The prevalence of pneumonia in generalized meningococcal disease (GMID) and its impact on the disease course remain poorly understood due to the nonspecificity of respiratory manifestations, difficulty in verifying the pathogen, and the lack of a standardized radiographic examination protocol.The aim: to determine the incidence of lung involvement in GMID and assess its impact on the disease course and prognosis.Materials and Methods: We analyzed the medical reports of patients with a confirmed diagnosis of GMID and chest computed tomography (CT) scans performed within 48 hours after hospitalization. Records with concomitant respiratory diseases and incomplete cases were excluded. Records were divided into groups with confirmed pneumonia and those with normal lung function. The groups were compared based on age, gender, mortality, intensive care unit (ICU) admission rate, need for respiratory support, length of hospital stay, and oxygen saturation levels. Medians, interquartile ranges, and proportions and 95% confidence intervals (CI) for qualitative variables were calculated. Differences were compared using the Mann-Whitney and Pearson chi-square tests. Differences were considered statistically significant at p ≤ 0.05.Results. The study included 307 reports. Pneumonia was diagnosed in 54 patients (17.6%, CI 13.7-22.1%) and was characterized by a low incidence of clinical symptoms. The groups were comparable in terms of age, gender, length of hospitalization, and ICU admission rate (p>0.05). Patients with pneumonia significantly more often required prehospital respiratory support and mechanical ventilation (p<0.001). Mortality in the absence of pneumonia was 11.5% (CI 7.6-15.2), unilateral pneumonia 14.3% (CI 0-33.3), and bilateral pneumonia 42.4% (CI 25.7-60), p < 0.001.Conclusions. Lung damage in GMID occurs in 13-22% of patients and develops concurrently with other GMID symptoms. The severity of the condition and prognosis correlate with the presence of pneumonia and the extent of lung damage. Due to the absence of respiratory symptoms in most cases, all patients with GMID should undergo lung imaging, and if lung consolidation is detected, more intensive treatment should be determined.
Objective: To identify current epidemiological characteristics of acute gastrointestinal infections (AGI) among patients 18 years and older hospitalized in an infectious diseases hospital.Materials and Methods: Data from Form No. 60/u of the «Journal of Infectious Diseases» was analyzed for patients hospitalized with AGI at the Clinical Infectious Diseases Hospital named after S.P. Botkin in St. Petersburg from January 1, 2022, to October 31, 2025. Etiological determination was performed using polymerase chain reaction, serology (indirect hemagglutination assay), and bacteriology. Microsoft Excel was used to process the obtained data.Results: Since 2022, an increase in the number of hospitalized adult patients with AGI of established etiology has been observed. In the etiological structure of acute intestinal infections, Norovirus, Salmonella spp., Campylobacter spp., and Rotavirus account for 73.9% to 80.4% of cases. Since December 2023, a dramatic increase in the number of patients admitted with acute intestinal infections of norovirus etiology has been detected; in 2025, their share reached 39%. An increase in the proportion of AGI of mixed etiology was detected from 4.5% in 2022 to 9.4% in 2024, while combinations of norovirus with other microorganisms accounted for 60.3% of associations. In addition to typical seasonality, increases in the number of patients with acute intestinal infections of viral etiology were observed in the summer months. An inverse correlation (r = -0.89) was observed between the number of admissions and the age of patients. The maximum number of hospitalizations was observed among individuals aged 18-19 in 2022-2023 and 19-23-year-olds in 2024-2025. More than 70% of those hospitalized with acute intestinal infections caused by campylobacter and norovirus were under 40 years of age, while the age distribution for rotavirus etiology was uniform, and for Clostridioides difficile, patients over 60 years of age predominated.Conclusion: An increase in hospitalizations of patients with AGI, whose etiology was subsequently elucidated, has been identified. An inverse relationship between patient age and hospitalization rate is observed. The main causative agents among young adults are Campylobacter and Norovirus. When collecting the epidemiological history, it is necessary to detail information on the consumption of ready-to-eat meals, including the public catering establishments where they were purchased.
Микобактерии представляют собой неоднородную группу кислотоустойчивых микроорганизмов, которые могут вызывать различные заболевания человека. Микобактерии, входящие в Mycobacterium avium complex, чаще других регистрируются у больных микобактериозами. К факторам риска, определяющим возможность инфицирования, относят обструктивные хронические заболевания лёгких: бронхиальную астму, бронхоэктазы, туберкулёз и наличие остаточных изменений после его излечения; работу в условиях вредного производства, способствующую развитию заболеваний лёгочной системы. Mycobacterium avium включает 4 подвида: Mycobacterium avium subspecies avium, Mycobacterium avium subspecies silvaticum, Mycobacterium avium subspecies paratuberculosis и Mycobacterium avium subspecies hominissuis. Подвиды Mycobacterium avium отличаются фенотипически и обладают различной патогенностью и влиянием на течение микобактериоза.
Aim: to assess the state of humoral immunity against measles and factors influencing its intensity among staff of an infectious diseases center.Materials and methods: the study included 463 employees of the Federal Scientific and Clinical Center for Infectious Diseases. The concentration of specific immunoglobulin G against measles virus in blood serum was determined by enzyme-linked immunosorbent assay. An antibody level of 0.18 international units per milliliter and above was considered protective. Data on age, professional status, vaccination history, and previous measles infection were collected. Student’s t-test and the chi-square test were used for statistical analysis.Results: a non-protective level of measles antibodies was found in 12.9% of the examined staff. The highest proportion of seronegative individuals was detected in the 20-37 age group: 22.5% among medical and 30% among nonmedical personnel. In the group over 57 years old, this rate was 1-4%. No statistically significant differences were found in antibody levels between medical and non-medical workers, nor between individuals in direct contact with infectious patients and other staff. Among employees with documented two-dose and three-dose vaccination, the proportion of individuals without protective immunity was 17-18.5%. Administration of an additional (booster) vaccine dose to staff with non-protective titers after a complete vaccination course led to seroconversion or a significant increase in antibody levels in 90.9% of cases.Conclusion: a significant proportion of staff at an infectious diseases center, especially young individuals, lack protective immunity against measles despite prior vaccination. Professional activity in an infectious diseases hospital setting is not a significant booster factor. The results justify the need to implement regular serological monitoring of measles immunity among all personnel, followed by revaccination of seronegative individuals.
The etiology of pneumonia remains a subject of close interest for researchers and practicing physicians. Many authors have noted a low rate of etiological identification for community-acquired pneumonia in the Russian Federation. Sample-based researches in these conditions are an important source of information.The purpose. To analyze the etiological structure of community-acquired pneumonia among hospitalized patients.Materials and Methods. The epidemiological retrospective descriptive observational research was conducted. We analyzed medical records (electronic health records) of patients (adults and children) hospitalized with pneumonia in the period from January 2024 and December 2024, inclusive at infectious diseases hospital in Moscow. The etiology of pneumonia was considered based on the patient’s final diagnosis. The sample size was 4,807. Inclusion criteria were: laboratory-confirmed diagnosis of community-acquired pneumonia, influenza with pneumonia, or COVID-19 with pneumonia; biological material was collected within the first 24 hours of hospitalization. Exclusion criteria included: patients with diagnoses “pneumonia without specifying the pathogen “; “pneumonia in diseases classified elsewhere”; patients with HIV infection, viral hepatitis B and/or C; and patients hospitalized at other medical organizations in the previous 14 days for a period of more than 48 hours.Data were analyzed using descriptive statistics. Statistical processing was carried out in the IBM SPSS Statistics 20 program, visualization in Microsoft Excel.Results. The most frequent etiologies of communityacquired pneumonia among hospitalized patients were: M. pneumoniae (28.7%; 95% CI 27.3–30.2), SARS-CoV-2 (21.1%; 95% CI 19.8–22.4), S. pneumoniae (11.8%; 95% CI 10.8–12.8), H. influenzae (10.7%; 95% CI 9.7–11.7), and rhinovirus (5.6%; 95% CI 4.9–6.3), with other pathogens occurring less frequently. Mixed etiology pneumonia accounted for 19.4% (95% CI 17.8–21.1) of cases.The predominant pathogens varied by age group: S. pneumoniae, H. influenzae, and M. pneumoniae prevailed among children; M. pneumoniae was the leading cause in adults aged 18–34; S. pneumoniae, H. influenzae, and M. pneumoniae were most common in the 35–64 age group; SARS-CoV-2, S. pneumoniae, and H. influenzae predominated in the 65–84 group; and SARS-CoV-2, influenza viruses, S. pneumoniae, and H. influenzae were most prevalent in patients aged 85 and older.A shift in the prevailing pathogen was observed throughout the year: from January to March, viral pneumonias had the highest proportion (caused by influenza in January, and SARS-CoV-2 and non-influenza respiratory viruses in February and March). Bacterial pathogens (S. pneumoniae, H. influenzae, etc.) predominated during the spring-summer period (April to July), while M. pneumoniae was most prevalent from August to November, followed by an increase in influenza-related pneumonia cases in December.Conclusion. In conclusion, the most frequent pathogens of community-acquired pneumonia among hospitalized patients in 2024 were M. pneumoniae, SARS-CoV-2, S. pneumoniae, H. influenzae, and rhinovirus. The results demonstrate varying levels of pathogen significance across different age groups, seasonal shifts in the predominant agents throughout the year, and a substantial proportion of mixedetiology pneumonia cases.
Objective: to characterize specific changes in the intestinal microbiome profile associated with progressive liver fibrosis in patients with chronic HCV infectionMaterials and methods: a single-center cross-sectional clinical study of 88 patients with chronic HCV infection (51 people with chronic viral hepatitis C and 37 people with liver cirrhosis of viral C etiology) was conducted, in which the profile of the gut microbiota was determined by 16S rRNA metagenomic sequencing. High-throughput sequencing was performed using a MiSeq genetic analyzer (Illumina, USA) using a protocol based on the analysis of variable regions of the 16S rRNA gene. The data was analyzed using Kraken2. The significance level is assumed to be 0,05.Results: significant changes in gut microbial diversity have been described in patients with severe liver fibrosis and cirrhosis. In patients with progressive fibrosis, there was a significant increase in representatives of the Enterobacteriaceae, Lactobacillus, Streptococcus, Enterococcus, Lactococcus and Leuconostoc families. Atypical microorganisms such as Photobacterium, Spiroplasma, Candidatus Portiera are also noted in the gut microbiota. The combination of these changes indicates a shift in microbial equilibrium. On the contrary, in the group of patients without liver fibrosis, there is an increase in the number of Odoribacter and Intestinimonas, which are butyrate producers. As well as Akkermansia and Barnesiella, which indicates the normal functioning of the intestinal microbial community.Conclusions: changes in the intestinal microbiota in severe fibrosis result in the formation of a stable and self-sustaining pathological microbial community. The identified changes can be used to develop corrective methods aimed at restoring the balance of the intestinal microbiota.
Sarcopenia in people living with the human immunodeficiency virus is gradually gaining clinical significance in its own right against the background of increasing life expectancy and aging patient chores. The review examines the prevalence and risk factors for decreased muscle mass and strength in people infected with the human immunodeficiency virus, including the impact of chronic immunoactivation, metabolic disorders, comorbidities, and antiretroviral therapy. data on the role of inflammation, myosteatosis, kynurenin pathway, musculoskeletal axis disorders and environmental factors. Special attention is paid to the current diagnostic approaches, adaptation of the logic of the European Group on Sarcopenia in the Elderly of the second revision, taking into account the characteristic features of phenotypes associated with the human immunodeficiency virus. Information on clinical manifestations of sarcopenic obesity, osteosarcopenia and the combination of sarcopenia with fragility are given. Modern methods of correction are analyzed: training programs, nutritional interventions, organizational management models and possible pharmacological approaches. The data reflecting the current tasks for Russian clinical practice are presented.
An increasing number of young adults with perinatal HIV infection (PHIV) are reaching adulthood and transitioning to adult care networks for continued treatment. Data on the disease course in adult PHIV patients tracked longitudinally from diagnosis is limited.Objective. To perform a clinical and laboratory analysis of the course of HIV infection in young adults infected perinatally.Materials and Methods. This retrospective-prospective study included 105 PHIV patients aged 18-25 years (50.4% male, 49.6% female) registered at the St. Petersburg AIDS Center. The study employed epidemiological (duration of infection, timing of diagnosis and ART initiation), clinical (assessment of HIV disease stage using CDC-1994 and Russian Federation-2006 classifications), and laboratory (analysis of CD4+ lymphocyte counts, HIV RNA levels, detection of antiretroviral drug (ARV) resistance over time) research methods. Statistical analysis was performed using STATISTICA 10, with statistical significance set at p < 0.05.Results. The mean age at HIV diagnosis was 2.6±4.3 years. By age 6, 70% of children already had advanced disease stages (CDC-1994 stages B3 and C). The mean age at ART initiation was 7.2±4.5 years. An inverse correlation was found between delayed ART initiation and the severity of immunodeficiency (r = -0.42, p < 0.001). In the first ART regimen, 95.2% of children received protease inhibitors (PIs). The mean number of ART regimens per child during follow-up was 3.4±1.08 (min=2, max=7). At transition to adult care, 22% of patients had immunodeficiency of varying severity; this prevalence increased to 25.6% after 3 years of observation. Post-transition, 22% of patients were lost to follow-up (LTFU). The use of fixed-dose combinations (FDCs) significantly improved treatment adherence (p < 0.05). High adherence was associated with female gender (increased odds by 3.8 times, p < 0.01), while low adherence was associated with an HIV infection duration exceeding 20 years (risk of low adherence increased by 2.8 times, p < 0.05).Conclusion. Perinatal HIV infection in this cohort resulted from: low coverage of preventive measures, high rates of substance use and HCV co-infection among the mothers, and low adherence to antenatal monitoring and treatment during pregnancy. The absence of clear, regulated timelines for early HIV testing in children led to late diagnosis. Treatment initiation criteria followed a watchful waiting approach, resulting in delayed ART initiation for a significant proportion of children, often amidst progressive immunodeficiency. Most children started ART late, against a background of advanced HIV stages and varying degrees of immunodeficiency. Threequarters of PHIV patients demonstrated good adherence to prescribed ART after transitioning to adult care, while onequarter were lost to follow-up.
The problem of brucellosis at the current stage determines the need to study the pathophysiological features of the infection, including the assessment of the significance of changes in the functions of platelets, vascular endothelium, and the immune system in the pathogenesis of the disease.The aim of the study is to determine the significance of inflammation factors, hemostasis, and indicators of endothelial dysfunction in the development of clinical and pathophysiological changes in acute brucellosis.Materials and methods of the study: 78 patients aged 19 to 68 with acute brucellosis were under observation during inpatient treatment. All patients underwent a comprehensive clinical and laboratory examination, including testing for inflammatory and hemostatic markers.Results: In patients with acute brucellosis, thrombocytopathy is observed despite normal platelet counts. Lipid A, a component of lipopolysaccharide (LPS) from Brucella, interacts with the platelet membrane, inhibiting activation and aggregation processes. The structural features of lipid A in Brucella LPS limit its ability to actively recruit Hageman factor (XII) into the hemostatic cascade, thereby reducing the level of inflammatory reactions. Relatively long-term persistence of Brucella in the body leads to mild (moderate) inflammation and is accompanied by a hemostatic balance between the coagulation and anticoagulation systems of the blood, indicating a sufficient adaptive response that prevents the development of thrombotic complications. An increase in the level of endothelial dysfunction indicators (due to the influence of inflammatory mediators released by platelets), acute phase proteins of inflammation, and the appearance of an Mpeak in the region of γ-globulins against the background of dysproteinemia were shown.Conclusion: The pathogenesis of acute brucellosis has been determined, including the formation of a systemic inflammatory response against a background of changes in the blood coagulation system and endothelial dysfunction caused by the action of Brucella LPS.
Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens. In recent years, it has been considered not only as a cause of cancer and non-cancerous growths, but also as a factor in reproductive dysfunction. In women, the virus alters the composition of the vaginal microbiota, reduces the functional activity of granulosa cells, egg maturation, and the ability of the uterine mucosa to implant and form the placenta. It also affects embryonic development and increases the risk of adverse pregnancy outcomes and premature birth.In men, HPV alters sperm motility and morphological characteristics, and contributes to damage to genetic material, which is considered a cause of male infertility. When HPV is introduced into the sperm, it is transferred to the egg, disrupting early embryonic development.The negative impact of HPV on the effectiveness of assisted reproductive technologies is also being studied. Infected men and women experience a reduced number of highquality embryos and the likelihood of pregnancy, as well as an increased incidence of early reproductive losses. Studying the role of HPV as a factor in subfertility, given its high prevalence, may provide additional support for widespread, gender-neutral vaccination against this infection.
Postmortem diagnostics of HIV infection, hepatitis B, C and syphilis in forensic medical examination institutions can provide access to the study of prevalence in key population groups, improve the quality of statistical data, increase the validity of forensic medical diagnoses and map biological risks. This potential, however, has not been realized today.The purpose of research was to assess the prevalence of HIV infection, hepatitis B and C, syphilis based on the results of a study of blood serum taken from corpses admitted to a forensic medical examination institution; assessment and analysis of the comorbidity level of socially significant infections in the study population.The research materials included blood taken from corpses admitted to the State Budgetary Healthcare Institution of the Tyumen Region “Regional Bureau of Forensic Medical Examination” in accordance with the current sanitary rules and regulations 3.3681-31.Research methods. Markers of HIV infection, viral hepatitis B, C and syphilis were determined using commercial test systems approved for use in Russia. A statistical analysis was performed based on the results.The results of research. Postmortem examination of blood serum from deceased individuals revealed serological markers of one or more of the above infections in 35.8% of cases. According to the study results, the chance of detecting antibodies to the hepatitis C virus in corpses with HIV infection was 12.96 times higher than in corpses without HIV infection, and the chance of detecting serological markers of two viral hepatitis infections simultaneously was 7.26 times higher. The presence of any marker of a socially significant infection significantly increases the likelihood of detecting another marker. The discussion of the obtained results includes a comparison of the obtained results with regional data and the results of similar foreign studies, and a significant limitation of the study, namely, the use of test systems that are not validated for studying cadaveric blood, is discussed in detail.Conclusion. Diagnostics of HIV infection, hepatitis B and C, syphilis during forensic autopsies allows access to testing in key population groups. Taking into account the data obtained in the course of our study, in order to improve the epidemiological surveillance system and improve preventive measures, the authors propose the introduction of expanded laboratory postmortem diagnostics of HIV infection, hepatitis B, C and syphilis during autopsies, provided that adequate algorithms for testing cadaveric blood are developed, taking into account the diagnostic sensitivity of test systems used in postmortem diagnostics of infections.
Objective. To conduct a comprehensive analysis of clinical and epidemiological features, laboratory characteristics, and the effectiveness of organizational decisions during a large-scale outbreak of aseptic meningitis in 2023.Materials and methods. A retrospective analysis of 880 cases of meningitis hospitalized in a regional infectious disease hospital during the epidemic rise was performed. The study cohort included 754 children (85.7%) and 126 adults (14.3%). Etiology verification was performed by PCR. Cerebrospinal fluid (CSF) parameters, duration of hospitalization, and outcomes were evaluated.Results. The outbreak was characterized by an “explosive” increase in incidence caused by the combined circulation of Coxsackie A6 and ECHO 30 enteroviruses (82.2% of verified cases). It was found that in 24% of cases in children, neutrophilic pleocytosis was recorded at the onset of the disease, mimicking the bacterial nature of inflammation. This required a revision of diagnostic algorithms with the introduction of repeated lumbar punctures to monitor sanitation. Adult patients were characterized by a longer hospital stay (17–19 days versus 13–14 in children) and required antibiotics 2.5 times more often. The use of tactics of early discharge of patients with residual pleocytosis (<30 cells/µl) allowed coping with the peak load. Mortality in the study group was 0%.Conclusion. Neutrophilic pleocytosis is a frequent variant of the onset of enteroviral meningitis (CVA6/ECHO30), which requires alertness in differential diagnosis. The introduction of dynamic cerebrospinal fluid monitoring allows minimizing antibacterial therapy safely and optimizing bed turnover.
In the pathogenesis of hemorrhagic syndrome in COVID-19, on the one hand, the development of heparin-induced coagulopathy cannot be excluded, on the other hand, the development of critical conditions accompanied by the release of proinflammatory factors into the bloodstream may occur. SARS-CoV-2 – associated endotheliopathy is considered as an additional link in the pathological process. At the same time, during the diagnostic process, it becomes necessary to identify markers that contribute to the development of gastrointestinal bleeding.The aim of the study was to determine the main risk factors for gastrointestinal bleeding in COVID-19 patients based on a comprehensive clinical, laboratory and instrumental examination, as well as to analyze the effectiveness of hemostasis methods in patients with gastroduodenal bleeding. The study involved 332 patients with COVID-19 and developed gastrointestinal bleeding.When creating a prognostic model using logistic regression with the ROC-curve construction, a correlation was established between the development of gastrointestinal bleeding and the level of APTT, D-dimer, the degree of lung parenchymal involvement according to CT, history of cardiac rhythm disorders, and the method of providing respiratory support (р 0,05).An immunohistochemical investigation using monoclonal antibodies to CD31, CD34, CD68 and vWF receptors expressed on the endothelial surface revealed an alteration of the endothelial monolayer, contributing to the occurrence of a hemorrhagic event. Thus, an increase in the frequency of gastrointestinal bleeding in COVID-19 patients is directly related to the direct cytopathic effect of the SARS-CoV-2 on endotheliocytes (destruction of the vascular wall due to degradation of the endothelial layer).Based on a model constructed by binary logistic regression, a prognostic risk scale for the development of gastroduodenal bleeding from the upper gastrointestinal tract in patients with COVID-19 was created (Eurasian Patent for Invention No. 047178 dated 06.17.2024). The sensitivity of the method was 64.3%, specificity 72.1%, accuracy 68%. The risk scale for the development of gastroduodenal bleeding from erosive and ulcerative mucosal defects in patients with COVID-19 is a highly informative method that allows to predict hemorrhagic events in a timely manner.Also, the effectiveness of combined hemostasis methods in patients with gastrointestinal bleeding has been confirmed.
Methicillin-resistant staphylococcus aureus (MRSA) nasal carriage is a significant source of infection and transmission in hospital environments. Effective infection control and antimicrobial stewardship are hampered in low-and middleincome countries by a lack of local monitoring data. This study investigated the prevalence, antimicrobial resistance pattern and genetic determinants of MRSA in patients and healthcare in two tertiary hospitals in Nigerian. A total 1, 309 nasal swabs specimens were collected from in-patients, healthcare workers and out-patients from two different tertiary hospitals. Staphylococcus aureus was identified and isolated using standard biochemical methods. The MRSA were phenotypically detected using Brilliance MRSA chromagar and cefoxitin and latter subjected to antimicrobial susceptibility testing following the standard Kirby–Bauer disk diffusion method. PCR-specific primers were used to screen for mecA and pvl genes in ten randomly selected MRSA. Out of the 1,309 nasal samples collected, 575 S. aureus representing 43.9% were isolated from the nasal samples of which 96 (17%) were MRSA, 81 from in-patients/out-patients and 15 from health care workers. The in-patients and doctors habour the highest number of MRSA, 73/81 and 8/15 respectively. All the MRSA isolates resistant to cefoxitin were also found to be resistant to tetracycline, amoxicillin, and amoxicillin-clavulanic acid. The mecA and pvl genes were detected in five of the isolates. However, pvl gene was detected in one isolate without corresponding detection of mecA gene. The high frequency of MRSA carriage among patients and healthcare personnel underscores the potential for hospital-acquired transmission and highlights the need for strengthened infection control and antibiotic stewardship in Nigerian tertiary hospitals.
We observed 100 patients with mucormycosis from 2002 to 2024. We used the EORTC/MSGERC 2019, 2020 criteria for diagnosing mucormycosis. Mucormycosis developed against the background of type 2 diabetes mellitus in 10% of patients, type 1 in 7%, in 83% – after coronavirus infection COVID-19 and glucocorticosteroid therapy. The average glycemia level on the day of diagnosis of mucormycosis was 17 mmol / l. Other risk factors were ketoacidosis – 48%, use of glucocorticosteroids – 85%, lymphocytopenia 44%. The main clinical variant was rhinoorbitocerebral mucormycosis – 93%. Less frequently were mucormycosis of brain (37%), skin (25%), lungs (8%), kidneys (1%). Antifungal therapy was used in 96% of patients: рosaconazole (69%), amphotericin B deoxycholate (59%), lipid forms of amphotericin B (25%), isavuconazole (17%). Surgical treatment used 97%. 12 weeks overall survival was 80%.
Aim: to study the clinical and epidemiological features of acute respiratory infections of the upper respiratory tract in individuals from an organized military unit at the initial stages of its formation in order to improve the quality of antiepidemic protection.Research objectives: to determine the structure of the causative agents of ARI of the upper respiratory tract, to assess the frequency of clinical symptoms in various etiological variants of the disease, to conduct a comparative analysis of clinical manifestations, and to propose clinical guidelines for the differential etiological diagnosis of acute respiratory infections of the upper respiratory tract at the initial stages of the formation of an organized military unit.Materials and methods: clinical, epidemiological, and laboratory data of 287 patients who sought medical care for upper respiratory tract infections were analyzed. The etiology of the disease was determined using multiplex PCR and classical bacteriological studies, and the results were used to form groups based on the type of isolated pathogens. The frequencies of clinical symptoms were calculated for each group.Results: 221 cases (77.0%) were monoinfections, and 66 cases (23.0%) were co-infections. The most common pathogens were rhinovirus (28.6%) and influenza B virus (11.5%). Rhinovirus infection was characterized by a predominance of catarrhal syndrome (rhinorrhea 75.6±4.7%, pharyngitis 65.9±5.1%) with a low frequency of fever (12.2±3.7%). In cases of influenza B and adenovirus infections, fever (36.4±8.8% and 40.0±10.7%, respectively) and cough (78.8±7.1% and 80.0±8.9%) were more common.Metapneumovirus and respiratory syncytial virus were manifested mainly by cough. Seasonal coronaviruses were mild infections with rhinitis and pharyngitis. SARS-CoV-2 infection had a variable clinical picture without specific signs. Diseases caused by bacterial agents were characterized by more pronounced inflammatory manifestations: Streptococcus pyogenes — typical tonsillitis without catarrhal symptoms, Staphylococcus aureus — intoxication and a purulent component. In co-infections, a combination of symptoms was observed.Conclusions: the clinical manifestations of ARI URT in members of organized groups may be characterized by certain symptom complexes, due to the etiology of the disease, which allows them to be used for preliminary differential diagnosis in conditions of limited laboratory availability.
Streptococcus pseudoporcinus – это бета-гемолитический стрептококк, который был впервые описан в 2006 г. Изначально S. pseudoporcinus рассматривался как колонизатор урогенитального тракта женщин. В дальнейшем S. pseudoporcinus был обнаружен и в других анатомических областях, включая раны, мочу, плаценту и даже молочные продукты. Изначально S. pseudoporcinus связывали с инфекциями мягких тканей, редко прогрессирующими до некротизирующего фасциита, и с осложнениями беременности (преждевременные роды, хориоамнионит и внутриутробная гибель плода). Начиная с 2017 г., появились данные, свидетельствующие о способности S. pseudoporcinus вызывать инвазивные и потенциально угрожающие жизни инфекции. В литературе наиболее часто описываются случаи возникновения S. pseudoporcinus инфекции у взрослых, только в единичных статьях есть данные о возникновении тяжелой инфекции у детей. В данной статье мы приводим клинический случай тяжелой инвазивной S. pseudoporcinus-инфекции у ранее здорового ребенка 2 лет. Особенностью данного случая является выделение из крови мультирезистентного штамма S. Pseudoporcinus.
Shigellosis remains a significant public health concern, particularly in regions with poor sanitation and limited access to healthcare. The disease is characterized by acute intestinal inflammation, leading to diarrhea, fever, and systemic intoxication. Standard treatment involves rehydration, antibiotics, and symptomatic therapy. However, the growing antimicrobial resistance of Shigella strains necessitates exploring adjunctive treatments to enhance therapeutic outcomes.Objective: To study the clinical-epidemiological and laboratory characteristics of shigellosis and current approaches to treatment, with a focus on the efficacy of Polisorb in improving clinical outcomes.Methods: A comparative analysis was conducted on 140 patients diagnosed with shigellosis, divided into two groups. The first group (n=62) received standard therapy supplemented with Polisorb, while the second group (n=65) received only standard therapy. Clinical symptoms, laboratory parameters, and recovery dynamics were assessed. Statistical analysis included Student’s t-test and non-parametric methods.Results: Patients treated with Polisorb demonstrated a more rapid resolution of intoxication symptoms, normalization of stool frequency, and improvement in laboratory markers of inflammation compared to the standard therapy group. The duration of fever, diarrhea, and abdominal pain was significantly shorter in the Polisorb group (p < 0.05). Additionally, economic evaluation indicated reduced hospitalization duration and lower treatment costs in this group.Conclusion: The inclusion of Polisorb in the treatment regimen for shigellosis contributes to a faster clinical recovery, improved laboratory parameters, and potential cost-effectiveness. This suggests that Polisorb can be an effective adjunctive therapy in managing shigellosis.
Objective: to characterize the clinical, laboratory and epidemiological features of respiratory mycoplasmosis in children during the period 2021–2024.Materials and methods: A single-center retrospective study was conducted at the Federal State Budgetary Institution Federal Research and Clinical Center for Infectious Diseases of the Federal Medical and Biological Agency of Russia during the period 2021-2024, including 236 pediatric patients with laboratory-confirmed infection caused by M. pneumoniae. Statistical data processing was performed using statistical analysis methods in Statistica 7.0 and Microsoft Excel. Differences were considered statistically significant at p<0.05.Results: The hospitalization rate was highest in 2024 (53.0%). The peak incidence was recorded in the autumn (44.1%). School-age children predominated in the age structure (60.6%). Patients were admitted to hospital late in the course of the disease – Me 8 days (IQR 5-13 days), indicating a subacute course of the infection. Contact with an acute respiratory infection was noted in a quarter of cases (25%). The clinical picture was dominated by fever (Me 38.9°C (IQR 38.0-39.5°C) lasting 6 days (IQR 2-9 days), cough developed in 91.9% of cases, predominantly frequent (51.3%), dry and/ or unproductive (62.3%) lasting 15 days (IQR 11-21 days). The leading cause of hospitalization was lower respiratory tract infection (83.9%). In 2024, the most common diagnosis was “Community-Acquired Pneumonia” (56.0%), which is significantly more common than in other years (p<0.001). Clinical blood tests revealed no significant inflammatory changes in most cases, and C-reactive protein levels remained within normal limits in 46.2%. ELISA was used more frequently (91.5%) than PCR (61.9%) to determine the etiology of the disease, due to the late stages of hospitalization. Macrolides were predominantly used as the etiological therapy, with doxycycline prescribed as monotherapy in 1.3% of cases.Conclusion: Clinical, epidemiological, and laboratory features of respiratory mycoplasmosis in children have been identified; however, further research is required to optimize approaches to diagnosis and treatment.
Group A streptococcus (GAS) is the leading bacterial cause of acute tonsillopharyngitis, as well as infections in other locations, most commonly skin infections, phlegmon, and erysipelas. It is important to start early specific antibacterial therapy in a timely manner especially to prevent possible complications.Rapid antigen tests have high sensitivity and specificity (95-97%), facilitate the rapid and accurate detection of GAS antigen in throat swabs.Objective: validation of the rapid test “RAPID-Streptococcus-A-LF” for detecting GAS (Streptococcus pyogenes) antigen in throat swabs from patients with suspected Streptococcal tonsillopharyngitis using the RAPID-StreptococcusALF immunochromatographic assay and to determine its diagnostic characteristics (sensitivity, specificity, and crossreactivity with Streptococcus agalactiae).Materials and Methods: sample type – throat swabs from patients with acute tonsillopharyngitis. 34 rapid antigen tests “RAPID-Streptococcus-A-LF” were tested on 28 samples with different colony-forming unit (CFU) counts of GAS and 6 comparison samples. The study was performed in two phases: the first phase involved sample selection according to the study plan and determination of CFU values in the samples, while the second phase included testing biological samples on the antigen tests and recording the results.Results: the “RAPID-Streptococcus-A-LF” antigen test showed high diagnostic sensitivity (93-100%) and specificity (100%) similar to the leading imported tests on Russian market.Conclusion: rapid testing, as an auxiliary method for detecting GAS, can significantly optimize the diagnostic algorithm for acute tonsillopharyngitis, ensuring timely etiotropic treatment of GAS infection and reducing the incidence of unnecessary antibiotic therapy.
