Prevention of post-transfusion hepatitis c transmission through donor blood and its components

The aim of organizational aspects of preventing the transmission of hepatitis C virus with donor blood and its components.Materials and methods. An activity of the blood service establishments in Russia for the prevention of HCV infection through transfusion of blood and its components on the basis of the analysis of sectoral statistical surveys was studied.Results. The frequency of detection of antibodies to hepatitis C virus in blood donors and its components during 2009–2013 decreased by more than 1,5 times. The percentage of donors who have identified markers of hepatitis C virus was significantly different in different regions: from 0,51% to 1,36%. The activity of the blood service implemented method of plasma quarantine resulting annually rejected from 0,32% to 0,23% as a result of the identified markers of HCV. Pathogen inactivated plasma volume increased in 3 times, the platelet concentrate in 3,2 times.Conclusion. To ensure the safety of donated blood and its components in the blood service effectively the modern technology use for to prevention transmission of the HCV: quarantine of plasma, donor selection and development, inactivation of pathogens. The degree of implementation in practice of nonpaid voluntary blood transfusions significantly increased and is characterized by regional features in recent years

Ускоренный метод идентификации бактерий и микромицетов в гемокультурах у детей с использованием мультиплексной пцр в режиме реального времени

Objective: To evaluate the effectiveness and clinical significance of an accelerated, method, for the identification of microorganisms in blood, cultures in children using real-time multiplex PCR.Materials and methods: A total of 72 blood, samples were obtained, from 62 children aged. 3 months to 16 years. The identification of the isolated cultures, according to the proposed, method, was carried out in real-time PCR and. also using classical culture microbiological methods.Results: Based, on the frequency of detection and. the clinical significance of pathogens isolated from children, a panel of test systems was formed to identify them, by means of real-time PCR. It was shown that the effectiveness of the developed, method, for identification, of bacteria and. micromycetes by real-time PCR was 86,7% as compared, with the microbiological method. A significant reduction in the time of identification, of pathogens (from 48 hours to 5—7 hours) was demonstrated. In addition, the use of this method, allows, at the same time, to identify a number of antibiotic resistance genes (in particular, the genes of acquired, carbapenemases and. methicillin-resistant staphylococci).Conclusion: The developed, method, with real-time PCR for detecting and identifying microorganisms in the blood has shown its effectiveness, clinical significance and. the possibility of using it for pediatric patients. Its use significantly shortens the time frame for obtaining results and, thus, allows timely initiation, of etiotropic therapy.Цель: оценить эффективность и клиническую значимость ускоренного метода идентификации микроорганизмов в гемокультурах у детей с использованием мультиплексной ПЦР в режиме реального времени.Материалы, и методы: всего было исследовано 72 образца крови, полученных от. 62 детей в возрасте от. 3 месяцев до 16 лет. Идентификацию выделенных культур проводили с помощью ПЦР в реальном времени, а также с использованием, классических культуральных микробиологических методов.Результаты: исходя из частоты выявления и клинической значимости патогенов, выделяемых от. больных, была сформирована панель тест-систем для их идентификации с помощью ПЦР в реальном времени. Показано, что эффективность метода идентификации бактерий и микромицетов с помощью ПЦР в реальном времени по сравнению с микробиологическим методом составила 86,7%. Установлено значительное сокращение времени идентификации возбудителей (с 48 ч до 5—7 ч). Кроме того, использование данного метода позволяет в эти же сроки выявлять ряд генов антибиотикорезистентности (в частности, гены приобретенных карбапене-маз и метициллин-резистентности стафилококков).Заключение: разработанный метод идентификации микроорганизмов в крови с использованием. ПЦР в реальном. времени показал свою эффективность, клиническую значимость и возможность использования при оказании медицинской помощи педиатрическим, пациентам.. Его применение значительно сокращает сроки получения результатов и, таким, образом., позволяет, начать своевременную этиотропную терапию

ПРОФИЛАКТИКА ПОСТТРАНСФУЗИОННОГО ВИРУСНОГО ГЕПАТИТА С ПРИ ПЕРЕЛИВАНИИ ДОНОРСКОЙ КРОВИ И ЕЕ КОМПОНЕНТОВ

The aim of organizational aspects of preventing the transmission of hepatitis C virus with donor blood and its components.Materials and methods. An activity of the blood service establishments in Russia for the prevention of HCV infection through transfusion of blood and its components on the basis of the analysis of sectoral statistical surveys was studied.Results. The frequency of detection of antibodies to hepatitis C virus in blood donors and its components during 2009–2013 decreased by more than 1,5 times. The percentage of donors who have identified markers of hepatitis C virus was significantly different in different regions: from 0,51% to 1,36%. The activity of the blood service implemented method of plasma quarantine resulting annually rejected from 0,32% to 0,23% as a result of the identified markers of HCV. Pathogen inactivated plasma volume increased in 3 times, the platelet concentrate in 3,2 times.Conclusion. To ensure the safety of donated blood and its components in the blood service effectively the modern technology use for to prevention transmission of the HCV: quarantine of plasma, donor selection and development, inactivation of pathogens. The degree of implementation in practice of nonpaid voluntary blood transfusions significantly increased and is characterized by regional features in recent years .Цель. Исследование организационных аспектов профилактики передачи вирусного гепатита С с донорской кровью и ее компонентами.Материалы и методы. Проведено изучение деятельности учреждений службы крови России по предупреждению инфицирования ВГС при переливании донорской крови и ее компонентов на основе анализа отраслевых статистических наблюдений.Результаты. Частота выявления антител к вирусному гепатиту С у доноров крови и ее компонентов в течение 2009–2013 гг. снизилась более чем в 1,5 раз. Процентное число доноров, у которых выявлены маркеры вируса гепатита С, существенно отличалось в различных регионах: от 0,51% до 1,36%. В деятельность службы крови внедрен метод карантинизации плазмы, в результате чего ежегодно бракуется от 0,32% до 0,23% вследствие выявленных маркеров ВГС. Объем патогенинактивированной плазмы увеличился в 3 раза, тромбоцитного концентрата – в 3,2 раза.Заключение. Для обеспечения безопасности донорской крови и ее компонентов в службе крови эффективно применяются современные технологии профилактики передачи ВГС: карантинизация плазмы, отбор доноров и развитие безвозмездного добровольного донорства, инактивация патогенов. Cтепень их внедрения в трансфузиологическую практику в последние годы существенно повышается и характеризуется региональными особенностями

ВИРУСНЫЙ ГЕПАТИТ В У ОНКОГЕМАТОЛОГИЧЕСКИХ БОЛЬНЫХ (ОБЗОР ЛИТЕРАТУРЫ)

The review presents current data on the role of viral hepatitis B in on-cohematological patients. Possible ways of infection, prophylaxis of infection and activation of hepatitis B in this category of patients are considered. Specific features of the course of hepatitis B in various clinical situations are described: against the background of other viral infections and in the conduct of specific anti-leukemia therapy. The need to identify occult (occult) hepatitis in donors and patients with hemoblastosis is emphasized and methods for its detection are considered.В обзоре представлены современные данные о роли вирусного гепатита В у онкогематологических больных. Рассмотрены возможные пути заражения, профилактики заражения и активации гепатита В у этой категории пациентов. Описаны особенности течения гепатита В в различных клинических ситуациях: на фоне других вирусных инфекций и при проведении специфической противолейкозной терапии. Подчеркивается необходимость выявления скрытого (оккультного) гепатита у доноров и больных гемобластозами и рассматриваются методы его выявления

Роль генодиагностики в прогнозировании ДВС-синдрома и риска развития полиорганной недостаточности у детей с генерализованными формами менингококковой инфекции

Aim: To investigate the features of allelic polymorphism, of several immune- and hemostasis-related genes in children with generalized, meningococcal infections and. to assess the usefulness of genotyping for prediction, of severe disseminated intravascular coagulation (DIC) and. multiple organ dysfunction, syndrome in these patients.Materials and methods: we studied. 20 children aged, from 8 months up to 17 years with generalized, meningococcal infections who developed DIC or/and multiple organ dysfunction syndrome. The control group consisted, of 200 blood, donors. Genomic DNA was isolated, from peripheral blood, leucocytes. Allelic variants of genes coding for plasma hemostatic factors (FI-A, FI-B, FXIII-A, PAI-1, ТРА) or pro-inflammatory cytokines (IL-6, IL-1B, TNF-A) were detected by PCR and. subsequent restriction, analysis. Allele and. genotype frequencies were calculated, by direct counting, and. their differences between the groups were assessed, by Fisher's exact test. For statistical analysis, the GraphPad. Prism, ver.4.0 software was used.Results: in the group of children with generalized, meningococcal infections, the frequency of heterozygotes for the IL-6 -174 G/C polymorphism, was 1.5-fold higher than in the controls (75.0% vs. 50.0%, respectively, OR=3.0; 95% CI: 1.1-8.6; p=0.037). Genotype TPA Del/Del was detected 4-fold more frequently in children who developed multiple organ dysfunction syndrome than in those with the more favorable disease course (45.4% vs. 11.1%, respectively, OR=6.7; 95% CI: 0.6-73.1; p=0.16). Moreover, among the patients having multiple organ dysfunction, syndrome, we observed, more frequently individuals who possessed, at least 2 unfavorable genetic variants (p=0.022).Conclusion: Simultaneous assessment of nucleotide variations in 8 studied genes could help to define the group of children with high, risk of multiple organ dysfunction, syn-drome.Genotype TPA Del/Del, associated, with decreased, production, of this factor, might serve as a marker of unfavorable DIC course and possible predictor of multiple organ dysfunction. syndrome in children with generalized, meningpcoc-cal infections.Цель: изучить особенности аллельного полиморфизма ряда генов иммунной системы, и гемостаза у детей с генерализованными формами менингококковой инфекции и оценить возможность использования результатов генотипирования для прогнозирования тяжелого течения ДВС-синдрома и развития полиорганной недостаточности (ПОН).Материалы, и методы.: обследовано 20 детей в возрасте от. 8 месяцев до 17 лет. с генерализованными формами менингококковой инфекции, протекающими с синдромом. ПОН или/и тромбогеморрагическими нарушениями. Контрольную группу составили 200 доноров крови. В качестве материала исследования использована геномная ДНК, выделенная из лейкоцитов периферической крови. Выявление аллельных вариантов генов, ассоциированных с дисфункцией плазменного звена гемостаза (FI-A, FI-B, FXIII-A, PAI-1, ТРА) и повышенной продукцией ряда провоспалительных цитокинов (IL-6, IL-1B, TNF-A), проводили с помощью полимеразной цепной реакции и последующего рестрикционного анализа. Частоты встречаемости аллелей и генотипов определялись прямым подсчетом. Межгрупповые различия в распределении аллелей и генотипов оценивались с помощью точного метода Фишера. Статистическая обработка проводилась с использованием программы GraphPadPrism, версия 4.0.Результаты: в группе детей с генерализованными формами менингококковой инфекции доля гетерозигот, по полиморфизму 174 G/C в гене IL-6 была в 1,5 раза выше, чем. в контроле (75,0% против 50,0% соответственно, OR=3,0; 95% CI: 1,1-8,6; p=0,037). Генотип ТРА Del/Del встречался в группе детей с ПОН в 4 раза чаще, чем у пациентов с относительно благоприятным течением заболевания (45,4% против 11,1% соответственно, OR=6,7; 95% CI: 0,6-73,1; p=0,16). Выявлено увеличение в группе детей с ПОН доли лиц, имеющих в генотипе два и более неблагоприятных варианта изученных генов (р=0,022).Заключение: комплексная оценка аллельного полиморфизма 8 генов плазменных факторов гемостаза и провоспалительных цитокинов позволяет, с высокой долей достоверности определить группу риска по развитию ПОН среди детей с генерализованными бактериальными инфекциями. Генотип ТРА Del/Del может, являться неблагоприятным, маркером, при данной патологии и быть ассоциированным, с высоким, риском, развития тяжелого ДВС-синдрома

Preventing of transfusion syphilis

Goal of the study. To study the prevalence of syphilis markers in donors in the Russian Federation, and to evaluate the effectiveness of measures to prevent blood transfusion syphilis and other bloodborne infections in the Blood Service in Russia. Materials and methods. Performance analysis of sectoral statistical surveys Russian Ministry of Health in the form number 39, «Report of the station, department of blood transfusion, hospital blood leading procurement» and the explanatory notes to them for the period from 2009 to 2013. Analysis of the results of screening donated blood for markers of syphilis. Results. It was found that the incidence of syphilis markers in donors in the whole of Russia was significantly (p < 0,05) decreased (from 0.79% in 2009 to 0.49% in 2013). However, there was heterogeneity in the proportion of donors with markers of syphilis in different regions of the Russian Federation. (From 0.68 to 0.35%). In 2013, the causative agent of syphilis markers are more often detected in donors of the North Caucasus and Siberian Federal Districts, seldom in donors in the North-Western and Urals Federal District. Hence, there remains a certain risk of transfusion transmission of syphilis. In recent years, widely implemented method viral inactivation of plasma and platelet concentrate. In 2013, the procedure viral inactivation subjected to 8% of the total issued for transfusion platelet concentrate. Conclusion. There remains a certain risk of transfusion transmission of syphilis. Further implementation of the methods of inactivation of pathogens in Blood Service of Russia will also contribute to reducing the risk of blood-borne transmission of Treponema pallidum

Clinical and microbiological characteristics of bloodstream infections in hematological cancer patients

Introduction. Bloodstream infections (BSI) are life-threatening illness for immunocompromised patients with hematological malignancies.The aim of the study was to compare epidemiology, causative pathogens and outcome of hospital-acquired BSI and clarifying the role of herpes group of viruses in their development.Materials and methods. During the period 1991–2013 438 bacterial strains obtained from 360 patients (pts) with hematological malignancies wеre studied. All blood cultures were incubated in the continuous monitoring system for 7 days before discard. The real-time PCR was used for human herpesviruses DNA detection: Herpes simplex viruses types 1 and 2 (HSV 1, 2), Cytomegalovirus (CMV), Epstein–Barr virus(EBV) and Herpesvirus 6 (HHV-6). In this study 64 hematological cancer patients with infectious complications who fulfilled criteria of systemic inflammatory response syndrome with positive peripheral blood cultures were investigated. All pts received empirical anti-infectious therapy with subsequent correction based on the bacteriological, virological and mycological analyses.Results and discussion. A total Gram-positive (G+) accounted for 69.2 % of BSI, Gram-negative (G–) for 30.8 %. Among G+ BSI Coagulase Negative Staphylococci and Staphylococcus aureus were the most frequent pathogens (58.8 %), among G– BSI Escherichia coli (13.0 %) was predominant. It is shown that the development of bacteremia were significantly more frequently occurs in the case of cytomegalovirusand the Epstein–Barr virus detection.Conclusion. Further epidemiological surveillance is warranted in order emerging resistant strains and related mortality. Reactivation of CMV and EBV is significantly associated with higher incidence of bacterial BSI

Accelerated method of identification of bacteria and micromycetes in hemocultures in children using multiplex PCR in real time

Objective: To evaluate the effectiveness and clinical significance of an accelerated, method, for the identification of microorganisms in blood, cultures in children using real-time multiplex PCR.Materials and methods: A total of 72 blood, samples were obtained, from 62 children aged. 3 months to 16 years. The identification of the isolated cultures, according to the proposed, method, was carried out in real-time PCR and. also using classical culture microbiological methods.Results: Based, on the frequency of detection and. the clinical significance of pathogens isolated from children, a panel of test systems was formed to identify them, by means of real-time PCR. It was shown that the effectiveness of the developed, method, for identification, of bacteria and. micromycetes by real-time PCR was 86,7% as compared, with the microbiological method. A significant reduction in the time of identification, of pathogens (from 48 hours to 5—7 hours) was demonstrated. In addition, the use of this method, allows, at the same time, to identify a number of antibiotic resistance genes (in particular, the genes of acquired, carbapenemases and. methicillin-resistant staphylococci).Conclusion: The developed, method, with real-time PCR for detecting and identifying microorganisms in the blood has shown its effectiveness, clinical significance and. the possibility of using it for pediatric patients. Its use significantly shortens the time frame for obtaining results and, thus, allows timely initiation, of etiotropic therapy

VIRAL HEPATITIS B IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES (ОVERVIEW)

The review presents current data on the role of viral hepatitis B in on-cohematological patients. Possible ways of infection, prophylaxis of infection and activation of hepatitis B in this category of patients are considered. Specific features of the course of hepatitis B in various clinical situations are described: against the background of other viral infections and in the conduct of specific anti-leukemia therapy. The need to identify occult (occult) hepatitis in donors and patients with hemoblastosis is emphasized and methods for its detection are considered