Vol 19, No 5 (2014)

Articles

Immunopathogenetic features of bacterial purulent meningitides

Balmasova I.P., Vengerov Y.Y., Razdobarina S.E., Nagibina M.V.

Abstract

The aim of the study. Comparative assessment of the state of cells of the immune system in patients with purulent bacterial meningitides caused by N.meningitidis and S.pneumoniae . Materials and methods. By the method offlow cytofluorometry there were tested blood and cerebrospinal fluid of 65 patients with bacterial purulent meningitis, with the meningococcal (38 people) and pneumococcal (27 people) nature of the disease. Results. There were revealed general consistencies of the immune response to CNS infection with meningococcus andpneumococcus: the fall of the number of CD16+ CD56+(NK) and the gain in the number of CD19+ cells in the blood, an increase in the absolute number of T lymphocytes, especially, CD3+ CD8+ and NK. In pneumococcal meningitis there was noted the more pronounced upsurge in the absolute number of the NKT (CD3+CD56+) and B-lymphocytes in the blood whereas in cerebrospinal fluid - the more pronounced upturn in the absolute number of NKT that testified to the severe course of the disease. Conclusion. As a result of performed studies there was identified a series of consistencies for the development of the immune response in bacterial purulent meningitides of meningococcal and pneumococcal etiology, which show the high informativeness of the study of immunograms of cerebrospinal fluid in these diseases as compared with blood. In the latter case, immunological studies may contribute not only to the identification of general consistencies of the development of the immune response in bacterial meningitis, but also serve as a basis for the differentiation of the impact of meningococcal and pneumococcal infection on immunocompetent cells, as well as to reflect the severity of the course of the disease, affecting the nature of the therapy.
Epidemiology and Infectious Diseases. 2014;19(5):4-9
pages 4-9 views

New data on the pathogenicity of genotype of Rickettsia sibirica subspecies BJ-90

Rudakov N.V., Shpynov S.N., Reshetnikova T.A., Penevskaya N.A., Abramova N.V., Kumpan L.V.

Abstract

New data about pathogenicity of Rickettsia sibirica subspecies BJ-90 were obtained. Rickettsial strains of this subspecies from the Primorye region were pathogenic for guinea pigs and chick embryos, multiplied in cell cultures Vero E6. Antibodies against Rickettsia sibirica subspecies BJ-90 in ELISA were detected in the Omsk region in patients with clinical manifestations after bites of ticks. Analysis of available data indicates to the likely pathogenicity of this genotype for human. Due to the low cross reactivity of R. sibirica subsp. BJ-90 and R. sibirica subsp. sibirica in combined foci serological diagnosis of tick-borne rickettsioses in ELISA should be carried out with antigens of both subspecies of Rickettsia sibirica.
Epidemiology and Infectious Diseases. 2014;19(5):10-13
pages 10-13 views

Clinical and microbiological comparisons in whooping cough in children under modern conditions

Popova O.P., Borisova O.Y., Petrova M.S., Gracheva N.M., Abramova E.N., Pimenova A.S., Gadua N.T.

Abstract

Comparative researches have been performing since 1990th years, and were devoted to the study of the interrelationship ofserotype landscape of circulating B.pertussis strains with the severity of clinical course of whooping cough. The researches performed in the 2000th years, showed that in patients with identified strains of B.pertussis serotype 1.0.3, the proportion of children with heavy forms of an illness, in comparison with the 1990thyears considerably increased, reaching 43,2±5,0%, against 18,6±3,6. The analysis of the dependence of clinical picture manifestations of whooping cough from the genotypes of B.pertussis has been performed in 83 patients, among them children at the age up to 1 year (77,1±4,6% ofpatients) prevailed. Genotyping of strains of B.pertussis was carried out with the help of two schemes of multilocus antigen sequence typing (MAST1 and MAST2). As a result of the study of the influence of genotypic properties of B.pertussis strains on clinical manifestations of an infection the most severe course of disease was established to be caused by strains of B.pertussis of genotypes 932 MAST1, 319 MAST2 and 329 MAST2. In work there is presented the careful analysis of symptomatology of the prodromal period and the spasmodic cough, performed in 2 groups of children with the severe and moderate form ofwhooping cough. In whooping cough caused by B.pertussis strains of genotypes 932 MAST1, 319 MAST2 and 329 MAST2, there are most pronounced symptoms determining the severity ofthe course of infection.
Epidemiology and Infectious Diseases. 2014;19(5):13-18
pages 13-18 views

New therapeutic approach for the treatment for staphylococcal bacteremia and sepsis

Beloborodov V.B.

Abstract

Introduction. Staphylococcal bacteremia is an early and dangerous manifestation of infection, it indicates to the presence of the source of infection in the bloodstream or the dissemination ofgerms from otherfoci, is the cause of high mortality rate. In that the approaches to the treatment for bacteremia/sepsis caused by S.aureus, have surprisingly low conclusiveness and require the optimization of antibiotic therapy, duration of treatment, criteria for cure. The aim of this study was to perform the systematic analysis of the current literature devoted to the problem of antibiotic treatment for staphylococcal infection, primarily followed by bacteremia and sepsis. Objectives of the study: the detection of the problem factors having the negative impact on the effectiveness of the antibiotic treatment of severe staphylococcal infections followed by bacteremia, and prospects for the use of new antibiotics. For the solution of the designated objectives in the scientific medical databases Medscape and Pubmed there was performed the search for the publications on subject headings, covering these problems Conclusion. Bacteremia and sepsis caused by S.aureus is not uncommon and severe infection which occurs everywhere, but remains to be poorly understood. The single isolation of S.aureus from the blood always is to be considered as clinically significant due to the high pathogenicity, high probability of infection and complications, rarity of contamination of blood samples with S.aureus. In cases of the isolation of staphylococci from the blood there is required an immediate and thorough search for any focus of invasion and deep metastatic foci of infection. There are strong evidences that the removal of the origin or the drainage of the locus of infection improves the results of the treatment. There is substantially less certainty about the patients with uncomplicated infections that can receive short courses of ABT. There is discussed the optimal choice of antibiotics, the duration and method of administration for the treatment of S. aureus bacteremia (SAB). Available data indicate to the more higher efficiency of f-lactams compared with glycopeptides for the treatment for infections caused by methicillin-sensitive SAB, the emergence of glycopeptide-intermediate Staphylococcus aureus (GISA) or hetero-GISA reduces the role of glycopeptides in the treatment of bacteremia caused by MRSA. Daptomycin showed the high efficacy in the treatment for severe staphylococcal infections accompanied by bacteremia and sepsis, especially when using in a dose of 6 mg/kg/ day and above. There is insufficient data for the assertion that cephalosporins are also effective as penicillins for treating SAB, but they are probably more effective than vancomycin for the treatment of methicillinsensitive SAB. The optimal duration of treatment is considered to be 10-14 days of intravenous administration for most cases of uncomplicated SAB associated with vascular catheterization, upon condition of the removal of the catheter and low risk of endocarditis.
Epidemiology and Infectious Diseases. 2014;19(5):19-25
pages 19-25 views

Modern aspects of epidemiology of ticks transmitted infections

Konkova-Reydman A.B., Ter-Bagdasaryan L.V.

Abstract

Modern literature data have changed our imaginations about the etiological "landscape" of the diseases arising after the suction biting of ticks. The possibility of transmitting mixt-infections by ticks has become an important scientific and practical problem. Ticks can be infected by the all 7 found pathogens (TBE virus, 3 species of Borrelia, Ehrlichia, Anaplasma, Babesia). Among ticks with the modified morphology monoinfected individuals occur 1.3 times, biinfected - 1.5 times more frequently, and the cases of triple infection appear twice more often than among normal cases. There were formed new ideas about genotypic and phenotypic heterogeneity of natural populations of tick-borne virus, there is discussed the heterogeneity of the genome and the pathogenic properties of the TBE virus. There was performed the analysis of literature data about the multifacetedness of the genetic polymorphism typical for the genus Borrelia in total, observed phenomena of the discrepancy of the spectrum of genospecies of Borrelia in natural foci and in biological materials from patients, complex antagonistic tolerant or symbiotic interactions between various intracellular and extracellular pathogens carried by ticks, in the vector's body, reservoir hosts and macroorganism.
Epidemiology and Infectious Diseases. 2014;19(5):26-31
pages 26-31 views

Medical social factors affecting the effectiveness of the treatment of viral hepatitis patients

Raduto O.I.

Abstract

There was performed the analysis of modern epidemiological, social and financial aspects of the hepatitis C treatment. There was considered the influence of some factors on the efficacy of the treatment efficacy, in particular, the genetic status of patients, stage of the disease, the development of side effects and patient compliance with the treatment regimen. Social factors were shown to include also the patient's race, language barriers, being in prison, availability of the treatment. The effectiveness of treatment for this group ofpatients is also influenced by the gender, young age, the presence of mental illness in the patient, drug and alcohol abuse. Financial constraints contribute to the reducing the commitment of the drugs intaking, the deterioration of the health status of viral hepatitis C and B patients, respectively, higher total health expenditure for the health care. There was made a conclusion about the necessity of the work on the formation of the adherence of this category of patients to the treatment, the patient and doctor must work together to make a treatment decision, after careful discussion of the need to comply treatment and risks of side effects, as well as re-infection.
Epidemiology and Infectious Diseases. 2014;19(5):32-36
pages 32-36 views

Enteroviral infections in the Republic of Belarus

Amvroseva T.V., Poklonskaya N.V., Zueva V.L., Bogush Z.F., Dedyulya K.L., Lukashev A.N.

Abstract

In the article there has been analyzed the current state of the problem of non-polio enteroviral infections (EVIs) in humans in the Republic of Belarus. There are reported clinical and epidemiological features of the development of the epidemic process, there is presented the dynamics of morbidity rate in the past decade, there is described the structure for the recorded in recent years EVIs in the context ofadministrative territories, clinicalforms, age groups, the impact of seasonal factors. The particular attention is given to the characteristic of disease outbreak with a description of its dominant pathogens. There are recommended the best ways of improving the surveillance of this group of infections.
Epidemiology and Infectious Diseases. 2014;19(5):37-43
pages 37-43 views

Social aspects of mortality from chronic viral hepatitides in rural and urban populations of the Altai territory

Saldan I.P., Pashkov A.P.

Abstract

In the rural population, died people were revealed more often to be of working age, the diagnosis to them statistically significantly more often was established after the death by the doctor, just has attested the death, and by the doctor-pathologist. By comparing the results obtained with the incidence rate, we came to the conclusion that in the rural population there is decreased the quality of diagnosis of chronic viral hepatitides, that leads to the upsurge of the hidden sources of infection.
Epidemiology and Infectious Diseases. 2014;19(5):43-46
pages 43-46 views

Vera Vasilyevna Ivanova

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Epidemiology and Infectious Diseases. 2014;19(5):47-48
pages 47-48 views


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