Modern problems of tuberculosis and ways solve them

The review provides a brief description of the current state and problems of tuberculosis infection in the first quarter of the 21 st century during the HIV epidemic and the coronavirus pandemic. The rise in tuberculosis incidence expected by many epidemiologists and tuberculosis specialists during the coronavirus pandemic did not happen; its steady decline continues, which could have been positively influenced by a reduction in contacts. However, it cannot be ruled out that an extreme increase in the influence of stressful social factors can lead to an exacerbation and increase in the number of cases of latent tuberculosis. The emergence of bacterial adaptation as a component of virulence is QUORUM SENSING – quorum sensing, which allows mycobacteria to behave like multicellular organism and form a protective biofilm, which serves as a direct obstacle to the action immunocompetent cells, antibacterial and disinfectant substances, and also greatly increases drug resistance. A major health problem in many parts of the world is the comorbidity of tuberculosis and HIV. This causes an increase in the importance of latent tuberculosis in the emergence of new cases of the disease due to changes in the immune status of the population and the reactivation and the persistent Mycobacterium tuberculosis in the body of people living with HIV. At the same time, the number of severe forms of the disease caused by drug-resistant strains of Mycobacterium tuberculosis continues to increase. Multidrug resistance, which WHO has designated as a global threat, and the crisis of classical antibacterial therapy dictate the need to develop a new strategy for the diagnosis and treatment of infectious diseases, which consists of influencing the genetic and enzymatic targets that determine the virulence of the pathogen.

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