Vol 20, No 5 (2015)

By force of hormonal and physiological changes occurring in the body throughout pregnancy, in the case of the flu, pregnant women are at greater risk of developing complications. In this regard, the study of clinical and pathogenetic features of influenza in pregnant women deserves special attention. So, on the basis of epidemiological data over the past few decades, WHO experts have included pregnant women in groups at risk of severe (complicated) course of the flu. The flu for a pregnant female is a dangerous infection, representing a real threat to the health of the expectant mother and her child. The clinical picture of influenza in pregnant women can vary significantly, and severe complications combine with the development of a pathology of pregnancy, which ultimately exacerbates the condition as well an expectant mother as the fetus. For the study both of the character of the clinical course of influenza in pregnant women and the mechanism of the immunosuppressive state FGBU "Influenza Research Institute" performed a simple multi-center comparative study on the base of the infectious-disease units of the GBOU "NGMU" and the Medical University "KrasGMU named after. prof. V.F. Voyno-Yasenetsky" of the Ministry of Health of the Russian Federation. The obtained results allowed to reveal some clinical and immunological features of the course of influenza in pregnant women: at the peak of the disease there was noted a significant inhibition of induced production of IFN-γ.

Objective To determine the frequency of bacteremia and pathogens, mortality rate in patients after cardiac surgery. Materials and methods There was performed a retrospective analysis of bacteremia for 13 years from 2000 to 2012 after 8292 cardiac surgeries. Identification of the causative agents of bacteremia was carried out with the use of panels BD Crystal and database BBL Crystal MIND, the detection of susceptibility of microbes to antibiotics by disk diffusion method in accordance with the standards NCCLS. Results The frequency of bacteremia decreased over the study period, from 6.8% in 2000 -2004 to 3.6% in 2010 - 2012. Bacteremia accounted for the bulk of postoperative infectious complications (PIC) - 77.8% - 80.4%. There is given the characteristic of the frequency of isolation in bacteremia with Gr+ and Gr- microbes, as well as the severity of PICs. In the spectrum of blood in bacteremias coagulase negative staphylococcocci prevailed at the background of the general dominance of Gr+ microflora. There was noted the resistance of gram-positive microflora to beta-lactam antibiotics and multiple resistance to antibiotics of non-fermenting bacteria except Polymyxine, Tigacil, and Cefepime, sulperazon

In the article there are presented the data of own investigations of changes of antiendotoxic humoral immunity in some infections of bacterial and viral origin - intestinal infections (rotaviral infection, localized forms of salmonellosis, gastroenteritis caused by opportunistic flora) and influenza A. The levels of antibodies to the lipopolysaccharide of Escherichia coli K235 (Sigma Chem. Co., USA) were determined in the serum of 81 patients with acute intestinal moderate infections and in the serum of 62 patients with influenza A /H1N1/California/09/ in various periods of the disease with the use of ELISA method. Studied immunoglobulin M was revealed to rise significantly in diseases of viral and bacterial etiology. More pronounced evidence of such changes of humoral antiendotoxic immunity was observed in acute infectious pathology proceeding with the involvement of the intestine. Obtained by ourselves data may attest to the stimulation of antiendotoxic immunity in the initial period of influenza and compensateness for this process in uncomplicated forms of the disease. The pronounced change in indices of humoral antiendotoxic immunity in cases of bacterial, viral-bacterial disease usually indicated to a more severe or complicated form of the disease. The performed study emphasizes the important role of various viral and bacterial associations and the ability of these associations to the system rather than the local pathogenetic impact on the human organism, in particular on the system of antiendotoxic immunity.

In the article there is presented the comparative analysis of the character of the specific humoral response to pertussis in dependence on the age, terms of the disease and vaccination history in 279 patients, among which 114 patients were under 1 and 165 patients - over 1 year of the age. In the study of the level of the production of antibodies of different isotypes in unvaccinated patients of different age in dependence on the terms of medical examination it has been revealed that in the patients under the age of 1 year there was typical the low production of all the classes of antibodies in any time of the disease, especially IgM. It has been shown that in babies aged from 0 to 3 and from 4 to 6 months old the production level of these immunoglobulins in examination at the early stages of the disease was established to be considerably lower than in the patients at the age from 7 to 12 months, and was equal to 1,1 ± 0,4 and 1,5 ± 0,1 U/ml versus 9,1 ± 3,8 U/ml correspondingly, (p<0,5). However in these age groups there were no revealed significant differences in the dynamics of the production of IgA and IgG. In the study of the features of the production of antibodies of different classes in patients with pertussis in dependence on the vaccination history in the vaccinated patients the mean concentration of IgG antibodies was shown to be considerably higher than in the unvaccinated cases at all the times of the disease. The studies have shown that the humoral response to pertussis is accompanied by the active production of anti-inflammatory cytokines IL-4 and IL-10 at the second or third week of the disease, which provides Th-2-dependent regulation of the immune response beginning with the early stages of the disease. Peculiarities of the functioning of the cytokine network were largely determined by the vaccination status of the patients.

Manifestation of functional capabilities of an any cell in the body is largely determined by intracellular metabolism, changing his parameters in dependence on the specifity of the pathological process. Indices with high informativeness and relevance for the recording features of intracellular processes in most of exogenous and endogenous effects on the cells are activity of enzymes in them and their lipid profile.