DETECTION OF TUBERCULOUS MYCOBACTERIA IN THE BLOOD OF PATIENTS WHEN SUSPECTING TUBERCULOUS SEPSIS

The increase in HIV patients manifesting clinical signs of sepsis requires up-to-date, rapid and reliable techniques for etiologic diagnostics.The analysis has included 53 publications related to various aspects of tuberculous bacteriemia, resources for its detection and their efficiency. According to the publications tuberculous mycobacteria in blood can be detected in HIV-positive patients with severe immune suppression (CD4: 17-18 cells/mcl) and presence of the following clinical and laboratory and X-ray signs: fever, severe anemia, paratracheal lymphoadenopathy, miliary dissemination. It is feasible to test the blood in order to detect tuberculous mycobacteria only in the very ill HIV positive patients in whom tuberculosis is suspected and it is impossible to collect sputum and there are no obvious signs of pulmonary lesions.The presence oftuberculous mycobacteria in blood isrelated to the high mortality level (up to 60%) and the immediate prescription of anti-tuberculosis therapy can reduce it. Antiretroviral therapy can reduce the chances of tuberculous sepsis development. Development and optimization of test systems for rapid detection of DNA of tuberculous mycobacteria in blood can be fairly promising for the diagnostics of the urgent tuberculosis

High prevalence of genotype B0/W148 of Mycobacterium tuberculosis among HIV-TB patients in Perm Krai and Irkutsk Region

Background. The population with HIV-infection plays significant role in ongoing tuberculosis pandemic. Immunosuppression due to HIV-infection is one of the causes of TB disseminated forms in this group of people. Having low immune status is also often associated with a polyclonal M. tuberculosis infection. Aim of the research: comparative assessment of epidemic genotypes of M. tuberculosis prevalence and mixed genotypes identification within HlV-TB co-infected patients in two Russian regions. Materials and methods. The DNAs of 78 clinical isolates from Irkutsk Region (IR) and 64 strains from Perm Krai (PK) have been genotyped by MIRU VNTR 24 and RD105/RD207. Strains were obtained from patients who did not have significant age and sex differences. In the PK age of the patients was 34.5 ± 0.9, in IR - 34.4 ± 1.5 years. The samples were obtained from 67.2 and 65.4 % of men, respectively. Result. The study of the M. tuberculosis indicates significant predominance of Beijing genotype strains in patients with TB-HIV of PK (92.2 %) compared to the IR (59.5 %) (х2 = 18.0; p < 0.01). The prevalence of MDR pathogens in TB-HIV patients exceeded 50 %. The mixed genotype detection in the PK and IR was high (14.1 and 12.7 % respectively). The level of virulent strains B0/W148 was 34.4 % in PK patients and 25.3 % in IR ones. Analysis of the results suggests the epidemic spread of MDR-TB in the immunocompromised individuals. Conclusions: The identified trends may indicate that Perm Kray have a process of active dissemination of transmissible strains of M. tuberculosis within HIV-infected population

ВЫЯВЛЕНИЕ МИКОБАКТЕРИЙ ТУБЕРКУЛЕЗА В КРОВИ КАК МЕТОД ДИАГНОСТИКИ ГЕНЕРАЛ ИЗОВАННОГО ТУБЕРКУЛЕЗА У ПАЦИЕНТОВ С ВИЧ-ИНФЕКЦИЕЙ

Objective: To study the informative value of the detection of mycobacteria in blood with the cultural method in patients with suspected tuberculous sepsis and to determine the most significant clinical and laboratory criteria for testing. Materials and methods: The investigation to detect M.tuberculosis was fulfilled in 159 HIV-positive patients with suspected tuberculosis sepsis. Blood culture was completed with culture medium Myco/F Lytic Culture Vials and analyzer BACTEC 9050. Results: Mycobacteria were detected in blood of 19 patients (11,9% of all patients): in 18 patients the growth of М. tuberculosis complex was detected (25,3% of all patients with diagnosed tuberculosis) and in 1 patient it was Mycobacterium avium complex (0,6% of all patients). It was shown, that the probability of M.tuberculosis detection was especially associated with the severity of the disease, immunosupression (less than 100 cells/mkl), hemoglobin quantity less than 90 g/l (levels were determined through the seeking for the most significant cutoffs). It was not proofed, that meningoencephalitis develops more often in patients with proven bacteremia. There were no evident differences in detection frequency of mycobacteria in sputum between patients with tuberculous sepsis and without it.Цель: изучить информативность культурального исследования крови на МБТ у больных ВИЧ-инфекцией с подозрением на туберкулезной сепсис и определить наиболее значимые предтестовые клинико-лабораторные критерии. Материалы и методы: обследование для выявления микобактерий в крови выполнено 159 больным ВИЧинфекцией с подозрением на туберкулезный сепсис. Посев крови производили на среду Myco/F Lytic Culture Vials и помещали в гемоанализатор BACTEC 9050. Результаты: микобактериальная инфекция кровотока выявлена у 19 пациентов (11,9% от числа тестируемых): у 18 человек обнаружен рост М. tuberculosis complex (25,3% от числа больных туберкулезом) и у одного больного – Mycobacterium avium complex (0,6% от числа тестируемых). Выявлено, что вероятность бактериемии наиболее связана с тяжестью состояния пациента; иммуносупрессией менее 100 клеток/мкл; снижением уровня гемоглобина менее 90 г/л (уровни были определены посредством поиска наиболее значимых порогов). Не удалось доказать, что менингоэнцефалит чаще развивается у лиц с подтвержденной бактериемией. Достоверных различий по частоте выявления МБТ в мокроте у больных с туберкулезным сепсисом и без него выявить не удалось

Study of High Porous Carbons Prepared by the Alkaline Activation of Anthracites

The influence of alkaline activation on the development of anthracite porous structure under the variation of different factors: anthracite and metal hydroxide origin, their mass ratio in a mixture, activation temperature and duration has been studied. The highest development of anthracite surface area was reached with mass ratio of anthracite/alkali 1:5-7 and the final heating temperature of 800 °С. Under these conditions the maximum value of surface area of carbon material was 2900 m2/g in case of КОН activated Siberian anthracite and 2550 m2/g for NaOH activated Ilovaisky anthracite

Palladium Catalysts on Carbon Supports Prepared from a Natural Graphite and Anthracite

Influence of the conditions of the carbon supports preparation from an expanded natural graphite and chemically modified anthracites on the formation of carbon porous structure, on the distribution and sizes of supported palladium particles and their catalytic activity in liquid phase reactions of hexene-1 and cyclohexene hydrogenation has been studied. At the same reaction parameters and Pd content the catalytic activity of different samples varies by more than 100 times. Besides, the activity of some catalysts in hexene hydrogenation is much higher (up to 20 times) than that in cyclohexene hydrogenation reaction. The possible reasons for observed differences in Pd catalyst behavior are analysed

Properties in CO Hydrogenation of the Nano-Catalysts Produced by Supporting Iron Carbonyls on SiO2

There have been studied the catalytic properties in the reaction of CO hydrogenation of nano-catalysts produced by supporting on silica the iron carbonyl compounds containing various numbers of metal atoms. It was determined that the catalytic activity of the supported carbonyls increases with the rise of the number of the metal atoms in their composition. Some of them have a very high selectivity in respect to the C2-C3 olefins

Formation of Iron Nanoparticles by Thermal Transformations of Iron Carbonyls on Silica Surface

There have been determined some regularities of thermochemical transformations of supported on silica iron carbonyls containing from 1 to 6 metal atoms. There have been selected the conditions of iron carbonyls thermal decomposition which provides the formation of metallic particles having the size of 0,5 -1,0nm