

Submitted as of 14.12.2018

We have described the microscopic detection of mycobacteria using Ziehl-Neelsen staining of smears. We described variants of smear preparation from untreated sputum, specimen sediments, and mycobacterial culture. We also represented the method of Ziehl-Neelsen smear staining, and analyzed possible errors, which occurred during preparation and staining of smears.

KEYWORDS:

mycobacteria, Ziehl-Neelsen microscopy.

FOR CORRESPONDENCE:

Central TB Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

Elina V. Sevastyanova, Doctor of Biological Sciences, Leading Researcher, Microbiology Department

Tel.: +7 (499) 785-90-91

Е-mail: elinasev@yandex.ru