No 1 (2012)

Healthcare-associated infections (HCAI) are a serious problem throughout the world. The actual task of modern medicine is to study the evolution of HCAI pathogens. Bacteriophages may play a significant role in the formation of pathogenic properties in nosocomial strains. At the same time, bacteriophages are effective agents for the treatment and prevention of HCAI. The mass and irrational use of antibiotics causes HCAI pathogens to acquire multiple resistance, therefore antibiotic effectiveness is reduced or frequently absent. In this connection, bacteriophages as antimicrobial agents assume particular importance. The circulation of phages and their biological properties were studied and nosocomial strains were tested for phage-mediated virulence factors at different hospitals. It was shown that moderate phages might affect the acquisition of virulence factors, as well as antibiotic resistance in bacteria. The therapeutic and preventive efficacies of bacteriophages were evaluated, by using Pseudomonas aeruginosa infection as an example at a traumatology hospital. The application of phages was demonstrated to reduce the incidence of Pseudomonas aeruginosa infection from 40.8 to 8.9%.

The incidence of pneumococcal meningitis was analyzed among children under 6 years of age in the Russian Federation. A proportion of pneumococcal meningitis in the etiological structure of purulent bacterial meningitis was ascertained and its morbidity rate calculated. Among children aged less 6 years in the Russian Federation in 2010, pneumococcal meningitides were shown to rank third in the structure of purulent bacterial meningitides and to be 10%. By taking into account the low-level laboratory interpretation of purulent bacterial meningitides (33%), the morbidity rate for pneumococcal meningitides to be 1.7 times greater than the registered rates.

Research Institute of Experimental Medicine, North-Western Branch, Russian Academy of Medical Sciences, St. Petersburg Live attenuated influenza vaccines (LAIV) are used in Russia to immunize all population groups, including children. The immunogenicity, acceptance, and transmissibility of the components of commercially available trivalent LAIV vaccine in vaccinated children aged 3 to 6 years were studied. Vaccine viruses were isolated from nasal swabs of the vaccinees, using chicken embryos and MDCK cells. The use of a combination of these two culture systems produced the best effect in isolating vaccine viruses. Examination of placebo group children who were in constant contact with the vaccinated subjects showed that LAIV strains had not been transmitted from the vaccinated to unvaccinated children. The acceptance of vaccine virus correlated well with its immunogenicity.

The paper gives a literature review that characterizes the current epidemiological features of erysipelas as a clinical type of non-invasive streptococcosis. These are its high incidence rates, the predominant development of severe hemorrhagic forms, and the high likelihood of recurrences.

The review outlines the present views of hepatitis C virus (HCV) infection in pregnant women and newborn infants and reflects its epidemiological and pathogenetic aspects and the clinical manifestations and diagnostic features of neonatal HCV infection transmitted from HCV-infected mothers.

The epidemic of HIV infection remains a priority for the world community. Russia and Ukraine are a basic reservoir of this social infection, HIV being mainly transmitted through the parenteral route that is common among injection narcotic users. Highly active antiretroviral therapy is associated with side effects and HIV resistance. In these conditions, there is an increasing demand for second-line agents with a good safety profile and a high barrier to the development of resistance. Etravirine (ETR) (intelence®, Janssen-Cilag) and raltegravir (RAL) (isentress®, Merck Sharp & Dohme B.V.) are indicated as components of combination therapy for previously treated adult patients infected with HIV-1. Meta-analysis of the results of the DUET I, II (ETR) and BENCHMARK I, II (RAL) studies showed that these drugs had the same therapeutic effect. The purpose of this study was to make a pharmacoeconomic analysis of antiretroviral therapy with ETR and RAL in HIV-infected patients. This study used a cost-minimization analysis. The cost of the compared drugs was taken from the 2011 Federal tender prices within the priority National Health project. Comparison of the estimated number of patients treated with each drug indicated that the use of ETR can provide much more patients with equally effective therapy than that with RAL. The annual cost of ETR is vastly below that of RAL. This allows the choice of ETR to be used for the treatment of previously untreated HIV-infected patients.

The paper gives the results of using recombinant α-2b-interferon as noninvasive formulations — suppositories, nasal drops — to treat and prevent acute respiratory viral infections (ARVI) in children. Rectal kipferon significantly decreased the duration of fever with a tendency to reduce catarrhal signs. The administration of grippferon significantly decreased the time of manifestations of rhinitis, cough, and pharyngeal hyperemia with a tendency to reduce a febrile reaction and intoxication. When used in children admitted to a bronchopulmonary sanatorium, grippferon exerted a significant positive effect on the rate of recurrent ARVI in them. Interferon preparations were administered as a short course of moderate doses in all cases. No adverse reactions were observed.