An excessively pronounced inflammatory response and endothelial dysfunction play a key role in the development of severe and complicated forms of influenza. Objective. To evaluate the role of plasma ICAM-1 in the development of severe influenza forms and in disease prognosis. Patients and methods. A total of 59 patients with influenza, aged 37 to 90 years, who received inpatient treatment between January and April 2025, were examined. Group 1 consisted of 29 patients with uncomplicated influenza, Group 2 – 30 patients whose disease was complicated by pneumonia, and the control group – 10 healthy individuals of comparable age. Among the pneumonia patients, 14 (23.7%) had a fatal outcome. Plasma ICAM-1 levels were measured once during the acute phase of the disease. Results. Elevated blood ICAM-1 levels were detected in patients with influenza complicated by pneumonia: the median was 3.2 times higher than in the control group (p = 0.004). In uncomplicated influenza, ICAM-1 values did not statistically differ from those in the control group (p = 0.2). Among deceased patients, plasma ICAM-1 levels were higher than among survivors (p = 0.01). An ICAM-1 level in blood >700 ng/mL increased the risk of fatal outcome by 8-fold. Conclusion. Elevated plasma ICAM-1 levels are observed exclusively in patients with influenza complicated by pneumonia. The association between high blood ICAM-1 levels and an unfavorable outcome underscores the importance of measuring this parameter for disease prognosis assessment. Key words: endothelial dysfunction, influenza, ICAM-1, pneumonia
Objective. To compare the efficacy and safety of antiviral chemotherapeutic agents when initiated at different time points in the treatment of moderate COVID-19. Patients and methods. A retrospective observational study included 254 patients with moderate COVID-19 who underwent treatment in an infectious diseases hospital during 2021–2022 and met the inclusion criteria. As etiotropic therapy, favipiravir and molnupiravir were used in accordance with the then-current versions of the Interim Guidelines “Prevention, Diagnosis, and Treatment of Novel Coronavirus Infection (COVID-19)”, as well as the drug riamilovir, used off-label. The following groups were formed: patients receiving riamilovir – 82 шndividuals (group 1), favipiravir – 98 individuals (group 2), and molnupiravir – 74 individuals (group 3). The groups were comparable in terms of age and sex. Based on the timing of antiviral therapy initiation, patients in each group were categorized into two subgroups: in the first subgroup, antiviral therapy was initiated within the first 6 days of illness onset, and in the second subgroup – after day 6. Results. Among patients who initiated antiviral chemotherapy within the first 6 days, compared to those who started antiviral therapy after day 6, a reduction in the duration of intoxication symptoms and respiratory system involvement was observed, including fever (p = 0.001), myalgia (p = 0.001), cough, and dyspnea (p = 0.01). With early initiation of etiotropic therapy, symptoms resolved more rapidly in patients receiving molnupiravir. When antiviral therapy was started after day 6, symptom resolution occurred more quickly in patients receiving riamilovir. Conclusion. It has been demonstrated that earlier administration of antiviral drugs results in a clear therapeutic effect, manifested by a reduction in the duration of the main disease symptoms across all compared antiviral agents. Among the SARSCoV-2 virus replication inhibitors used, it was noted that at a later time of initiation of therapy, the clinical effect was more often manifested when using the drug riamilovir. Key words: COVID-19, riamilovir, favipiravir, molnupiravir, timing of antiviral therapy initiation
The article presents the results of an original study investigating the features of neuroendocrine regulation in children with Multisystem Inflammatory Syndrome (MIS-C) associated with SARS-CoV-2. Objective. To investigate blood laboratory parameters characterizing neuroimmunoendocrine dysregulation and identify predictors of severe disease course in MIS-C. Patients and methods. A clinical and laboratory examination of 30 children diagnosed with MIS-C was conducted. Additionally, levels of cytokines (n = 48), immunoglobulins (IgA, IgM, IgG), protein S-100B, neuron-specific enolase (NSE), and cortisol were analyzed. Results. During the acute phase of MIS-C, a significant increase was observed in the levels of 11 cytokines (IL-2Rα, IL-18, MIF, IL-1ra, IL-16, IP-10, MIG, MIP-1α, G-CSF, HGF, M-CSF), protein S-100B, and cortisol, along with a significant decrease in the levels of 9 cytokines (IFN-α2, IL-1α, IL-12(p70), TNF-β, IL-4, TRAIL, IL-3, IL-7, PDGF-BB) compared to the control group. During the convalescence period, normalization of most laboratory parameters was noted; however, a significant reduction compared to controls was observed for 16 cytokines (IFN-α2, IFN-γ, IL-1α, IL-1β, IL-6, IL-12(p70), IL-15, TNF-α, IL-4, IL-10, IL-13, MCP-3, IL-3, IL-5, IL-7, VEGF). Furthermore, levels of 5 cytokines (IL-18, IP-10, MIG, M-CSF, PDGF-BB), immunoglobulins, and platelets were significantly elevated. Laboratory predictors for the development of cardiovascular complications were identified: levels of platelets, lymphocytes, IgM, eotaxin, TNF-β, ferritin, and vascular endothelial growth factor (VEGF). Conclusion. The study identified laboratory criteria indicative of neuroimmunoendocrine dysregulation and hemostasis system disturbances in MIS-C, which correlate with the disease course severity. These findings provide a rationale for considering the use of Cytoflavin in the treatment regimen. Key words: SARS-CoV-2, S100B protein, immunoglobulins, cortisol, multisystem inflammatory syndrome in children, neuron-specific enolase, cytokines, Cytoflavin
Objective. To study the efficacy and safety of bulevirtide, an entry inhibitor of the hepatitis D/B viruses (HDV/HBV), in patients with chronic hepatitis D (CHD) in real-world clinical practice. Patients and methods. The study group consisted of 63 patients with CHD, predominantly with liver cirrhosis (67%) and high HDV RNA load (median 6.8 log10 copies/mL), including 19 patients with HIV co-infection. Treatment outcomes were analyzed in 48 patients: 29 received monotherapy, and 19 received combination therapy with pegylated interferon α (including 3 who switched to monotherapy). Results. After 96 weeks of treatment, the median HDV RNA level decreased from 6.8 log10 to undetectable levels (median reduction –5.9 log10), with an increase in the rate of virologic response (VR) during treatment to 88%, and complete virologic response (cVR) to 63%. The high rate of early partial virologic response (pVR) (29% at week 12) subsequently decreased due to the conversion of pVR to VR. Combination therapy was associated with higher rates of VR and cVR in the first year of treatment compared to monotherapy, and later normalization of alanine aminotransferase (ALT) activity (at 48 weeks, due to the cytolytic effect of interferon). With monotherapy, early normalization of ALT activity (at 12 weeks) was observed, and VR and cVR rates reached levels comparable to combination therapy by the end of the second year of treatment. All patients with HIV co-infection and available follow-up of HDV RNA levels achieved VR (including cVR) or pVR; the dynamics of biochemical response were consistent with those in the overall group. Treatment was characterized by good tolerability, with no serious adverse reactions, no cases of treatment discontinuation, and no deterioration of liver function in patients with cirrhosis. Conclusion. High virologic and biochemical efficacy, safety, and good tolerability of bulevirtide in the treatment of CHD in realworld practice, including in HIV co-infected patients, were demonstrated. The obtained data support the choice of combination therapy as a first-line treatment and emphasize the importance of treatment duration for increasing its effectiveness. Further accumulation of real-world experience with antiviral therapy is necessary to develop an optimal treatment algorithm aimed at disease cure. Key words: bulevirtide, HIV co-infection, monotherapy, combination therapy, pegylated interferon, chronic hepatitis D
This review focuses on various aspects of the application of a complex immunoglobulin preparation – CIP (Complex Immunoglobulin Preparation), which contains human immunoglobulins of the main isotypes (G, A, M). The preparation is recommended for oral therapy of viral and bacterial intestinal infections in children aged one month and older, as well as in adults. However, over more than thirty years of use, significant experience has been accumulated regarding its application in various infectious diseases accompanied by microbiome alterations and gastrointestinal disorders. CIP exerts a local effect throughout the entire gastrointestinal tract, contributes to the formation of immunological memory alongside the body's own antibodies, and enhances local immunity in all compartments of the mucous membranes. CIP is successfully used for the treatment of salmonellosis, dysentery, rotavirus and norovirus infections, yersiniosis, dysbiosis of various etiologies, and other gastrointestinal diseases. Its broad spectrum of antibodies and ability to restore microbial balance enable its application in acute respiratory infections of diverse etiology and pertussis. The preparation demonstrates therapeutic effects in allergodermatoses and chlamydial infections, corrects the oral microbiota, and the presence of antibodies against SARS-CoV-2 suggests its potential prophylactic activity against novel coronavirus infection. Key words: complex immunoglobulin preparation, CIP, antibodies, mucosal immunity, acute enteric infections, acute viral infections
Objective. To study the epidemiological features of acute enteric infection (AEI) outbreaks in healthcare settings in the context of shifting dominant pathogen variants and to provide recommendations for the application of modern epidemiological practices in outbreak investigations. Materials and methods. A retrospective analysis of 21 AEI outbreaks in healthcare settings, involving 416 affected individuals, was conducted. The analysis utilized data from Form No 23, outbreak epidemiological investigation reports, and statistical analysis methods. Results. 80.95% of outbreaks in healthcare settings were caused by enteric viruses (norovirus, rotavirus, enterovirus), primarily transmitted via fomites and contact routes. 14.3% were caused by bacteria (Salmonella enteritidis, Shigella sonnei) with foodborne transmission. Outbreaks of bacterial etiology predominantly affected patients over 18 years of age, occurred during the summer months, were characterized by a large number of affected individuals (Me = 81), a high proportion of severe clinical forms (4.6%), and a high index of spread within the outbreak (79.3). For viral outbreaks, the spread index was 17, and the number of cases during outbreak propagation was Me = 8 (Q1–Q3: 6.5–10.5). A direct correlation was established between outbreak duration and the number of affected individuals (an increase of 2.7 persons per day). Conclusion. The investigation of AEI outbreaks in healthcare settings necessitates novel epidemiological practices. These practices should be founded on a comprehensive understanding of the characteristics and epidemic potential of the pathogens involved, and must employ molecular genetic methods for accurate etiological diagnosis and pathogen identification. Key words: outbreak-related morbidity, healthcare settings, epidemiological practices, acute enteric infections
Acute respiratory infections (ARI) remain the leading cause of morbidity in children. In 2024, 21.5% of the population of the Russian Federation had acute respiratory viral infections, with children in the first two years of life being the most vulnerable. Objective. To analyze the dynamics of the proportion of ARI cases in children in 2018–2024 using the example of a Moscow polyclinic and to evaluate the effectiveness of antiviral therapy in a family cluster of respiratory infection. Patients and methods. A retrospective analysis of outpatient records of 487,425 children who visited a local polyclinic (State Budgetary Healthcare Institution "Children's City Polyclinic No 30 of the Moscow Department of Health", Moscow) in 2018–2024 was conducted (the registered population is 7,674 children). Statistical processing was performed using the z-test for comparing proportions (α = 0.05). Results. A retrospective analysis (2018–2024) revealed a decrease in the proportion of ARI in the structure of children's visits to local polyclinics during the pandemic; however, in the post-pandemic period, an increase in lower respiratory tract lesions was noted, exceeding the pre-COVID level. The economic burden of influenza and COVID-19 remains significant to this day. The article presents data on the efficacy of the drug VIFERON® (recombinant interferon alfa-2b with antioxidants) in pediatric practice. The therapeutic effect of the drug is due to its antiviral, immunomodulatory, and membrane-stabilizing effects. Clinical studies confirm the advisability of using VIFERON® in a wide range of infections: RSV infection and ARI (accelerating virus elimination, relieving catarrhal and obstructive syndromes, shortening treatment duration); herpesvirus infections (EBV, CMV, HSV) (reducing viremia, preventing relapses, improving neurological outcomes in encephalitis); intestinal infections of viral etiology (reducing the duration of fever, diarrhea, and intoxication); COVID-19 (rapid formation of specific antibodies and restoration of clinical status). The article presents a clinical example of the effective use of a drug containing recombinant interferon alfa-2b with antioxidants in a 4-month-old child admitted to a specialized hospital with RSV infection. Conclusion. Respiratory infections in children represent a challenge that physicians face on a daily basis. Determining the etiology of ARI will enable timely and adequate treatment. Key words: acute respiratory infections, treatment, respiratory viruses, Viferon
Objective. To evaluate selected parameters of peroxide homeostasis in patients with norovirus gastroenteritis (NVGE) receiving comprehensive pathogenetic therapy that includes colloidal silicon dioxide (Polysorb MP). Patients and methods. Two comparative groups were formed: Group 1 (n = 27) received Polysorb MP; Group 2 (n = 25) received “Activated Charcoal”. Clinical and laboratory parameters, including levels of malondialdehyde (MDA) and superoxide dismutase (SOD), were assessed on days 1 and 5 of treatment. Mathematical and statistical analysis was performed using Microsoft Excel (Office 2021) and SPSS version 25.0 software packages. Results. In Group 1, a more rapid reduction in clinical and laboratory signs of inflammation was observed: intoxication (p = 0.023), fever (p = 0.025), gastroenteritis (p = 0.001), as well as a decrease in C-reactive protein (p = 0.041), leukocyte count (p = 0.006), and the leukocyte index (p = 0.001). MDA levels, which were elevated by 2.5–3 times upon admission in all patients, and SOD levels, reduced by 20-30% from the norm, while showing a general trend toward normalization by day 5 of treatment, remained elevated. In patients of Groups 1 and 2, mean MDA values were 3.24 ± 0.17 and 3.97 ± 0.08 nmol/ml (p < 0.001), respectively, and mean SOD values were 148.23 ± 1.94 and 141.38 ± 1.77 U/ml (p = 0.012), respectively. Conclusion. Colloidal silicon dioxide (Polysorb MP) demonstrated higher detoxifying activity and significantly reduced manifestations of systemic oxidative stress, making it the drug of choice when planning comprehensive pathogenetic therapy. Key words: colloidal silicon dioxide, norovirus gastroenteritis, lipid peroxidation
Novel coronavirus infection (COVID-19) remains one of the leading causes of in-hospital mortality, particularly in patients with severe disease and significant comorbid pathology. Secondary infectious complications, among which fungal infections occupy a special place, contribute significantly to adverse outcomes. Objective. To analyze the prognostic significance of fungal complications in COVID-19 within the framework of factors associated with adverse outcomes, taking into account clinical and demographic characteristics and administered therapy. Patients and methods. A retrospective, single-center, observational study was conducted, including 797 hospitalized patients with a confirmed diagnosis of COVID-19 during the period 2020–2023. Results. Clinical and demographic data, presence of comorbidities, features of pathogenetic therapy, and disease outcomes were analyzed. Lethal outcome was registered in 15.2% of patients. Fungal infections were detected in 50.0% of patients with lethal outcome and in 17.8% of survivors (p < 0.001). Mortality among patients with fungal infections was 33.7%, which significantly exceeded the rate in the group without fungal complications (9.9%). In multivariate logistic regression analysis, the presence of fungal infection maintained independent prognostic significance for lethal outcome after adjustment for age. Conclusion. The obtained results emphasize the significance of fungal infections as an important prognostic factor for adverse outcomes of COVID-19 in hospitalized patients. Key words: COVID-19, fungal infections, candidiasis, mortality, prognosis, risk factors
Objective. To evaluate the clinical, laboratory, and immunological features of the convalescent period in patients who have recovered from COVID-19 with underlying metabolic syndrome (MS) and to substantiate an improved follow-up algorithm. Patients and methods. A total of 100 convalescents aged 45–59 years were examined: 50 with MS and 50 without metabolic disorders. At 6–12 months, the following assessments were performed: questionnaire survey (complaints, frequency and complications of acute respiratory viral infections (ARVI)), complete blood count, biochemical blood analysis, coagulogram, immunogram with lymphocyte subpopulation determination, and measurement of interleukin-6 (IL-6) and IL-8 levels. Subsequently, from the 100 examined convalescents, a subgroup of 50 patients (25 convalescents without MS + 25 convalescents with MS) was selected for a one-year follow-up of respiratory outcomes. Results. In patients with MS, persistent leukopenia and lymphopenia, cytolytic syndrome, residual hypercoagulation, decreased CD4+ and CD19+ cell counts, and sustained overproduction of IL-6 and IL-8 (associated with dyspnea, cough, asthenia, and anxiety) were observed. Over the course of one year, these patients experienced significantly higher rates of recurrent ARVI, relapsing bronchitis, ENT pathology, and bacterial pneumonia; the proportion of patients without respiratory events was minimal. Conclusion. The combination of COVID-19 and MS is associated with prolonged immune disorders and a high frequency of respiratory complications, necessitating differentiated follow-up. The following algorithm is proposed: for patients without MS – follow-up visits at 1 and 6 months; for patients with MS – visits at 1, 3, 6, and 12 months, with mandatory involvement of an allergist-immunologist and extended immunomonitoring. Key words: COVID-19, metabolic syndrome, post-COVID syndrome, follow-up, immune status
Objective. Analysis of interim results of chronic hepatitis D treatment in real-world practice using bulevirtide, an inhibitor of hepatitis B/D virus (HBV/HDV) entry into the cell. Patients and methods. The study group consisted of 11 patients, predominantly male (64%), with liver cirrhosis (55%), esophageal varices (27%), thrombocytopenia (55% – <150·109/L); the analysis included 1 patient with decompensated cirrhosis and 1 patient with hepatitis D recurrence after liver transplantation. Results. According to qualitative HDV RNA testing, 8 (73%) patients achieved complete virologic response (cVR), including 7 on monotherapy (including the patient with post-transplant recurrence) and 1 on combination therapy. The timing of cVR achievement was 24 weeks (5 patients), 48 weeks (2 patients), and 72 weeks (1 patient); the duration of cVR maintenance was 24 weeks (1 patient). In 3 patients with persistently positive qualitative HDV RNA test results, assessment of virologic or partial virologic response was not possible due to the lack of quantitative testing data. All patients with initially elevated alanine aminotransferase (ALT) activity demonstrated a biochemical response (reduction and/or normalization of ALT activity). Results. Treatment was characterized by good tolerability, with no severe or serious adverse reactions, no treatment discontinuation due to adverse reactions, and no deterioration of liver function in patients with cirrhosis, including decompensated cirrhosis. Conclusion. Analysis of interim results of bulevirtide use in patients with chronic hepatitis D in real-world practice demonstrated high efficacy, safety, and good treatment tolerability, including in patients with compensated and decompensated cirrhosis, with hepatitis D recurrence after liver transplantation. Further accumulation of real-world experience is necessary to refine the optimal treatment algorithm. Key words: bulevirtide, decompensated cirrhosis, monotherapy, combination therapy, chronic hepatitis D, liver cirrhosis
This paper presents the effectiveness assessment results of the intranasal recombinant interferon α-2b-based medicine (IFN‑α2b) for the prevention of acute respiratory viral infections (ARVI) in perinatal centre medical workers. Objective. To assess the effectiveness of the original intranasal recombinant IFN-α2b-based medicine (Grippferon®) for the prevention of ARVI to ensure the epidemiological safety of the perinatal centre medical workers. Patients and methods. A prospective analytical cohort study was conducted, involving 100 perinatal center medical workers. The main group (n = 50) received intranasal recombinant IFN-α2b-based medicine for the prevention of ARVI, while the comparison group (n = 50) did not receive this preventive medicine. Active medical observation and questionnaires were used to monitor the participants for 30 days, with symptoms of ARVI recorded. Results. The frequency of ARVI in the main group was statistically significantly lower, than in the comparison group (40.0 vs. 220.0 per 1000 people). The preventive use of the interferon-based medicine showed a high effectiveness. The frequency of ARVI in the main group who used the medicine Grippferon® preventively was significantly lower (by 5.5 times), than in the comparison group (an effectiveness index of 5.5 and preventive effectiveness coefficient of 82%). In isolated cases of ARVI in the main group the infectious process was mild: without the development of fever (body temperature did not exceed 36.8°C) and with a reduction in the symptom duration by an average of 2.3 days compared to the control group. Conclusion. The use of intranasal recombinant IFN-α2b-based medicine (Grippferon®) effectively reduces ARVI incidence among medical workers, alleviates the disease course and shortens symptom duration. Key words: acute respiratory viral infections, perinatal centre, medical workers, prevention, effectiveness, recombinant interferon α-2b, Grippferon®
The possibility of reducing the frequency, duration, and severity of acute respiratory infections (ARI) during the epidemic season in children with tuberculosis is an important component of a comprehensive approach to the treatment of the disease and its favorable outcome. In this regard, the anti-inflammatory drug ammonium glycyrrhizinate is of particular practical interest, as it has a successful experience of use during the ARI epidemic season in the pediatric patient population. Patients and methods. We observed 2 groups of patients (main (n = 44) and control (n = 32)) aged 3–17 years with various forms of respiratory tuberculosis during the ARI epidemic season. Patients in the main group, in addition to baseline therapy for the underlying disease, were prescribed ammonium glycyrrhizinate for 60 days. On days 1, 15, 30, 45, and 60 of observation, physical examination was performed; cases and duration of ARI, the volume of additionally required therapy, and cases of adverse reactions associated with the study drug were recorded. ARI symptoms were assessed using a 4-point scale. Results. Among patients receiving ammonium glycyrrhizinate, the frequency of ARI was recorded more than 2 times lower compared to the control group (15.9% vs 34.4%); 9.4% of children in the control group had ARI twice, while no recurrent ARI episodes were noted in the main group. The average duration of ARI in the main group was 3 days – 40% less compared to the control group (5 [4; 8] days, p = 0.008). In the group of patients receiving ammonium glycyrrhizinate, compared to the control group, ARI episodes occurred with a lower frequency of symptoms of weakness (40% vs 90%, p = 0.04), decreased appetite (6.7% vs 63.6%, p = 0.003), headache (13.3% vs 54.5%, p = 0.003); the duration of fever was significantly shorter (Me 2 [1; 2] vs 3 [3; 5] days (p = 0.014)). Regarding respiratory symptoms, the main group showed a tendency towards a higher frequency of daytime cough (40% vs 18.2%) along with a lower frequency of sputum (6.7% vs 27.3%) and nighttime cough (6.7% vs 9.1%), which was associated with the mucoregulatory effect of the drug. The mean score for weakness and decreased appetite in the main group was 0.5 ± 0.3 and 0.14 ± 0.01 points, respectively; in the control group, these symptoms were significantly more intense – 1.9 ± 0.7 and 1.3 ± 0.5 points, respectively (p < 0.05). Conclusion. The obtained results demonstrate the efficacy and safety of administering ammonium glycyrrhizinate to patients with respiratory tuberculosis during the ARI epidemic season in addition to baseline anti-tuberculosis therapy in order to reduce the frequency, duration, and intensity of ARI symptoms. Key words: children, tuberculosis, acute respiratory infection, ammonium glycyrrhizinate, cough, intoxication
This study demonstrated the possibility of nearly complete recovery in a patient 2.5 years after an extremely severe course of coronavirus infection with 100% lung involvement and prolonged extracorporeal membrane oxygenation. Nevertheless, the presence of subclinical signs of pulmonary fibrosis according to spiral computed tomography and body plethysmography, as well as signs of post-infarction cardiosclerosis and chronic heart failure according to laboratory tests and electrocardiography, dictates the need for long-term dynamic health monitoring for this particular patient and for convalescents of coronavirus infection in general. Key words: COVID-19, cardiorenal syndrome, post-COVID syndrome, pulmonary fibrosis, chronic heart failure
The present study aimed to investigate the prevalence of antibiotic resistance among bacterial isolates obtained from various clinical specimens. A total of 76 specimens were collected from patients attending AL-Nasiriyah General Hospital in southern Iraq. Samples were obtained from urine, wound swabs, sputum, and bronchoalveolar lavage (BAL) fluid; they were directly cultivated on suitable media and incubated overnight at 37°C. The isolates were tested against 27 antibiotics. The identification of bacterial species was based on the morphological and biochemical features of colonies, as well as DNA sequencing results. As a result of bacterial culture, 63 species belonging to 10 genera were isolated, of which 63.5% were Gram-negative and 36.5% were Gram-positive. The distribution of isolates by sample type was as follows: 24 (38%) were from urine, 15 (24%) from wound swabs, 12 (19%) from sputum, and 12 (19%) from BAL fluid. Slightly more than half of the isolates (57%) were obtained from women, while the remaining 43% were from men. The highest positivity rate was observed in the 31–40 age group (27.6%), whereas the lowest was recorded in the 61–70 age group (9.2%). Antibiotic susceptibility testing showed that Ampicillin was the least effective antibiotic (81.80% resistance), while Amikacin was the most effective (9% resistance). Among the isolates, Acinetobacter sp. demonstrated the highest overall resistance (93%). In contrast, Bacillus sp. and Streptococcus sp. were the most susceptible genera, exhibiting 0% and 7% resistance, respectively. Based on resistance patterns, Acinetobacter sp. was classified as a pan-drug-resistant bacterium. Pseudomonas aeruginosa, Enterobacter sp., and Enterococcus faecium were identified as extensively drug-resistant bacteria, while Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Staphylococcus aureus, and Serratia sp. were categorized as multidrug-resistant (MDR). Conversely, Bacillus subtilis and Streptococcus sp. were considered non-MDR. Key words: multiple drug resistance, antibiotic resistance, Sanger sequencing, antimicrobial susceptibility testing, healthcare-associated infections
This review analyzes and summarizes current literature data on the variants of hemostatic disorders associated with acute enteric infections in adults and children. Their epidemiology, clinical manifestations, diagnosis, and treatment are presented. Acute enteric infections, leading the structure of infectious morbidity and causing significant social and economic burden, are associated with the development of life-threatening complications, among which hemostatic disorders with thrombohemorrhagic manifestations occupy a special place. Against the background of various etiological types of intestinal infections, the literature describes cases of myocardial infarction, acute cerebrovascular accident, pulmonary embolism, mesenteric thrombosis, pneumatosis intestinalis, thrombotic microangiopathies, gastrointestinal and rectal bleeding, up to the development of hemorrhagic shock, hemorrhages into the lung parenchyma, brain, skin, and mucous membranes of the gastrointestinal tract. Studies by various authors have revealed common trends in laboratory test alterations: during the first 12–24 hours of the disease, a hypercoagulable phase of thrombohemorrhagic syndrome is recorded, which later transitions into a hypocoagulable phase. Primarily, changes affect the functional activity of platelets (degree of aggregation and degree of exocytosis) and the temporal parameters of thromboelastography, while biochemical coagulation assay parameters do not demonstrate any significant changes. Additionally, an increase in the levels of endothelial dysfunction markers is observed. Current national and international clinical guidelines for acute enteric infections do not provide for the prevention of thrombohemorrhagic complications, even in severe cases of the disease. Treatment is administered strictly according to the clinical variant of the developed hemostatic disorder, following standard protocols. Key words: hemostasis, hemostatic disorders, infarction, acute enteric infections, salmonellosis
Objective. To identify the characteristics of long-term dynamics of the epidemic process of acute intestinal infections (AII) in the constituent entities of the Far Eastern Federal District (FEFD). Materials and methods. Based on official statistical data, an analysis of the incidence of acute intestinal infections was conducted, broken down by administrative territories of the Far Eastern Federal District, individual nosological forms, and months of the year, with the calculation of average annual monthly indicators. Results. The Far Eastern Federal District has high rates of acute intestinal infections, exceeding the Russian average by 34.6%. The Sakhalin Region and Khabarovsk Krai have the highest rates of acute intestinal infections. In 2010–2023, the number of patients with dysentery (from 24.15 to 0.04 per 10,000) and salmonellosis (from 45.99 to 22.9 per 10,000) decreased significantly throughout the district. Viruses, mainly rotaviruses (79.3%) and noroviruses (16.6%), predominated in the structure of AII pathogens of established etiology. There was a 24.7% decrease in the incidence of AII of unknown etiology and a 21.4% decrease in AII of established etiology. In the structure of the overall incidence of acute infectious diseases and the incidence of acute infectious diseases of established etiology, children in the first two years of life led (33.7% and 40.9%, respectively), while preschool children (3–6 years old) predominated among diseases of unknown etiology (29.4%). The introduction of rotavirus vaccination into the regional preventive vaccination calendar in a number of Far Eastern regions may have contributed to a decrease in the incidence of this infection among children, mainly in the first year of life. Conclusion. Conducting an epidemiological analysis of long-term AII incidence and identifying the probable causes of changes in the epidemiological situation contributes to the improvement of a set of preventive and anti-epidemic measures in the Far East regions. Key words: morbidity, norovirus infection, acute intestinal infections, rotavirus infection
Currently, the professional community is actively discussing the approach to the treatment of acute respiratory infections in children. For example, in the Voronezh region, since 2021, there has been a significant increase in the hospitalization of children with bocavirus infection, peaking in 2024 with 475 cases. Patients and methods. A total of 132 children hospitalized in an infectious diseases hospital with bocavirus infection were observed. Results. It was found that the infection was most frequently registered in children under 3 years of age (53.0%) and in 39.3% of cases it proceeded as a mixed infection, more often with adenoviruses and rhinoviruses. An autumn-winter seasonality of the infection was identified. The disease manifests itself with fever and catarrhal syndrome (cough and moderate rhinorrhea). Almost half (46.9%) develop bronchial obstructive syndrome, and 28.7% of children experience respiratory failure. 7.5% are diagnosed with pneumonia. Conclusion. Given these characteristics of bocavirus infection, it is advisable to use broad-spectrum antiviral drugs in the treatment of children, especially those with proven antiviral activity against DNA-containing viruses. Key words: bocavirus infection, children, mixed infection, pneumonia, antiviral therapy
Objective. To confirm the in vitro antiviral activity of recombinant interferon alpha-2b preparations combined with antioxidants (Viferon® rectal suppositories, ointment for external and local use, gel for external and local use) against the most common respiratory viral infections, including influenza. Materials and methods. The antiviral activity of interferon alpha-2b preparations combined with antioxidants (rectal suppositories, ointment for external and local use, gel for external and local use) was evaluated against the most common respiratory viruses: influenza A virus subtypes H1N1 and H3N2, influenza B virus, human adenovirus type 5, enterovirus (Coxsackie B3 virus), and SARS-CoV-2. The evaluation was performed using various passaged cell culture lines. Antiviral activity assessment was conducted in accordance with the recommendations of OFS.1.7.2.0002.15, “Biological Methods for Testing Interferon Preparations Using Cell Cultures” of the State Pharmacopoeia of the Russian Federation. Statistical analysis of the experimental results was performed using the Spearman-Kärber method. Results. All interferon alpha-2b preparations exhibited no cytotoxicity toward any of the cell cultures used, even at the maximum concentration of 105 IU/mL, indicating a high safety profile of the active substance, interferon alpha-2b. The observed dosedependent activity of the tested interferon alpha-2b preparations against various respiratory viruses highlights the need for differentiated dosing of the preparations depending on the viral etiology. The observed decrease in antiviral activity 48 hours after virus inoculation, compared to the activity measured 24 hours postinoculation, indicates a time-dependent reduction in the effect of interferon alpha-2b on the cells. This finding explains the need for repeated administration of the preparation to maintain a sustained antiviral effect, at intervals of no less than every 24 hours. Conclusion. The positive results of the study on the activity of interferon alpha-2b preparations combined with antioxidants (Viferon® rectal suppositories, ointment for external and local use, gel for external and local use) demonstrate high antiviral activity of interferon alpha-2b in all dosage forms against a broad spectrum of respiratory viral infections. The observed decrease in antiviral activity 48 hours after virus inoculation supports the recommendation for continuous daily administration of interferon alpha-2b preparations for the prevention and treatment of various respiratory viral infections. Since no cytotoxic effects were observed for interferon alpha-2b or its combination preparations with antioxidants, but dose-dependent activity was noted, it is recommended to use the maximum possible doses of the preparations to achieve the greatest therapeutic effect against a wide range of respiratory viruses. Key words: acute respiratory viral infections, interferon alpha-2b, assessment of therapy efficacy in vitro
Objective. To evaluate the prognostic potential of exosomal microRNAs (miR-146a-5p, miR-155-5p, miR-126-3p, miR-218-5p, miR-410-3p, miR-503-5p, miR-29a-3p) depending on the severity of HFRS. Patients and methods. We examined 288 patients at the Republican Clinical Infectious Diseases Hospital in Ufa in 2023–2025 with a diagnosis of HFRS: moderate severity (n = 105), severe (n = 99), and severe with complications (n = 84). Blood samples for molecular genetic analysis were taken during the febrile, oliguric, and convalescent periods of HPS. Total RNA was isolated using the exoRNeasy Midi Kit (Qiagen, Germany). Quantitative real-time PCR (qRT-PCR) was performed using the miRCURY LNA SYBR Green PCR Kit (Qiagen, Germany) and the LightCycler96 real-time PCR product detection system (Roche, Switzerland). Results. When comparing groups of patients with varying severity, distinct differences were found in the levels of exosomal microRNAs miR-146a-5p and miR-155-5p. In patients with severe disease with complications, the level of miR-146a-5p was higher than in patients with moderate disease (FC = 2.70, p = 0.0022, q = 0.007). For miR-155-5p, the increase was FC = 1.86 in severe cases (p = 0.049, q = 0.11 – trend) and FC = 1.98 in severe cases with complications (p = 0.001, q = 0.009). For miR‑503-5p, a weak tendency toward a decrease was identified in severe forms (–25–30% of the medium to severe form, p = 0.08), which may have pathogenetic significance. Significant correlations were found between miR-155-5p/miR-503-5p and clinical and laboratory parameters: creatinine, C-reactive protein, and duration of fever. Conclusion. MicroRNA-146a-5p and microRNA-155-5p can be considered as early prognostic biomarkers of HFRS severity. Our findings expand the understanding of the role of microRNAs in the pathogenesis of HFRS and confirm the need for further research to develop microRNA-based prognostic tests and targeted interventions. Key words: hemorrhagic fever with renal syndrome, microRNA severity of HFRS
