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Nº 2 (2016)
- Ano: 2016
- Artigos: 11
- URL: https://journals.eco-vector.com/2226-6976/issue/view/6685
Articles
Molecular biological monitoring of Neisseria meningitidis in Moscow in the period 2011 to 2015
Resumo
Objective. To estimate serogroup distribution and to characterize the genetic properties of N. meningitidis that caused generalized meningococcal infections (GMIs) in Moscow in the period 2011 to 2015. Material and methods. 253 biological samples from patients with GMIs were examined. The serogroup of N. meningitidis was determined using a PCR-based procedure. Multilocus sequence typing (MLST) of N. meningitidis was conducted in accordance with the international requirements; alleles, sequence types, and clonal complexes were numbered using the database http://pubmlst.org/neisseria/. Results. Serogroup A N. meningitidis ranks first in the etiological pattern of GMIs in Moscow as before, but in the past 4 years there has been a declining trend for its percentage, and in 2014-2015, there was an increase in the proportion of serogroups B and W. The investigators determined the genetic characteristics of 38 N. meningitidis serogroups A and W isolates, by using MLST, and their belonging to clonal complexes. The results are published in the database http://pubmlst.org/neisseria/. Conclusion. The epidemic situation due to N. meningitidis serogroup A may be considered to be stable and to cause no concern. At the same time, the larger proportion of N. meningitidis serogroup W and the detection of the representatives of the hypervirulent clonal complex ET-37 necessitate further monitoring of the circulation of these strains.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):4-9
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Assessment of the awareness of healthcare personnel regarding the possible role of glucometers in transmitting healthcare-associated infections
Resumo
Objective. To assess the awareness of healthcare personnel regarding the possible role of glucometers in transmitting healthcare-associated infections. Materials and methods. Physicians of different specialties, nurses, and patients with different abnormalities from various medical institutions were surveyed in the subjects of the Russian Federation. A total of 1371 people took part in the study on a voluntary basis. The results were processed by up-to-date statistical methods. Results. A complex sociomedical survey revealed varying awareness about the role of glucometers as transmitting factors for healthcare-associated infections among the healthcare personnel. The latter was found to consider the disinfection of the glucometer case ambiguously. 23% of the physicians were sure that the glucometer should be disinfected after each use. The majority (69%) of nurses denied that the glucometers might be contaminated with blood. A substantial proportion of patients were also unaware of this. 20% of the patients had given their individual glucometer to other people for use. Conclusion. The findings suggest that both the personnel and patients are little aware of the possible epidemiological risk of glucometers.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):10-14
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Possible socioeconomic effect of the introduction of innovative treatment technology for chronic hepatitis C in Russia
Resumo
Objective. To study the role of antiviral therapy (AVT) for chronic hepatitis C (CHC), which includes innovative direct-acting antiviral agents for controlling the spread of this disease in Russia. Materials and methods. A mathematical imitation model allowing for scenary estimations of the incidence and death of CHC during different AVT options was created to assess its projected epidemiological burden of CHC. To estimate the economic effects of the introduction of innovative treatment technology for CHC, the calculated reduction of the epidemiological burden was transferred into monetary terms, by using the value of economic burden per patient during the respective years of a relevant year. Results. The introduction of the new treatment regimen for patients with CHC, which envisages that AVT coverage should be increased up to the WHO recommended level for countries with limited possibilities (3.8%) and that innovative drugs, the cost of which is not higher than that of currently used agents, should be used, will be able to treat additional 7600 patients in 2016-2030 due to the economic effect obtained. An increase in the coverage for patients to that recommended for the European Region (48.6%) under the same conditions will be able to treat additional 31000 patients due to the economic effect. Conclusion. The introduction of the new treatment regimen envisaging the considerably increased ATV coverage for patients and the use of innovative drugs may be appropriate from both the economic, social, and humanitarian standpoints.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):15-22
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An association of human herpesviruses and human papillomaviruses with abnormal key sperm indicators in men with infertility and inflammatory diseases of the urogenital tract
Resumo
Objective. To investigate the spread of human herpesviruses (HHV) and high-risk human papillomaviruses (hrHPV) in the urogenital tract, by analyzing their viral load in men with infertility and inflammatory diseases of the urogenital tract, and to evaluate the effect of these viruses on the quality of sperm. Subjects and methods. A total of 605 patients with infertility and inflammatory diseases of the urogenital tract were examined. A real-time PCR assay was used to determine viral DNA in the clinical materials (ejaculate, urethral scrape, and prostate fluid). The key indicators of sperm were studied according to the WHO guidelines). Results. HHV DNA and hrHPV DNA in the ejaculate were detected in a total of 142 (32.5%) patients. Examination of the three materials (ejaculate, urethral scrape, and prostate fluid) from patients with an exacerbation of chronic prostatitis showed that 67 (51.9%) cases had viral DNA. HHV in mono- and mixed infections were found in 98 (22.4%) ejaculates, HHV-6 being more common than cytomegalovirus and Epstein-Barr virus ((10.3, 6.6, and 5.5%, respectively). hrHPV DNA was detected in the ejaculates of 78 (17.8%) patients. Viral DNA was found in the ejaculate of none of the healthy men. There were combinations of the viruses in the ejaculates in 6.9% of the patients, these being statistically significantly more frequent in the men with inflammatory diseases of the urogenital tract than in those with infertility, but without inflammatory diseases. Quantitative analysis of viral DNA showed that more than 30% of the ejaculates contained hrHPV at a clinical concentration (> 3 lg/105 cells) and 10.5% had these at a high risk concentrations (> 5 lg/105 cells). Comparative analysis of spermograms established a statistically significant decrease in sperm motility and a smaller number of morphologically normal forms of spermatozoids in the patients with inflammatory diseases of the urogenital tract. Conclusion. Detection of the viruses in the male urogenital tract is associated with diminished fertility and with a high viral load suggests that there is a high risk for the unfavorable development of infect, including oncogenesis. The findings allow for the recommendation of virological examination of patients with infertility and inflammatory diseases of the urogenital tract, by applying molecular methods for quantitative analysis.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):23-29
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Can colitis be in rotavirus infection?
Resumo
Objective. To analyze the possible pathogenetic mechanisms of large intestinal lesion in children with rotavirus infection. Subjects and methods. A total of 460 pediatric patients with verified monoetiologic rotavirus infection were followed up; acute infectious gastroenterocolitis (AIGEC) was recorded in 12 (2.6 ± 0.7%) children of them; this was accompanied by hemocolitis in 1 (0.2 ± 0.2%) child. Every day clinical data were assessed in all the patients; clinical laboratory examination (fecal bacteriological test, fecal rotavirus antigen enzyme immunoassay, and PCR diagnosis) was performed. Results. Antibiotics were used in the patients with AIGEC significantly more frequently (by more than 5 times) prior to admission to hospital. Antibiotic therapy preceding acute enteric infections was ascertained to be the most significant risk factor for large intestinal lesion: it increased the incidence of AIGEC by 16.7-fold in rotavirus infection. Correspondingly, the chances of large intestinal lesion were 25.9 times higher (odds ratio) in these patients than in the comparison group. This factor is characterized by high specificity (0.84) and sensitivity (0.83) as to the cause-effect relation to large intestinal lesion. Conclusion. The key factor in the pathogenesis of colitis has been established to be the development of the disease in the presence of antibiotic-associated diarrhea.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):30-34
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Zika fever
Resumo
This article presents systematized and generalized data on the current global Zika fever epidemic situation, considers the patterns of its formation and development, and gives general information on the etiology and environment of the pathogen, and clinical and diagnostic features. Special attention is paid to the characteristics of the manifestations of an epidemic process and to the Russian Federation-adapted scientifically sound system for the surveillance and control of this infection.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):35-47
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Comparative characteristics of major international and national guidelines for the treatment of chronic hepatitis B
Resumo
The mainstay of treatment for chronic hepatitis B (CHB) is to improve the quality of life and its duration, by preventing disease progression to cirrhosis, decompensated cirrhosis, end-stage liver disease, hepatocellular carcinoma, and death. By 2015, pegylated interferons and six nucleoside analogues may be used to treat CHB. The article provides comparative characteristics of major international and Russian guidelines for the selection of patients with CHB for antiviral therapy and compares a treatment policy for this category of patients.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):48-57
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Helminth antigens and metabolites as regulatory factors of antiparasitic immunity
Resumo
Antigens are crucial and regulatory external factors for immunogenesis. The weak ability of the host immune system to successfully resist invasion has been groundlessly associated with the low immunogenicity of helminths for a long time. In fact, numerous studies have shown that helminths are absolutely fully antigenic. The most important fact is that they have a certain set of specific mechanisms simultaneously ensuring the avoidance of host protective factors and the elaboration of essential products that regulate the function of the respective host genes that provide the relative safe passage of the parasite from one environmental niche to another (the host). Recently, scientists could make progress in solving this enigma and decipher some mechanisms by which the parasites manipulate host homeostasis and immunity. It turns out that during evolution the parasite has developed a great variety of effective mechanisms to mask their own antigens and those to attenuate the immune response of the host (man) due to immunosuppression and induction of self-tolerance.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):58-63
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Use of non-boosted atazanavir in clinical practice
Resumo
The paper gives the results of using non-boosted atazanavir (ATV) in clinical trials and real clinical practice. Comparison of regimens including boosted and non-boosted ATV has indicated their equally high efficacy, but a better safety profile when the drug is used without ritonavir. Despite the elevated levels of unconjugated bilirubin in a number of patients taking ATV, jaundice develops in only 10% of patients, transaminase levels do not change and only 1-2% of patients need the drug to be discontinued because of hyperbilirubinemia (HBR). The predictors of its development, which are associated with both the characteristics of a patient (UGT1A1 deficiency) and with the pharmacokinetics of the drug, are identified. Several trials (NCT00440947, ARIES, and ASSURE) have shown that changing boosted ATV to non-boosted one decreases by more than twice the risk of not only HBR, but also any side effects, by altering pharmacokinetics and reducing the plasma concentration of the drug. The paper gives the results of several studies where non-boosted ATV has been used to simplify ATV regimens. After switching patients with sustained virologic suppression to the simplified regimen, there was a reduction in the daily number of taken tablets, a significant improvement in lipid parameters, and a decrease in the incidence of HBR with the equivalent efficiency of regimens and the low probability of treatment failure.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):64-72
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A focus of hemorrhagic fever with renal syndrome in a summer health camp
Resumo
The incidence of hemorrhagic fever with renal syndrome (HFRS) among children is sporadic in most cases. A clinical and epidemiological analysis of its incidence was carried out in a summer health camp where in June to September 2014 five patients, including 4 schoolchildren and 1 teacher, fell ill. The diagnosis of HFRS was confirmed by indirect immunofluorescence. The disease was moderate; two children had signs of acute abdomen. The disease was due to that the rodents had appeared in the camp because of their access to the buildings (summer cottages) and the children had been involved in the dry cleaning of the camp’s area. It is noted that the most important measure to prevent the outbreaks of the disease in the organized children’s collective bodies is to exclude the penetration of rodents into the rooms where the children live and to create a barrier (including deratization measures) during their migration from natural biotopes.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):73-76
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On the occasion of the 75 th anniversary of the Department of Epidemiology, Аcademician E.A. Wagner Perm State Medical University
Resumo
The paper deals with the 75th anniversary of the Department of Epidemiology, Academician E.A. Wagner Perm State Medical University. The founder of the Department was B.I. Raikher, a Stalin Prize winner, a man of great scholarship, and an outstanding experimenter. Professor N.M. Koza, Honored Worker of Higher School, was at the head of the Department for more than 20 years. The main research area of the Department in that period was to improve the epidemiological supervision of infections with a different transmission mechanism (whooping cough, diphtheria, measles, and salmonellosis). The present-day period of the Department’s activities is associated with elaboration of the theoretical problems of epidemiology, study of the population-based aspects of vaccination, the epidemiology and prevention of viral hepatitides, HIV infection, and healthcare-associated infections. The Department has trained 12 Doctors of Medical Sciences and 47 Candidates of Medical Sciences. The role of the Department in renewing and developing an educational process to train medical preventive students at the pre- and postgraduate levels is great. The Perm scientific school of epidemiologists develops the basic principles of the Russian school of epidemiologists in terms of the achievements of world science in close collaboration with leading Russian specialists and research medical centers.
Epidemiology and Infectious Diseases. Current Items. 2016;(2):77-84
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