Vol 9, No 2 (2019)

Objective. To identify and evaluate the epidemiological characteristics of the concomitant incidence of tuberculosis (TB) and parenteral viral hepatitides (PVH) among the population of Moscow in the period 2009 to 2017. Materials and methods. Data on concurrent PVH + TB diseases were obtained on the basis of an analysis of 276 574 infectious disease registration cards available in the Moscow Citywide Automatic Information System «ORUIB» for registering the cases of infectious and parasitic diseases and the statistical data of the Center of Hygiene and Epidemiology in the City of Moscow. Epidemiological and statistical methods were used. Results. The number of patients with the concomitant forms ranged from 311 to 406cases annually (the incidence rate was 3 to 3.7 0/0000), while every ten patients with TB were infected with parenteral hepatitis viruses. These patients were more often found to have severe forms of TB: generalized TB and disseminated TB were by 5.8 and 2.6 times, respectively. The main cause of death was TB (60 to 80% of cases). The risk for a fatal outcome was significantly higher (by 32.0%) in the group of patients with TB burdened by PVH. The chronic forms of hepatitis B and C in patients with TB were significantly more common (by 39 and 116 times, respectively) than among the total population (p <0.05). The incidence of all clinical forms of PVH in patients with TB was 46 times higher than that among the total population (the correlation coefficient was 0.87). Conclusion. Every ten patients with TB were infected with PVH viruses. The severe forms of TB can contribute to the long-term release of mycobacteria into the environment and increase the number of sources of infection. The modern features of the epidemic situation of concomitant incidence of PVH + TB were revealed in the population of Moscow in the period 2009 to 2017.

With obvious successes in the control of measles, rubella and mumps, today it has become extremely relevant to establish what aggravates the epidemic situation of these infections in Russia and European countries. Objective. To estimate the immunological structure of the Moscow population to vaccine-preventable infections. Materials and methods. Epidemiological, statistical, and serological (including 1951 serum samples) methods were used. Results. In 2016-2017, among the total Moscow population, the immune stratum to measles, rubella, and mumps viruses averaged 54.2% [95% CI, 51.9-56.4], 89.1% [95% CI 87.7-90.5], and 69.5% [95% CI, 67.5-71.6], respectively. The proportion of persons immune to the causative agents of the above infections varied according to age; children and young people (their mean age was less than 35 years) are more susceptible than those in older age groups. Conclusion. When non-immune children and young people get older, there may be an increase in the proportion of people susceptible to measles, rubella, and mumps among the Moscow adult population, which necessitates additional vaccination among the population previously unvaccinated.

Despite the widespread prevalence of HIV infection in Africa, the specific features of its epidemic in a number of countries in this continent have not been sufficiently studied. Objective. To carry out a molecular biological analysis of HIV variants circulating in the territory of the Republic of Guinea in 2015-2017. Materials and methods. Plasma samples were collected from 5,566 citizens residing in the Republic of Guinea and were tested for HIV infection. The nucleotide sequences of the pol gene of HIV-1 were studied in HIV-positive samples; the structure and level of drug resistance in the virus were determ ined. Results. HIV-1 infection was detected in 200 (3.59%) individuals. No cases of HIV-2 infection were found. The sequences were obtained for 35 samples, 30 (85.71%) of them were AG recombinants, 6 (17.14%) contained nucleoside reverse transcriptase inhibitor (NRTI) and non-NRTIresistance mutations.

The high incidence of multidrug-resistant strains among the opportunistic enterobacteria isolated from the intestine of infants with dysbioses determines the use of bacteriophages for antibacterial therapy. Objective. To characterize the qualitative and quantitative composition of the large intestinal microflora in infants and to study the sensitivity of the opportunistic pathogens isolated from them to Russian bacteriophage preparations. Subjects and methods. The large intestinal microflora was studied in 870 infants at risk for acute intestinal infections. The sensitivity of650 opportunistic enterobacterial isolates from infants to bacteriophages was examined by the sterile spot method. Results. All the infants were found to have microbiocenotic disorders, grades 2 and 3 being found in 80.5% of cases. There was a low content of bifidobacteria and a large percentage of opportunistic pathogens in associations. Of the 650 opportunistic enterobacterial strains, the high and low sensitivities to bacteriophages were noted in 53.0 ± 2.0 and 10.0 ± 1.1% of the cultures, respectively; resistance to bacteriophages was seen in 37.0 ± 1.8%. Conclusion. Opportunistic microorganisms isolated from infants are characterized by varying degrees of sensitivity to bacteriophage preparations made in Russia.

Objective. To identify the trends andfeatures of the distribution of P. aeruginosa, K. pneumoniae, A. baumannii, and S. maltophilia in hospital and the dynamics of their antibiotic resistance. Materials and methods. A total of 633 gram-negative bacterial isolates were studied. The bacteria were identified using biochemical tests and mass spectrometry; antibiotic resistance genes were determined by a polymerase chain reaction assay; antibiotic susceptibility was defined by diffusion methods. Results. The leading pathogens P. aeruginosa (n = 193), K. pneumoniae (n = 180), A. baumannii (n = 177), and S. maltophilia (n = 83) were identified in the bacterial profile of hospital. They showed a 2.8-fold preponderance in the intensive care units versus surgical units; the studied biomaterial displayed a predominance of monocultures in 79.1 % of cases; there was an uneven distribution of the pathogens in seasonal dynamics, their varying incidence according to gender, and non-specific colonization of patients (p < 0.05). Stable morphological types of antibiotic-resistant isolates were detected in A. baumannii (19.8%) and P. aeruginosa (19.7%). Conclusion. Local monitoring the leading pathogens of healthcare-associated infections makes it possible to obtain reliable data on their colonization of inpatients, on the characteristics of their distribution in seasonal and annual dynamics, and increased antibiotic resistance, which contributes to their timely consideration in a package of preventive and anti-epidemic measures implemented in a healthcare facility and promotes the maintenance of the eff iciency of its used antimicrobial agents.

The review presents information on the immunological and epidemiological efficacy of current meningococcal conjugate polysaccharide and protein (against serogroup B) vaccines. All literature sources indicate not only the high epidemiological efficacy of conjugate polysaccharide vaccines, but also their undoubted effects on the prevalence of carriage of the meningococcal serogroup homologous to the vaccine. Lower carriage is detected no earlier than several months after mass immunization. The protein vaccines against meningococcal serogroup B disease have high immunogenicity and epidemiological efficacy only if the composition of the vaccine is consistent with the protein antigens of the strain that causes the disease, mostly against porin A. In the insignificant number of studies so far, the direct effect of this vaccine on the prevalence of meningococcal serogroup B carriage could not be noted, but the groups are found to have a lower carriage of all meningococcal strains several months after immunization, which is explained by the cross-reactive antigens in the vaccine. Whether meningococcal carriage is completely eradicated under current conditions is discussed.

The paper presents the currently available data in the Russian and foreign literature on latent tuberculosis infection (LTBI) and its role in the risk of tuberculosis (TB) in various population groups, including in those with HIV infection. The greatest risk of TB in people with LTBI is shown to occur in HIV infection: it increases by 10% every year. Allergy skin tests (Mantoux test and Diaskintest), detection of MBT antigens (PCR) and antibodies (ELISA) and in vitro tests based on the production of interferon-y by various MBT antigens are now used in the Russian Federation for the diagnosis of LTBI. Based on the findings, the author defines treatment tactics and regimen for LTBI. The paper considers the topical issues of chemoprophylaxis of TB in HIV-infected patients and presents effective treatment regimens aimed at reducing the risk of TB reactivation rates and adverse reactions and at lowering the drug load on the patient. Obtaining new LTBI knowledge will contribute to the solution of the important task - to the control of the progression of TB in patients with HIV infection.