EPIDEMIC PROCESS IN MODERN CONDITIONS

Nowadays the evolution of epidemic process is under active influence of a new adjusting risk factor - technogenic environmental contamination. Negative influence of ecological pressure on manifestations of infectious diseases is realized in destabilization of epidemic process: significantly higher level of incidence, greater amplitude of its fluctuations around a trendline and. shortening cyclic componenta. Besides this, the more heavy clinical manifestations of infectious process and its longer duration with simultaneous development of the complications, accompanying diseases and. synchronization of process takes place. Decrease of immunological and epidemiological effectiveness of vaccination is also registered. This paper establishes, that the minimal period of infection incidence is the most vulnerable part in a uniform circuit of epidemic process. It is shown in epidemiological experiment that the complex of preventive actions at management of infection incidence is necessary for making active during a minimum level of development of epidemic process in its intraannual dynamics

Clinical manifestation of radiation-exposed tuberculosis when uranium production

Present study was performed in Krasnokamensk city. We conducted retrospective study of 34 incident cases of tuberculosis (TB) among employees of the Priargunsky Industrial Mining and Chemical Union exposed to radiation (uranium production and processing). The comparison group included 47 TB patients, permanent residents of Krasnokamensk. The study found out that long-term dynamics of TB morbidity in the main group exceeded the one of the comparison group. Among the employees, most cases were registered in the 20-35 age group (47.0 %), and among the Krasnokamensk residents - in the 35-50 age group (51.0 %). In the main group, the most common cases were gross and extrapulmonary forms of tuberculosis (53.0 % and 14.7 % respectively). In the comparison group, minor TB forms dominated (59.5 %) and only one case of extrapulmonary tuberculosis was registered (p < 0.05). The effectiveness of the treatment in compared groups did not differ

NEW METHOD OF EPIDEMIOLOGICAL EVALUATION OF THE INCIDENCE OF COMPLICATIONS AFTER ANTI-TUBERCULOSIS VACCINATION

The article offers a new method for calculation of incidence of complications after primary anti-tuberculosis vaccination. Using the example of analysis of continuous sampling of complications after anti-tuberculosis vaccination (n = 110) in Irkutsk Region in 2005-2014 the article shows the advantage of the offered method compared to the existing ones

Analysis of Long-Term Dynamics of Incidence of Healthcare-Associated Infections in the Irkutsk Region

Introduction.Healthcare-associated infections incidence is one of the most pressing issues in modern healthcare due to their high abundance as well as economic loss they cause.The aimis to study regional features of the incidence of healthcare-associated infections.Methods.We conducted a retrospective epidemiological analysis of nosocomial morbidity in hospitals of the Irkutsk region within 2006-2017 years. We used data, presented in the following state reports: “On the state of sanitary and epidemiological welfare of the population in the Russian Federation”, “On the state of sanitary and epidemiological welfare of the population in the Irkutsk region”.Results and discussion.According to the results of the conducted analysis, it was shown that the average long-term prevalence of healthcare-associated infections in the Irkutsk region was 41.94 ± 2.040/00000 (Russian Federation – 17.49) with a tendency to stabilization in recent years. The therapeutic and prophylactic organizations of the surgical profile have the highest epidemiological significance (over 51 %). At the same time, the share of postoperative complications during the study period decreased by 1.5 times. We have noted a rising trend line with a positive rate of increase in the incidence of nosocomial pneumonia, which in the last two years has taken a leading position in the structure of healthcare-associated infections. The incidence of infections in newborns in the Irkutsk region ranks the third, with a specific weight of 11.54 %. Moreover, if before 2013 purulent-septic diseases of the newborns were the predominant nosological form, in recent years pneumonia has firmly taken over the leadership. During the study period we revealed an increase in the incidence of postpartum endometritis in puerperas. It has been shown that the registration of sepsis, urinary tract infections in the region is low

Personalized Approach as a Basis for the Future Diagnosis of Tuberculosis (Literature Review)

The global spread of tuberculosis remains one of actual problems of public health despite of introduction of public health safety programs. Early, rapid and accurate identification of M. tuberculosis and determination of drug susceptibility are essential for treatment and management of this disease. Delay in delivering results prolongs potentially inappropriate antituberculosis therapy, contributing to emergence of drug resistance, reducing treatment options and increasing treatment duration and associated costs, resulting in increased mortality and morbidity. Faster, more comprehensive diagnostics will enable earlier use of the most appropriate drug regimen, thus improving patient outcomes and reducing overall healthcare costs. The treatment of infection based on the using of massive antimicrobial therapy with analysis of bacterial strains resistance to first line drugs (FLD) isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), ethambutol (EMB) and streptomycin (SM). However, the public health practitioners pay no attention to functional activity of human immune system genes. The interaction of bacterial genomes and immune system genes plays the major role in infection progress. There is growing evidence that, together with human and environmental factors, Mycobacterium tuberculosis complex strain diversity contributes to the variable outcome of infection and disease in human TB. We suppose that the future of diagnosis and treatment of tuberculosis lies in the field of personal medicine with comprehensive analysis of host and pathogen genes

CHARACTERISTICS OF OPPORTUNISTIC BACTERIA OF MICROBIAL COMMUNITIES OF THE LENA RIVER ON THE DEGREE OF DOMINANCE AND DIVERSiTY

The results of the study of opportunistic bacteria of the Lena river are show in the article. The microbial community of the river is represented by bacteria of different families. Opportunistic Enterobacteriaceae is absolutely dominated. Enterobacteria of different type belonged to four classes of dominance. The fluctuations in the frequency of their occurrence did. not extend beyond the class for the period of observation. At the same time the changes in their populations at the level of diversity are identified

Antibiotic resistance of microbial community of the lake Baikal ecosystem in the area of Listvyanka, Slyudyanka and Baikalsk

The article presents the results of study of antibiotic resistance of bacteria isolated from the lake Baikal ecosystem. It was revealed that in the littoral zone of the lake Baikal (area of Listvyanka, Baikalsk, Slyudyanka) under the anthropogenic impact there are strains of microorganisms resistant to a wide range of antibiotics. Strains resistant to all antibiotics are 1 % of the isolated bacterial strains; strains sensitive to all antibiotics are 6 %; strains isolated from the drill samples of bottom sediments are 80 %. This phenomenon can be considered as an indicator of anthropogenic influence

Multi-Drug Resistance of Mycobacterium Tuberculosis – the Problem of Modern Phthisiology

The 21st century is characterized by the exacerbation of the problem formation and spreading of drug-resistant strains throughout the world. Genetic mutations of Mycobacterium tuberculosis lead to the formation of drug-resistant forms because of long-term use of anti-tuberculosis drugs. The Russian Federation is among the top three countries with a high burden of tuberculosis with multidrug resistance (MDR). The estimated number of cases of tuberculosis with MDR in the Russian Federation was 60,000, which corresponds to half the burden of the European Region in 2015. In the Irkutsk region from 2014 till 2018 the proportion of TB cases with MDR cases increased from 15.2 % to 18.3 %. According to the reference laboratory of the Irkutsk Regional Clinical Tuberculosis Hospital, a significantly higher level of MDR among primary diagnosed was registered in the cities (27.7 %) and the lowest in rural areas of the region (16.5 %). Among the cohorts of patients with tuberculosis, the highest proportion of MDR was in the northern territories of the region (43.1 %), in Irkutsk district (41.2 %) and in large cities, including Irkutsk (38.5 %). Positive correlations were established between cohort of primary diagnosed TB with MDR and among populations in areas with high morbidity along the railway (r = 0.91; p = 0.00001), in the Irkutsk region (r = 0.89; p = 0,00008), and also in the Irkutsk city (r = 0.91; p = 0.00002). This is probably due to the influence of reservoir of tuberculosis infection formed in these localities. The regulatory documents of the Ministry of Health of the Irkutsk Region was developed on the basis of the data obtained, and they include recommendations for improving the diagnosis of tuberculosis in the region using fast and accelerated microbiological diagnostic methods

Bacteria Biofilms in Purulent-Septic Infections

The causative agents of many infectious diseases can exist in the form of biofilms. The aim of the work is to study of the frequency of occurrence and the degree of activity of biofilm formation of microorganisms isolated from different locus in purulent-septic infections.Materials and methods. Fifteen strains isolated from patients with purulent-septic infections were examined. Biofilms were determined by the ability to adsorption a crystalviolet to ethanol.Results. 73,3 ± 11,4 % strains had biofilms (including gram-negative bacteria – 69,2 ± 11,9 %; Staphylococcus – 100,0 %; p &lt; 0,05).The degree of activity of formation of biofilm by gram-negative bacteria was higher than Staphylococcus (0,302 ± 0,04 и 0,134 ± 0,01 units of optical density; p &lt; 0,01). The highest activity of formation of biofilm was detected in K. pneumoniae isolated from patients with sepsis. Strains from clinically important locus (blood, sputum, wound discharge, abdominal fluid) had biofilms in 75,0 %; from locus of monitoring – 66,7 %. The pathogens isolated from locus of the monitoring were characterized by an average degree of activity of biofilm formation (0,180–0,360 units of optical density). Strains from clinically important locus (blood and sputum from patients with sepsis) had a highdegree of biofilm formation (more than 0,360 units of optical density). Conclusion. In most cases, strains were characterized by the presence of biofilms and differed in degrees activity of biofilm formation depending on locus