Vol 22, No 5 (2017)

Background. Nosocomial transmission of HBV and HCV is often believed to be associated with transfusion of inapparent infection blood. Nevertheless, recently both promotion of voluntary (fee free) donorship and the evolution of laboratory screening, including the introduction of high-sensitivity tests, have significantly reduced the transfusion-associated complications, including infectious ones. The incidence ratae of primary transfusion-transmitted infections in patients with hematological malignancies remains to be high. A lot of publications are devoted to epidemiological studies on the determination of the source of infection with parenteral viral hepatitis by virtue of molecular analysis of viral strains, which is one of the important tools for obtaining objective data on the presence or absence of epidemiological relationship in the investigation of iatrogenic cases of infection. However, there is still no clear algorithm for pursuing epidemiological investigations of such cases. The aim of this study was to develop the procedure for the epidemiological investigation of probable transfusion-transmitted HBV and HCV infection with the use of Laboratory Information System and Transfusiology Information System software in patients with hematological malignancies. Material and methods. 6 cases of primary HBV and 3 cases of primary HCV were registered in patients with hematological malignancies in the National Medical Research Center for Hematology. All patients had a history of blood transfusions. A two-steps procedure for the epidemiological investigation was developed. 5 epidemiological investigations were held according to this procedure. 35 archival blood samples (7 from patients and 28 from blood donors) were tested for serological and/or molecular markers of HBV and HCV to fulfill this. Results. First step of procedure includes the determination of the date of initial infection (IID). IID is an earliest point of maximal likelihood of the detection of viral markers by laboratory techniques. This value is calculated on the basis of the results of a comprehensive virological examination of the recipient. The second step includes a history of blood transfusions from IID up to date of initial detection of primary infection evaluation. Then the analysis of donor-recipient pairs should be executed for the detection of probable sources of infection. As the result of study 5 epidemiological investigations were held in accordance to the developed procedure and the Laboratory Information System and Transfusiology Information System software. Two of the five investigations cannot be completed because of donors’ rejection to undergo a follow-up examination. In other cases infection transmission through the blood transfusion was excluded. Conclusion. A standard operating procedure of epidemiological investigation of HBV or HCV transmission has been developed and implemented. In order to reveal the latent forms of these infections a protocol of viral screening in patients with hematological malignancies at the admission to hematology ward was also developed and implemented.

1,746 specimens of H. marginatum ticks collected in the Astrakhan region were examined by RT-PCR, their infection rate with CCHF virus amounted to 1.5%. This is comparable with results of earlier studies performed in different years in the Astrakhan and Rostov regions and testified to such indices of viral resistance as 0.1; 0.9; 2.4; 0.6; 0.9 and 2.3%. As a result of sequencing of fragments of the genome (fourteen of the 26 isolates of RNA, they refer to the genotype «Europe-1.» Seven out of 14 isolates belong to the subtype Va «Stavropol-Rostov-Astrakhan», two represent the reassortant genetic variant S-Vc; M-Vb; L-Va.

The goal was to optimize the treatment of shigellosis patients on the basis of an evaluation of the functional state of the thiol-disulfide unit of the antioxidant system (AOS) on a background of various treatment methods. Materials and methods. 400 patients with acute bacterial dysentery of varying severity of the course were observed; Shigella Flexner was isolated in 324(81%) cases, Shigella Sonne - in 76(19%) cases. The determination of sulfhydryl (SH-) groups and disulfide bonds (SS-) was carried out by the direct and reverse amperometric titration with the use of silver nitrate and unithiol in hemolysate. Three groups separated by random sampling were considered. In group I (122 patients), basic therapy was prescribed, including etiotropic and pathogenetic treatment. In group II (134 patients), pathogenetic treatment was prescribed in the combination with a complex of natural cytokines and antimicrobial peptides secreted by pig peripheral blood leukocytesa (»superlimph» preparation). In the third group (144 patients), the drug «superlimph» was prescribed along with etiotropic and pathogenetic treatment. Results. In acute bacterial dysentery disturbances of the redox balance were established to be correlated with the severity of the course in the form of a significant decrease in the level of SH-groups and the thiol-disulfide coefficient on the background of an increase in the level of SS-groups, which indicates to a decrease in the buffer capacity of the AOS. These data can serve as predictors of the nature of the course of dysentery. Comparative clinical evaluation of the effectiveness of various treatment methods revealed the most pronounced in severe disease advantages of complex therapy, including a combination of basic etiotropic, pathogenetic treatment with a complex of natural cytokines and antimicrobial peptides («superlimph»). Conclusion. The change in the ratio of oxidative processes to AOS occurs at any severity of dysentery, but in severe cases these changes acquire a qualitative character. In the survey standards for bacterial dysentery there is recommended to include the determination of indices of the thiol-disulfide unit, as an additional criterion for the severity of the course and the prognosis of the course of the disease. Exceeding the concentration of SS-groups of the concentration of SH-groups and the inversion of the thiol-disulfide coefficient as markers of the breakdown in AOS seem to be prognostically unfavorable factor. The severe course of acute bacterial dysentery is an indication for inclusion of antioxidant agents in the therapeutic complex. Based on the mechanism of revealed abnormalities in AOS, the use of a complex of natural cytokines and antimicrobial peptides («superlimph») can be considered as an immunocorrecting drug.