Vol 11, No 1 (2021)

Objective. To analyze the incidence of Lyme disease (LD) in the region of Caucasian Mineralnye Vody (CMV), Stavropol Territory, in 2015-2019. Materials and methods. The authors used information from 105 schedules for epidemiological survey of the focus of an infectious disease (Form No. 357/y), provided by the Directorate for the Stavropol Territory, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being. Results. LD cases were registered in all CMV areas, but most patients were detected in Kislovodsk. The peak incidence occurred in May-July. Registration of patients in autumn-winter may be associated with the possible awakening of ticks during thaw periods. The study risk group is persons who spend a lot of time on nature biotopes and homestead lands. Most patients’ late access to medical care indicates a lack of knowledge about tick-borne diseases and their prevention methods. Conclusion. The epidemic situation of LD remained tense in CMV in 2015-2019. The activity of natural foci of LD creates a constant risk for the disease both among the local population and persons who come for spa treatment. In this connection, it is necessary to pay special attention to the evidence-based planning of preventive measures using modern information (including GlS) technologies and timely implementation of acaricide measures.

Objective. To analyze the stages and the main clinical and demographic characteristics of COVID-19 patients hospitalized at the first specialized infectious diseases hospital in the Moscow Region. Materials and methods. Data on hospitalizations from the conversion of the first specialized hospital for COVID-19 were retrospectively analyzed, by assessing the age and gender of the patients, comorbidity, nosological entity, disease severity, hospitalization length, and the need for mechanical ventilation. Diagnosis of theforms of COVID-19 severity and treatment of patients were done according to the Temporary Guidelines of the Ministry of Health of the Russian Federation. Results. Prior to the spread of SARS-CoV-2, the unit worked as an observation facility for hospitalizations of citizens with acute respiratory viral infections from Moscow airports. A total of 662 patients (315 men and 347 women), including 89.2% of Russian citizens, were hospitalized with suspected novel coronavirus infection in January to June 2020. As the pandemic spread, the patients’ mean age increased progressively, and the number of patients with concomitant diseases rose. However, the hospitalization rate did not change substantially for patients with grades 2-3 respiratory insufficiency. The maximum number of oxygen-dependent persons was recorded in April and May (52.2-52.7%). Hospitalized patients who for the first time required mechanical ventilation in April accounted for 9.5%; these in May were maximum (13.2%). The daily load of newly hospitalized patients in April and May was approximately the same: (8.2 and 8.3 patients per day, respectively); in June it decreased slightly and amounted to 6.4 patients per day. Conclusion. The example of the first converted unit shows a clear stage-by-stage organizational response to the spread of COVID-19 in the Moscow Region. At the peak of morbidity, hospitalization of patients with severe forms of the disease and high-risk factors in specialized hospitals is justified. Hospitalization of patients over 65 years of age with severe comorbid diseases and a low probability of COVID-19 in specially designated hospitals can be useful for optimizing routing and providing specialized medical care.

Objective. To analyze the pattern and epidemiological features of healthcare-associated infections (HCAI) in the healthcare facilities of the Orenburg Region. Materials and methods. The data from annual statistical reporting forms for 2013-2019 and nonparametric statistical tests for study results were used. Results. The region annually registers 500-800 HCAI cases with the largest number (42.4%) in surgical hospitals. Nosocomial pneumonia (34.5%) held the lead in the pattern of HCAI in 2019, with its trend rate of growth. There was a two-fold decrease in the proportion of HCAI in the obstetric facilities. Since 2008, there had been no reports on nosocomial acute hepatitis B and C in the region. Conclusion. The results of HCAI surveillance suggest that there are considerable problems in terms of their identification and accounting, monitoring, and compliance with the sanitary and anti-epidemic regime in the healthcare facilities, which can negatively affect the provision of epidemiological safety of medical care in the Orenburg Region.

Objective. To compare the results of molecular biological and bacteriological studies to identify blood methicillin-resistant staphylococcus strains. Subjects and methods. A parallel bacteriological and molecular biological (real-time PCR) study was conducted to examine biomaterials from 240 patients with signs of infection who were treated in a Moscow multidisciplinary hospital. The biological material was peripheral vein blood taken in vacuum test tubes with EDTA for PCR and in vials containing a nutrient medium for bacteriological testing. Results. The sensitivity and specificity of the PCR assay versus the bacteriological test in detecting blood methicillin-resistant staphylococci were 100 and 97%, respectively. Methicillin-resistant staphylococci were detected by PCR in 6.3% of patients with signs of infection and by bacteriological tests in 3.3% of patients. Conclusion. The real-time PcR assay used for the detection of blood methicillin-resistant staphylococci will be able to reduce the time of a diagnostic study, to increase the possibility of identifying the etiological agent for bacteremia, and to timely perform adequate antimicrobial therapy.

Objective. To describe a clinical case of acute rickettsial fever without a rash in a woman from the town of Tekeli, Almaty Region, Republic of Kazakhstan. Materials and methods. The discrepancies in the primary and final diagnoses were analyzed. A retrospective analysis of the clinical manifestations and dynamics of the disease was carried out on the basis of the patient’s medical history. A retrospective serological analysis for immunoglobulins to Rickettsia of the tick-borne spotted fever group was carried out by an enzyme immunoassay. Results. Upon admission, the patient had a fever, intoxication syndrome, hyperemia of the pharynx, hemorrhages of the soft palate, enlarged liver, positive reactions to brucellosis, a history of chronic brucellosis, while no skin rash was observed. The study of serum taken from the patient on day 13 of the disease revealed IgM and IgG against rickettsia of the spotted fever group. Conclusion. There is an urgent need to introduce a comprehensive laboratory and etiological examination of febrile patients for tick-borne rickettsioses in Southern Kazakhstan, including the Almaty Region.

Healthcare-associated infections (HCAI) are a huge problem for healthcare facilities in both developed and developing countries. Surgical, intensive care, and obstetric units are most often considered to be high-risk for HCAI due to the special specific features of medical care rendered in these units. Analysis of Russian and international experience allows us to consider the risks of HCAI in the obstetric facilities for further optimization of a package of measures for their prevention.

Objective. To analyze moderate and severe influenza cases in the clinical center in the 2018-2019 season and to generalize clinical manifestations, complications, and follow-up cases. Subjects and methods. The retrospective study enrolled 61 patients aged 18-95 years with a confirmed diagnosis of influenza. Influenza virus RNA was detected by a reverse transcription-polymerase chain reaction (PCR) assay. IFNL3 single nucleotide polymorphism (rs8099917 T/G) and IFNL4 (rs12979860 C/T) were determined by PCR using the certified Russian reagent kit. Results. The predominant influenza A (H1N1)pdm09 strain was detected in 97% of patients with typical clinical signs of the disease. The proportion of vaccinated patients was 9.8%. The main complication of influenza was community-acquired pneumonia (54%). The combination of the antiviral drugs oseltamivir and imidazolylidene pentandiol acid (IPA) did not increase the efficiency of treatment. Complaints persisted in a significant proportion of patients within 30 days following hospital discharge. There was a tendency towards more frequent detection of the IFNL4 rs12979860 TT genotype in patients with pneumonia. Conclusion. The disease had typical clinical presentations, with community-acquired pneumonia prevailing among the complications. No complications of influenza occurred in patients under 30 years of age and in vaccinated patients. Most patients had a long recovery period.