Особенности клинической картины орнитоза и респираторной микоплазменной инфекции во время вспышки 2012 г.

The aim of the current study was the investigation of the clinical features of ornithosis and respiratory mycoplasma infection during autumn outbreak in 2012 in 58 patients admitted to the Institute of influenza department of adult respiratory viral infections based at St Petersburg Botkin Infectious Diseases Hospital. It has been shown that the concomitant ornithosis and respiratory mycoplasma infection were registered more often in the group of young patients and the finding was statistically significant. Pulmonary form of the infection was registered more often in patients with respiratory mycoplasmosis. It was found that in patients with mycoplasma infection catarrhal and constitutional symptoms were longer in duration than in ornithosis or in concomitant ornithosis and mycoplasmosis and the findings were statistically significant. Macrolide antibiotics can be considered as the first-line medications in treatment of respiratory mycoplasmosis and ornithosis. According to our data, these antibiotics were more effective in ornithosis.Целью настоящего исследования было изучение особенностей течения орнитоза и респираторной микоплазменной инфекции во время осенней вспышки 2012 г. у 58 человек, госпитализированных на отделение респираторных вирусных инфекций у взрослых Научно-исследовательского института гриппа, на базе 23-го отделения Клинической инфекционной больницы им. С.П. Боткина. Показано, что сочетание орнитоза с респираторным микоплазмозом статистически значимо чаще регистрировалось в группе лиц молодого возраста. Пневмоническая форма заболевания регистрировалась чаще у пациентов с респираторной микоплазменной инфекцией. Установлено, что у пациентов с микоплазменной инфекцией катаральный и интоксикационный синдром статистически значимо более продолжительный, чем при орнитозе или сочетании орнитоза с микоплазменной инфекцией. Макролидные антибиотики можно рассматривать как препараты первого ряда в лечении респираторного микоплазмоза и орнитозной инфекции. По нашим данным, препараты этой группы являлись более эффективными при орнитозной инфекции

КЛИНИКО-ЛАБОРАТОРНЫЙ АНАЛИЗ ЛЕТАЛЬНЫХ СЛУЧАЕВ ТЯЖЕЛОЙ ФОРМЫ ГРИППА А(H1N1) PDM 2009 ЗА ПЕРИОД ЭПИДЕМИИ 2015/2016 ГГ. В САНКТ-ПЕТЕРБУРГЕ

The purpose of our study was to investigate the characteristics of severe form of influenza A (H1N1) pdm 2009 with a fatal outcome, given the comorbidities. Materials and methods. Medical histories of 105 people who died in hospitals of St. Petersburg for the period of the epidemic of 2015/16 served as material for analysis.The lethality caused by the pandemic virus type A/ H1N1 / 2009 pdm was higher in males. Most of the patients had concomitant chronic diseases in the anamnesis. Obesity was observed in 44.8% (47/105) of patients, diabetes mellitus — 28.5% (30/105), isolated heart disease — 19.0% (20/ 105), combined pathology — 48.6% (51/105). In the first biochemical analysis of blood, creatine phosphokinase, lactate dehydrogenase were increased, total protein and prothrombin consumption index were reduced. The patient's death occurred after 5 days of illness in 88.6% cases, in 11.4% — up to 5 days of illness (inclusive). The analysis of fatal cases up to 5 days of a disease and death from complications (2—4 week) didn't find significant differences in the character and frequency of comorbidity. Specific antiviral therapy has been assigned to all patients, but 48 hours later.Bilateral subtotal viral and bacterial pneumonia was identified on the section, in the majority of cases, in 70.5% with hemorrhagic component. 30% patients had cerebral oedema, 41% patients had severe toxic parenchymatouse degeneration of miocardium, liver and kidneys. The pathology of the cardiovascular system, diabetes and obesity worsen the prognosis of the disease. Increased creatine phosphokinase, lactate dehydrogenase, and reduced total protein and prothrombin consumption index can be considered as markers of severe influenza. The ineffectiveness of antiviral therapy due to its late appointment, thus timely initiation of etiotropic treatment is very impotent. Целью нашего исследования было изучение особенностей течения тяжелой формы гриппа А(H1N1) pdm 2009 с летальным исходом у взрослых с учетом преморбидного фона. Материалом для анализа послужили истории болезни 105 человек, умерших в стационарах Санкт-Петербурга за эпидемию 2015/16 гг.Показано, что летальные случаи, обусловленные пандемическим вирусом типа А/Н1N1/ pdm 2009 чаще регистрировались у мужчин. В анамнезе у большей части пациентов были отмечены сопутствующие хронические заболевания. Сочетанная патология — 48,6% (51/105), ожирение — 44,8% (47/105), сахарный диабет — 28,5% (30/105), изолировано сердечно-сосудистая патология — в 19,0% (20/105) случаев. Зарегистрировано значимое повышение креатинфосфокиназы и лактатдегидрогеназы уже при первичном биохимическом анализе крови, а также снижение протромбинового индекса и общего белка. У большей части пациентов смерть наступала после 5 дня болезни (88,6%), у 12 (11,4%) пациентов — до 5 дня болезни (включительно). Достоверных различий между сопутствующей патологией у больных, умерших до 5 дня, и от осложнений (в течение 2—4 недель) не выявлено. На секции выявлялясь в большинстве случаев двусторонняя субтотальная вирусно-бактериальная пневмония, в 70,5% — с геморрагический компонентом, отек головного мозга (30%), тяжелая токсическая паренхиматозная дистрофия миокарда, печени, почек у 43 пациентов (41%). Специфическая противовирусная терапия была назначена всем пациентам, но позже 48 часов.Неблагоприятными факторами, ухудшающими прогноз заболевания, являются: патология сердечно-сосудистой системы, сахарный диабет и ожирение. Повышение ферментов креатинфосфокиназы, лактатдегидрогеназы, а также снижение протромбинового индекса и общего белка можно расценивать как маркеры тяжелого гриппа. Неэффективность противовирусной терапии обусловлена поздним ее назначением, что еще раз подчеркивает важность своевременного начала лечения этиотропными препаратами.

CLINICAL AND IMMUNOLOGICAL EFFICIENCY OF BETALEUKIN IN PATIENTS WITH INFLUENZA AND FLU-LIKE DISEASES COMPLICATED BY PNEUMONIA

This investigation was aimed for studying efficacy of Betaleukin in combined therapy of influenza and flu-like respiratory diseases complicated by pneumonia, and development of inclusion criteria. Treatment with Betaleukin was significantly associated with shorter duration of catarrhal syndrome and decreased resolution terms of lung infiltrates. Usage of Betaleukin was shown to influence the levels of pro- and anti-inflammatory cytokines and interferons. Betaleukin is effective in patients under 50 years old, independent on initial volume of lung infiltrates. Full resolution of pneumonia treated with Betaleukin was observed in patients with initial IL-1β concentrations under 80  pg/ml, or 80-120  pg/ml, and IL-1rа concentrations of 500-1000  pg/ml in blood serum

Clinical features of ornithosis and respiratory mycoplasmosis during an outbreak in 2012

The aim of the current study was the investigation of the clinical features of ornithosis and respiratory mycoplasma infection during autumn outbreak in 2012 in 58 patients admitted to the Institute of influenza department of adult respiratory viral infections based at St Petersburg Botkin Infectious Diseases Hospital. It has been shown that the concomitant ornithosis and respiratory mycoplasma infection were registered more often in the group of young patients and the finding was statistically significant. Pulmonary form of the infection was registered more often in patients with respiratory mycoplasmosis. It was found that in patients with mycoplasma infection catarrhal and constitutional symptoms were longer in duration than in ornithosis or in concomitant ornithosis and mycoplasmosis and the findings were statistically significant. Macrolide antibiotics can be considered as the first-line medications in treatment of respiratory mycoplasmosis and ornithosis. According to our data, these antibiotics were more effective in ornithosis

CLINICAL AND LABORATORY ANALYSIS OF LETHAL CASES OF SEVERE INFLUENZA A(H1N1) PDM 2009 DURING THE EPIDEMIC 2015/2016 IN ST. PETERSBURG

The purpose of our study was to investigate the characteristics of severe form of influenza A (H1N1) pdm 2009 with a fatal outcome, given the comorbidities. Materials and methods. Medical histories of 105 people who died in hospitals of St. Petersburg for the period of the epidemic of 2015/16 served as material for analysis.The lethality caused by the pandemic virus type A/ H1N1 / 2009 pdm was higher in males. Most of the patients had concomitant chronic diseases in the anamnesis. Obesity was observed in 44.8% (47/105) of patients, diabetes mellitus — 28.5% (30/105), isolated heart disease — 19.0% (20/ 105), combined pathology — 48.6% (51/105). In the first biochemical analysis of blood, creatine phosphokinase, lactate dehydrogenase were increased, total protein and prothrombin consumption index were reduced. The patient's death occurred after 5 days of illness in 88.6% cases, in 11.4% — up to 5 days of illness (inclusive). The analysis of fatal cases up to 5 days of a disease and death from complications (2—4 week) didn't find significant differences in the character and frequency of comorbidity. Specific antiviral therapy has been assigned to all patients, but 48 hours later.Bilateral subtotal viral and bacterial pneumonia was identified on the section, in the majority of cases, in 70.5% with hemorrhagic component. 30% patients had cerebral oedema, 41% patients had severe toxic parenchymatouse degeneration of miocardium, liver and kidneys. The pathology of the cardiovascular system, diabetes and obesity worsen the prognosis of the disease. Increased creatine phosphokinase, lactate dehydrogenase, and reduced total protein and prothrombin consumption index can be considered as markers of severe influenza. The ineffectiveness of antiviral therapy due to its late appointment, thus timely initiation of etiotropic treatment is very impotent

КЛИНИКО-ЛАБОРАТОРНЫЙ АНАЛИЗ ЛЕТАЛЬНЫХ СЛУЧАЕВ ТЯЖЕЛОЙ ФОРМЫ ГРИППА А(H1N1) PDM 2009 ЗА ПЕРИОД ЭПИДЕМИИ 2015/2016 ГГ. В САНКТ-ПЕТЕРБУРГЕ

The purpose of our study was to investigate the characteristics of severe form of influenza A (H1N1) pdm 2009 with a fatal outcome, given the comorbidities. Materials and methods. Medical histories of 105 people who died in hospitals of St. Petersburg for the period of the epidemic of 2015/16 served as material for analysis.The lethality caused by the pandemic virus type A/ H1N1 / 2009 pdm was higher in males. Most of the patients had concomitant chronic diseases in the anamnesis. Obesity was observed in 44.8% (47/105) of patients, diabetes mellitus — 28.5% (30/105), isolated heart disease — 19.0% (20/ 105), combined pathology — 48.6% (51/105). In the first biochemical analysis of blood, creatine phosphokinase, lactate dehydrogenase were increased, total protein and prothrombin consumption index were reduced. The patient's death occurred after 5 days of illness in 88.6% cases, in 11.4% — up to 5 days of illness (inclusive). The analysis of fatal cases up to 5 days of a disease and death from complications (2—4 week) didn't find significant differences in the character and frequency of comorbidity. Specific antiviral therapy has been assigned to all patients, but 48 hours later.Bilateral subtotal viral and bacterial pneumonia was identified on the section, in the majority of cases, in 70.5% with hemorrhagic component. 30% patients had cerebral oedema, 41% patients had severe toxic parenchymatouse degeneration of miocardium, liver and kidneys. The pathology of the cardiovascular system, diabetes and obesity worsen the prognosis of the disease. Increased creatine phosphokinase, lactate dehydrogenase, and reduced total protein and prothrombin consumption index can be considered as markers of severe influenza. The ineffectiveness of antiviral therapy due to its late appointment, thus timely initiation of etiotropic treatment is very impotent. Целью нашего исследования было изучение особенностей течения тяжелой формы гриппа А(H1N1) pdm 2009 с летальным исходом у взрослых с учетом преморбидного фона. Материалом для анализа послужили истории болезни 105 человек, умерших в стационарах Санкт-Петербурга за эпидемию 2015/16 гг.Показано, что летальные случаи, обусловленные пандемическим вирусом типа А/Н1N1/ pdm 2009 чаще регистрировались у мужчин. В анамнезе у большей части пациентов были отмечены сопутствующие хронические заболевания. Сочетанная патология — 48,6% (51/105), ожирение — 44,8% (47/105), сахарный диабет — 28,5% (30/105), изолировано сердечно-сосудистая патология — в 19,0% (20/105) случаев. Зарегистрировано значимое повышение креатинфосфокиназы и лактатдегидрогеназы уже при первичном биохимическом анализе крови, а также снижение протромбинового индекса и общего белка. У большей части пациентов смерть наступала после 5 дня болезни (88,6%), у 12 (11,4%) пациентов — до 5 дня болезни (включительно). Достоверных различий между сопутствующей патологией у больных, умерших до 5 дня, и от осложнений (в течение 2—4 недель) не выявлено. На секции выявлялясь в большинстве случаев двусторонняя субтотальная вирусно-бактериальная пневмония, в 70,5% — с геморрагический компонентом, отек головного мозга (30%), тяжелая токсическая паренхиматозная дистрофия миокарда, печени, почек у 43 пациентов (41%). Специфическая противовирусная терапия была назначена всем пациентам, но позже 48 часов.Неблагоприятными факторами, ухудшающими прогноз заболевания, являются: патология сердечно-сосудистой системы, сахарный диабет и ожирение. Повышение ферментов креатинфосфокиназы, лактатдегидрогеназы, а также снижение протромбинового индекса и общего белка можно расценивать как маркеры тяжелого гриппа. Неэффективность противовирусной терапии обусловлена поздним ее назначением, что еще раз подчеркивает важность своевременного начала лечения этиотропными препаратами. </p

Influenza Epidemiology And Influenza Vaccine Effectiveness During The 2016-2017 Season In The Global Influenza Hospital Surveillance Network (Gihsn)

BackgroundThe Global Influenza Hospital Surveillance Network (GIHSN) aims to determine the burden of severe influenza disease and Influenza Vaccine Effectiveness (IVE). This is a prospective, active surveillance and hospital-based epidemiological study to collect epidemiological data in the GIHSN. In the 2016-2017 influenza season, 15 sites in 14 countries participated in the GIHSN, although the analyses could not be performed in 2 sites. A common core protocol was used in order to make results comparable. Here we present the results of the GIHSN 2016-2017 influenza season.MethodsA RT-PCR test was performed to all patients that accomplished the requirements detailed on a common core protocol. Patients admitted were included in the study after signing the informed consent, if they were residents, not institutionalised, not discharged in the previous 30days from other hospitalisation with symptoms onset within the 7days prior to admission. Patients 5years old or more must also complied the Influenza-Like Illness definition. A test negative-design was implemented to perform IVE analysis. IVE was estimated using a logistic regression model, with the formula IVE=(1-aOR)x100, where aOR is the adjusted Odds Ratio comparing cases and controls.ResultsAmong 21,967 screened patients, 10,140 (46.16%) were included, as they accomplished the inclusion criteria, and tested, and therefore 11,827 (53.84%) patients were excluded. Around 60% of all patients included with laboratory results were recruited at 3 sites. The predominant strain was A(H3N2), detected in 63.6% of the cases (1840 patients), followed by B/Victoria, in 21.3% of the cases (618 patients). There were 2895 influenza positive patients (28.6% of the included patients). A(H1N1)pdm09 strain was mainly found in Mexico. IVE could only be performed in 6 sites separately. Overall IVE was 27.24 (95% CI 15.62-37.27. Vaccination seemed to confer better protection against influenza B and in people 2-4years, or 85years old or older. The aOR for hospitalized and testing positive for influenza was 3.02 (95% CI 1.59-5.76) comparing pregnant with non-pregnant women.ConclusionsVaccination prevented around 1 in 4 hospitalisations with influenza. Sparse numbers didn't allow estimating IVE in all sites separately. Pregnancy was found a risk factor for influenza, having 3 times more risk of being admitted with influenza for pregnant women.Wo