编号 4 (2018)

The problem of hepatitis A (HA) currently remains relevant, despite the changes in the epidemiological situation over the past decade and the improved prevention of this disease. Objective. To assess the epidemiological and serological characteristics of HA in some areas of the Russian Federation at the present stage. Materials and methods. The incidence of HA in the Federal Districts (FD) of the Russian Federation was analyzed. The epidemic situation in 6 (Moscow, Belgorod, Kaluga, Lipetsk, Tambov, and Tver) Regions of the Central FD was studied in detail; herd immunity was investigated in different population groups of these regions. The findings were statistically processed. Results. The incidence of FI A was found to have tended to decline among the population as a whole in the Russian Federation over the past 8 years. At the same time, the incidence rate in the North Caucasus, Ural and Siberian FDs exceeded the mean Russian rate by 2.5, 1.3 and 1.2 times, respectively. In the 6 regions of the Central FD, the mean annual HA rate was mainly higher than the mean district rate, but lower than that in the Russian Federation as a whole. The Kaluga Region is HA unfavorable, which is consistent with the high detection rate of anti-HA virus antibodies in this territory. The minimum HA morbidity rates were established in the Lipetsk Region, which corresponded to the results of a serological screening. Information on the recorded incidence of infectious disease does not always provide a clear picture of the true spread of infection. The serological studies showed that the Tver Region occupied the second place in the detection rate of anti-HA virus antibodies of the LgG class among the population (84.5%), while it ranked third by morbidity rates. Conclusion. The incidence of HA among the population as a whole of the Russian Federation, and in the Central FD tends to decrease, which causes a decline in herd immunity (mainly in the adult population) and in combination with a low level of community-level improvements in certain areas can lead to the higher incidence of HA.

Objective. To analyze the epidemic situation of ascariasis in the Astrakhan Region over 2015-2017. Subjects and methods. Thirty-eight epidemiological survey schedules were analyzed in persons infected with Ascaris worms. Among the patients, there were 19 (50%) children younger than 17 years and 19 (50%) adults aged 18 to 65 years. Coproovoscopic techniques were used to diagnose the disease. Results. The main complaints were abdominal pain (23.7%), bowel dysfunction (10.5%), poor appetite (10.5%), nausea (79%), vomiting (79%), fever (5.3%), rapid fatigue (5.3%), headache (5.3%), and cough (5.3%). In isolated cases, the patients complained of teeth grinding at night (2.6%), heaviness and rumbling in the epigastric region (2.6%), skin itch (2.6%), and general weakness (2.6%); 6 (15.8%) persons noted an independent exit of a round parasite measuring 10 to 30 cm. Conclusion. Annual preventive examinations revealed most of the patients with ascariasis. The primary cause of the infection is failure to comply with good personal hygiene. The presence of cough in ascariasis indicates the extraintestinal site of the parasite. The absence of complaints in persons invaded by Ascaridae is characteristic of the asymptomatic course of the disease. The unfertilized parasite eggs found in the stool suggest that only an immature female Ascaris worm is present in the patient’s body. Negative test results and the exit of a male roundworm at time of defecation confirm that the adults are absent in the human body.

Objective. To identify the phenotypic characteristics of biological properties of antibiotic-resistant clinically relevant E. faecalis. Materials and methods. E. faecalis cultures (n = 71) isolated from the urine samples of children with urinary tract infection were investigated during the study. The biological properties of enterococci were studied by classical microbiological techniques. The sensitivity of enterococci to antimicrobial agents was determined by the disc-diffusion method. The findings were statistically processed using the applied Statistica 10.0 software package. Results. The majority of the enterococcal cultures tested had polyantibiotic resistance. A relationship was established between the sensitivity of E. faecalis to antimicrobial agents and its biological properties. Uropathogenic enterococci that had proteolytic activity were resistant to many antibacterial drugs with different mechanisms of action. E. faecalis resistant to linezolid and chloramphenicol had a great pathogenic potential (gelatinase, lecithinase and lipolytic activities). Conclusions. E. faecalis isolated from the urine of children with urinary tract infection have polyantibiotic resistance and certain phenotypic manifestations of biological properties. The set of biological properties of E. faecalis, which has been established in the investigation, can serve as an in vitro diagnostic marker for its resistance to certain groups of antibacterial drugs.

Objective. To develop a procedure for the simultaneous identification of toxic epidemically dangerous Vibrio cholerae biovar El Tor strains and for the differentiation of nontoxigenic strains into potentially epidemic dangerous and epidemic safe ones. Materials and methods. The investigators used 167 V. cholerae 01 biovar El Tor strains, 6 nontoxigenic V. cholerae non-01/0139 strains, 5 bacterial strains of closely related species in the genus Vibrio, and 3 Enterobacteriaceae strains. Results. One-step multiplex PCR for the identification of marker genes was carried out in 2 reaction mixtures. The toxigenic epidemically dangerous strains were typified by the formation of 4 amplified fragments corresponding to the vc0180, vc0514, ctxA, and tcpA genes; the nontoxigenic potentially epidemically dangerous strains were characterized by 3 fragments corresponding to the vc0180, vc0514 and tcpA genes, and the nontoxigenic epidemically safe strains were typical of the formation of 1 fragment corresponding to the tcpA gene, or the absence of ail detected marker genes, respectively. Conclusion. A procedure has been developed to differentiate V, cholerae 01 biovar El Tor strains of different epidemic importance. The investigation has shown the specificity and effectiveness of the developed multiplex PCR that can be used in epidemiological investigations, monitoring studies of environmental objects and for the certification of V. cholera strains.

Objective. To investigate healthcare workers’ awareness of HIV testing counselling. Subjects and methods. A questionnaire survey was conducted among 128 specialists within certification training cycles in 2017 The survey participants made up 4 groups: 3 groups according to the territory (Group 1 included respondents (n = 34) in Nizhny Novgorod; Group 2 consisted of those (n = 25) in Chelyabinsk; Group 3 comprised those (n = 22) in Moscow). Group 4 (n = 47) included the employees of molecular diagnosis centers, who were trained, attending the thematic workshop for counselling skills during HIV testing. The indicator questions about the purposes of HIV testing counseling, about differences in preventive methods, and about the mechanisms improving their effectiveness. Results. There were two views of respondents about the purpose of HIV testing counseling: to inform about various issues associated with HIV infection and to change infection-related behavior. The majority of respondents noted no distinction between counselling and informing and also favored that there was a direct relationship between behavior and the information received. Conclusion. The prevention work based solely on informing cannot effectively curb the HIV epidemic. The emotional component of attitude towards the choice of the mode of behavior while informing is not considerably changed and requires the use of dialogic communication.

Pneumococcal infections are an important problem for organized collectives. The incidence of pneumonia among the servicemen of different military and security forces remains high (30-50%o), whereas the pneumococcus is the most common microbiological finding in young patients with pneumonia from the organized groups. Severe invasive pneumococcal infections, the treatment of which requires significant resources from practical health care, are also a serious problem. Many countries of the world adopt a restrained attitude towards the prevention of pneumococcal diseases by vaccination in the servicemen; however, necessary vaccination against severe invasive pneumococcal infections in the security forces of Russia is a very important event according to the authors of this publication. The use of pneumococcal vaccines in the servicemen results in a decline in the number of severe pneumococcal pneumonia cases,

The vast majority of patients with acute enteric and respiratory infections are treated in the outpatient setting. The low identification of pathogens with significant amounts of research leads to errors in choosing etiotropic treatment, to the biased assessment of the epidemic situation, and to the inefficient use of limited financial resources of facilities. The way to organize the preanalytical stage of microbiological studies in the outpatient settings is fundamentally different from that in the inpatient settings, which is associated with the limited time of patient contact with healthcare workers and with the remoteness of the patient from the laboratory. The recent active centralization of research in the large laboratory centers increases material delivery time. The article analyzes the organizational, methodological and technical problems with the organization of a preanalytic stage of microbiological studies faced by outpatient facilities, and without which the etiological interpretation of infectious diseases cannot be improved.