Vol 9, No 4 (2019)

Objective. To analyze the results of monitoring vibrio cholerae in the Republic of Kalmykia in 2013 to 2017. Materials and methods. A total of 105 nontoxigenic El Tor vibrio cholerae strains selected applying the geographic information systems (GIS) were used. PCR typing of the strains was performed by the previously developed procedure. The findings were statistically processed according to the STATISTIKA computer program (StatSoftRussia). Results. The investigation showed variability in V. cholerae 01 El Tor strains by phage lysability. It established the genetic diversity of V. cholerae isolates. The investigators revealed V. cholerae strains included in the cluster found only in the Republic of Kalmykia and in the Rostov Region. The presence of this set of genetic determinants suggested that water basins could be considered as a reservoir of pathogenicity/persistence genes. Conclusion. The aquatic ecosystems of the Republic of Kalmykia were ascertained to have the most favorable conditions for survival of nontoxigenic V. cholerae 01 El Tor strains in them for a few years, without excluding new drifts.

Immunization is the most effective technology that allows mass diseases and epidemics to be avoided; nonetheless, increasing anti-vaccination moods are a serious obstacle to the expansion of immunization in modern society, and therefore there is a need for active work with the population. Objective. To determine able-bodied adults’ attitude towards influenza vaccination. Subjects and methods. A sociohygienic study was conducted in 106 able-bodied people. A specially designed questionnaire was used for their survey. Respondents were selected randomly; each survey participant was asked to answer 28 questions contained in an anonymous questionnaire. Results. Most (62.3%) of the able-bodied respondents have a positive attitude towards influenza vaccination and one half of the respondents intend to immunize their children in the future. The educational level in patients, the degree of their confidence in healthcare workers, and the presence of children in the family affect the formation of a positive attitude towards vaccination. Conclusion. The analysis of the survey can determine the attitude of certain population groups towards influenza vaccination; this makes it possible to purposefully develop a strategy of effective preventive measures for specific patient audience.

When medical care is rendered to seriously ill patients with Crimean hemorrhagic fever (CHF), there is an increased risk of healthcare-associated infection (HCAI) at first- and second-level hospitals. There is a need for the uniform assessment of disease severity, according to which the patient at high risk of death should be immediately transferred to a third-level hospital. Objective. To develop a procedure for assessing the risk of death in patients with CHF, by determining the clinical and laboratory values available at first-/second-level hospitals on the day of hospitalization. Materials and methods. By analyzing four procedures for evaluating the severity of the condition in patients with CHF, the investigators designed a mortality risk prediction scale based on 12 clinical and laboratory parameters and 2-4 gradations of each parameter, which was reflected in 32 criteria of the scale. The scale was tested based on the Epidemiologia i infekcionnye bolezni. aktual'nye voprosy retrospective analysis of case records of 52 patients with CHF who had been treated at the hospitals of the Turkestan Region, Republic of Kazakhstan, in 2000-2018. Results. The patients’ clinical and laboratory values were rated using the designed point scale for assessing the risk of death in patients with CHF. Each parameter was assigned a certain number of scores and then their total amount was determined. When the patient had a total score of > 11, he was predicted to be at high risk of an unfavorable outcome. When the total score was < 11, the risk for an adverse outcome was considered to be low in patients with CHF. The sensitivity of the proposed procedure was 100%; its specificity was 98%, and the predicted value was 90%. Conclusion. The proposed procedure with a high probability allows prediction of a poor outcome of CHF; it should be used at first- and second-level hospitals to optimize healthcare provision to patients with this disease and to prevent HCAI.

Objective. To study the prevalence of inherited chromosomally integrated human herpesvirus 6A/B (iciHHV-6A/B) in Russia. Subjects and methods. A total of 262 apparently healthy people living in Moscow and its Region, as well as 3 members of one family were examined to establish the hereditary transmission of the virus. The investigators used diagnostic and exploratory research techniques, such as real-time PCR, Sanger sequencing, and massively parallel sequencing. Results. HHV- 6A/B DNA was detected in the blood of 5.7% (15/262) cases. The concentrations of HHV- 6A/B DNA were <1.0, 1.0-2.0, and >5.0 lg copies/105 cells in 12 (4.6%), 2 (0.8%), and 1 (0.4%) cases, respectively. PCR analysis of the hair follicles and nail plates verified iciHHV-6B status in one examinee. Interpretation of this case established the hereditary transmission in three generations: mother-daughter-grandson. Phylogenomic analysis showed that the Russian clinical endogenous isolates formed a unique monophilic branch within the clade that was represented mainly by iciHHV-6B isolates from Europe. Conclusion. The investigation provided preliminary data on the detection rate of inherited iciHHV-6A/B in Russia. The prevalence of inherited iciHHV-6B was 0.4% (1/262; 95% CI, 0-2.1); inherited iciHHV-6B was detected and confirmed by laboratory tests in 3 generations. Endogenous iciHHV-6A was not identified. Further large-scale studies are needed in Russia to understand the genetic diversity and geographic stratification of inherited iciHHV- 6A and iciHHV-6B.

Subjects and methods. A total of 62 patients born at 29 to 34 weeks’ gestation with CP were examined in a neonatal intensive care unit (NICU). A study group included 30 newborns who received viferon® (rectal suppositories 150,000 IU) as part of the combination therapy for 10 days. A comparison group consisted of 32 preterm infants having the corresponding gestational age who did not receive the drug. The premature infants underwent a dynamic assessment of their clinical status and disease severity daily for 10 days. The investigators carried out lung X-ray study and laboratory, biochemical, and microbiological monitoring on days 1 and 10 of the investigation. Clinical and laboratory examinations were subsequently made at the age of 1 month in the intensive care unit for newborns and premature babies and at the age of 3 months at the day-care follow-up hospital. Results. The preterm infants in the study group showed positive changes in clinical and laboratory parameters, including oxygen status (lactate) and neonatal multiple organ dysfunction (NEOMOD) scores (p <0.05). Elimination of the bacterial agents isolated from tracheal aspirates occurred 3 times faster in the study group than that in the comparison group (p < 0.05). The durations of mechanical ventilation, NICU treatment, parenteral nutrition, and antibiotic therapy were significantly shorter in the babies of the study group than in those in the comparison group (p < 0.05). Conclusion. The investigation provided evidence for the efficiency and safety of using recombinant human IFN-a-2b as part of the combination treatment of CP in premature newborns. There was a statistically signif icant decrease in the isolation of microbial pathogens from tracheal aspirates in the study group on day 10 after the start of combination therapy unlike in the comparison group. Elimination of the isolated microbial pathogen occurred 3 times faster in the study group than that in the comparison group. The durations of mechanical ventilation, NICU treatment, parenteral nutrition, and antibiotic therapy were significantly shorter in the infants of the study group than in those of the comparison group (p < 0.05).

The review analyzes the clinical and epidemiological data obtained in recent years on the worldwide incidence and spread of histoplasmosis, a particularly dangerous (endemic) mycosis. It describes various clinical symptoms of mycosis in immunocompetent and immunosuppressed patients. The authors consider difficulties in the clinical diagnosis of histoplasmosis outside the endemic regions and the need to use new molecular laboratory diagnostic methods.

Objective. To evaluate the efficiency of allokin-alpha therapy on the level of isolation of Epstein-Barr virus (EBV) and herpes simplex virus type 6 (HHV-6) DNA copy numbers in saliva samples, on the time course of changes in the production of IFN-a and IFN-y and on that of clinical complaints in patients with chronic fatigue syndrome in the presence of chronic EBV and HHV-6 infections. Subjects and methods. A total of 53 patients (36 women and 17 men) with with chronic fatigue syndrome in the presence of chronic herpesvirus infection were examined; the patients’ their mean age was 34.51 ± 1.74 years. All the patients underwent determination of the amount of EBV and HHV- 6 DNA in their saliva samples by polymerase chain reaction (PCR) and the blood levels of IFN-a and IFN-y, and the spontaneous and induced production of these cytokines in the blood lymphocyte cultures. All the patients received allokin-alpha therapy with 9 subcutaneous injections of 1.0 mg every other day. The patients were divided into three groups: 1) 26 patients with chronic EBV infection; 2) 18 patients with EBV + HHV-6 co-infection; 3) 9 patients with HHV-6 infection. Results. After allokin-alpha therapy, in Group 1, EBV DNA was PCR negative in 57.69% of patients; in Group 3, that was positive in all patients. In Group 2, EBV and HHV-6 DNA was found to be absent in 44.44 and 5.55% of patients, respectively. In all the groups, the serum and spontaneous production of IFN-a did not change significantly one month after the end of therapy. The level of induced IFN-a tended to decrease. IFN-y production also tended to reduce in all the groups. After the end of therapy, the patients in all the groups showed a significant decline in the number of clinical complaints. Conclusion. The efficiency of allokin-alpha therapy varies in patients with chronic herpesvirus infection and depends upon virus type. The greatest efficacy of the drug was found in patients with EBV infection.