Prospects for researches in the prevention of healthcare-associated infections

  • Authors: Tutelyan A.V1,2,3, Pisarev V.M1,2,4, Gaponov A.M1,2, Akimkin V.G1,3,5
  • Affiliations:
    1. Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare
    2. Dmitry Rogachev Federal Research-and-Clinical Center for Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia
    3. I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
    4. V.A. Negovsky Research Institute of General Reanimatology, Russian Academy of Medical Sciences
    5. Research Institute of Disinfectology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare
  • Issue: No 2 (2014)
  • Pages: 45-51
  • Section: Articles
  • URL: https://journals.eco-vector.com/2226-6976/article/view/277471
  • ID: 277471

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Abstract

Despite the excellent sanitary and epidemiological situation and respective architecture planning decisions, the incidence of healthcare-associated infections (HCAI) remains rather high in the healthcare facilities of many countries of the world. This fact is attributable to that, besides socially mediated factors, there are relatively socially independent ones, such as the selection of highly virulent strains that are multidrug-resistant to physical and chemical factors: decreased defenses and varying susceptibility to therapeutic and preventive measures in the patients. The paper discusses that there are forms of microorganisms (persistent cells) characterized by their drastically reduced metabolic and proliferative activities, which results in their insusceptibility to antimicrobial drugs, which has derived the name of antibiotic tolerance (AT) in the literature. Unlike antibiotic resistance, AT in persistent cells is unassociated with genetic changes in microorganisms and characterized by the possibility to recover antibiotic susceptibility. To investigate the influence of innate and adaptive immunity and some peptide regulatory molecules (antibacterial peptides and neuromediators) on the formation of persistent cells of the opportunistic flora is a new scientific and methodical approach. To study the phenotypic biomarkers of an immune response, which are of informative value for predicting the development of a generalized infectious process, the so-called immunophenomics is of interest in the prevention of HCAI. Biomarkers could also find application at the genetic platform, by using the mass analysis of the variant genes regulating immune reactions to an infectious agent. The determination of the profile of genetic polymorphism of candidate markers together with the quantitative characteristics of immunophenotypical markers may methodically make it possible to create biomarker panels for personalized healthcare. An inflammatory response to infectious pathogen molecules leads to a change in the production of innate and adaptive immunity factors, the activation of which is of pathogenetic value in the poor outcome of an infectious process. By using the abundant evidence available in the literature and their results as an example, the authors show that it is necessary to stratify patients by the quantitative parameters of the immune system as biomarkers for a poor outcome to personalize treatment and to more carefully use immunomodulators, specifically when superinfection is probable.

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About the authors

A. V Tutelyan

Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare; Dmitry Rogachev Federal Research-and-Clinical Center for Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: bio-tav@yandex.ru

V. M Pisarev

Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare; Dmitry Rogachev Federal Research-and-Clinical Center for Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia; V.A. Negovsky Research Institute of General Reanimatology, Russian Academy of Medical Sciences

Email: vpisarev@gmail.com

A. M Gaponov

Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare; Dmitry Rogachev Federal Research-and-Clinical Center for Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia

Email: zorba@yandex.ru

V. G Akimkin

Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; Research Institute of Disinfectology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

Email: vgakimkin@yandex.ru

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