Features of antifungal therapy during long-lasting infectious process: a clinical case of fungal keratitis and profile of antifungal sensitivity based on assessing biofilm formation

Among infectious diseases, opportunistic mycoses hold a special place. There has been accumulating a lot of evidence regarding the clinical and epidemiological aspects of infection caused by Fusarium spp., which global incidence rate among microbial keratitis ranges from 2 to 40% depending on the geographical location of the country. Colonizing mucous membranes, fungi can exist not only in the form of plankton, but form biofilms after surface attachment, which leads to elevated resistance to multiple antifungal agents. Here we describe a clinical case of fungal keratitis due to Fusarium solani by determining profile of the antifungal sensitivity for isolated fungal strains, by taking into account their potential for biofilm formation. We used an F. solani culture isolated from the patient as well as F. solani test culture obtained from the Russian National Collection of Microorganisms. While determining the sensitivity of fungal planktonic cultures to antifungal agents from the azole group (fluconazole, voriconazole), amphotericin B and terbinafine, it was revealed that antimycotics amphotericin B and voriconazole exerted a marked antifungal activity against clinical isolate, whereas the plankton F. solani test culture was more sensitive to all groups of antifungal agents. Due to a long-lasting progressive course of the infectious process and the high biofilm-forming ability of the clinical strain F. solani, the activity of antifungal agents on biofilm cells was modeled and examined in vitro. It was shown that regarding to the fungal biofilms, value of the minimally inhibitory concentration exceeded those for planktonic cultures by 100-fold. The mechanisms of action for antifungal agents on vital parameters of fungal cell structures were analyzed by using confocal laser scanning microscopy after staining samples with propidium iodide and acridine orange for 15 min to detect changes between intact and damaged cell surface. It was found that within the biofilm fungal cells preserved viability even after exposure to high concentrations of antifungals. In addition, despite the fungicidal drug activity at substantial concentrations acting on the biofilm cell membrane, the cell nuclei remained viable. Owing to the presence ot the mechanism of resistance in mycelial fungi shown in the study, it is necessary to take into account and investigate characteristics of biofilms in terms of drug sensitivity that will allow to optimize a choice of antimicrobial therapy

Assessment of epidemiological and epizootiological situation on tularemia in the Republic of tatarstan

Objective of the study was to assess epidemiological and epizootiological activity of natural tularemia foci in the Republic of Tatarstan for further forecasting of the developments and working out the tactics for implementation of preventive and anti-epidemic measures. Materials and methods. We utilized statistical data, reports of the Center of Hygiene and Epidemiology in the Republic of Tatarstan, and literature sources for the analysis. Results and conclusions. Since 1995, the incidence among the population in Tatarstan has not been registered. Natural tularemia foci are situated in 19 enzootic as regards the infection administrative districts in the territory of the Republic. Epizootiological monitoring of the natural foci suggests that over the last four years their activation occurred. In this contest realization of complex anti-epidemic  measures,  regulated  by  the  current  normative-methodological  documents  remains  relevant,  as  well  as timely and effective diagnostics, including among the patients with a similar to tularemia symptoms

Analysis of the Epidemiological Situation of Hemorrhagic Fever with Renal Syndrome in the Russian Federation in 2022 and Forecast of its Development for 2023

The paper provides the analysis of epidemiological process of hemorrhagic fever with renal syndrome (HFRS) in the Russian Federation in the context of federal districts in 2022 and a forecast of the HFRS incidence for 2023. According to the results of the analysis, there was a three-fold increase in the morbidity rates of HFRS in Russia in 2022 as compared to the indicators of 2021. The evidence of epizootiological survey and laboratory studies in certain federal districts of the Russian Federation indicate the continuing tense epidemiological situation on HFRS. In a number of regions of the country, high risk of infection with HFRS is predicted due to the favorable natural and climatic conditions of the winter period 2022/2023 for reservoir hosts of pathogenic for humans Hantaviruses. The findings of infected rodents attest to a high probability of complication of the epidemiological situation in the territories of increased epidemic hazard as regards HFRS

Clinical-Laboratory Effectiveness of Immune-Replacement Therapy of Hemorrhagic Fever with Renal Syndrome

Currently, hemorrhagic fever with renal syndrome (HFRS) remains the most common natural focal disease of viral etiology in the Russian Federation. Effective antiviral drugs have not yet been developed. Pathogenetic and symptomatic drugs are mainly used in the treatment of HFRS.The aim of the study was to evaluate the clinical and laboratory effectiveness of intravenous gabriglobin in the treatment of moderate forms of HFRS.Materials and methods. The study included 22 patients with a diagnosis “HFRS of moderate severity” in the febrile stage of the disease. In the febrile period of HFRS, patients of the main group (n=10) were given gabriglobin via intravenous route at a dose of 0.1 g/kg per day along with pathogenetic therapy. The course of treatment was 2–3 infusions. The control group (n=12) received only pathogenetic therapy.Results and conclusions. As a result of the studies, the clinical and laboratory efficacy of intravenous administration of gabriglobin in the treatment of patients with moderate-grade HFRS was revealed, which was manifested by a decrease in the duration of the febrile period by 2.1 days, the severity of oliguria and a decrease in the duration of thrombocytopenia by 3.5 days compared with the group of patients receiving only pathogenetic therapy

Experience in Studying Herd and Individual Immunity to the SARS-CoV-2 Virus in Medical Workers

The aim was to study SARS-CoV-2 immunity among medical workers in Kazan.Materials and methods. Studied were serum samples from 348 medical workers from 10 medical organizations in Kazan, divided into groups according to the level of the alleged risk of infection of employees. To determine IgG, a two-stage direct version of the solid-phase ELISA and the test-system “SARS-CoV-2-IgG-ELISA-BEST” (Russia) were used.Results and discussion. At the time of the study and over the previous three months, the examined medical workers had no symptoms of acute respiratory viral infection or respiratory tract infections; there were negative results of examining nasopharyngeal/ oropharyngeal swabs for the presence of SARS-CoV-2 RNA. Seroprevalence for IgG to SARS-CoV-2 virus for different medical organizations in Kazan ranged within the scope of 3.3–30.8 % and averaged 16.4 %. The wide variation in seroprevalence values in medical workers of different medical organizations may indicate different levels of intensity of professional contacts and the effectiveness of anti-epidemic measures in these medical organizations. Among medical workers with seropositive results, the prevalence of persons with a very high coefficient of positivity (49.1 %) is observed, which characterizes high level of antiviral antibodies. The presence of a high proportion of seropositive individuals among medical workers, who have had an asymptomatic form of COVID-19 confirms the high intensity of the latent epidemic process, which must be taken into account when organizing preventive measures, including vaccination

Anthrax in the Republic of Tatarstan (1920–2020)

The aim of the work was to characterize the epidemiological and epizootic situation on anthrax among population and animals in the Republic of Tatarstan over a period of 1920–2020.Materials and methods. The analysis of the epidemiological and epizootic situation is based on the archival data, epidemiological maps of anthrax patients, results of epizootiological-epidemiological survey of anthrax foci conducted by the Rospotrebnadzor Administration in the Republic of Tatarstan and Center of Hygiene and Epidemiology in the Republic of Tatarstan, materials of the Main Directorate of Veterinary Medicine of the Republic of Tatarstan. Microbiological studies of samples from patients and environmental objects were performed in accordance with the requirements of MR 4.2.2413-08 “Laboratory diagnostics and detection of anthrax pathogen”, real-time PCR was set using the AmpliSense Bacillus anthracis-FRT test-system (Central Research Institute of Epidemiology, Moscow). Statistical data processing was carried out using the quantile ranking method.Results and discussion. There are more than 1000 anthrax soil foci in the Republic of Tatarstan, which territorially belongs to the Volga Federal District. Analysis of the epizootic and epidemiological situation in the Republic of Tatarstan over the period of 1920–2020 has revealed that it has undergone significant changes, from mass diseases in animals and humans in early 20th century to sporadic cases of infection among population and animals at the beginning of the 21st century, primarily due to preventive veterinarysanitary measures, including veterinary and sanitary examination of animal products, mass specific immunization of animals against anthrax, arrangement of anthrax cattle burial grounds. In view of the improvement of epizootiological situation and implementation of preventive measures, there was a decrease in the incidence of anthrax among the population. The regions of the Republic have been ranked by the number of animal anthrax cases

Study of features of humoral immune response to the new coronavirus infection COVID-19 among healthcare workers

Relevance. Since the beginning of the epidemic in China, there have been reports of nosocomial cases of SARSCoV-2 infection, including among medical workers. Studies of the intensity of humoral immune response to the SARSCoV-2 virus among medical workers who are much more likely to have professional contact with COVID-19 patients than are of particular importance. The aim is to study the seroprevalence and features of the humoral immune response to SARS-CoV-2 among medical workers. Materials and methods. The study included 61 medical workers from a multidisciplinary hospital in Kazan, which was redesigned to provide medical care to patients with new coronavirus infection, using the method of random sampling. The control group consisted of 60 non-medical workers. For the determination of IgG, a solid-phase ELISA was used. Statistical processing of the results was carried out using MS Excel software. The error of the relative value (M±m) was calculated, and the 95% confidence interval of the frequency of occurrence. To assess the significance of differences, the Student’s test (t-test) was used for independent samples. Results. The proportion of those seropositive to SARS-CoV-2 in the study group was 45.9%, compared with 21.7% in the control group. Among medical workers seropositive to the SARS-CoV-2 virus, the proportion of asymptomatic forms was 18.5%, mild forms — 53.6%, moderate forms and severe forms 25%. Two forms of the formation of a humoral immune response among seropositive ones were revealed: the first is characterized by the gradual elimination of specific IgG antibodies to SARSCoV-2 after 8 weeks from the onset of the first symptoms of COVID-19, the second form is an increase in specific IgG to SARS-CoV-2 and a higher value of the coefficient level of IgM positivity to SARS-CoV-2 after 8–10 weeks from the onset of the first symptoms. The group of seropositive, “raising antibodies”, prevailed over the group of individuals “eliminating antibodies”. Among seropositive medical workers, two forms of the formation of a humoral immune response were revealed: synchronous with the parallel elimination of IgG and IgM antibodies and a parallel increase in IgG and IgM. Conclusion. The study of the level of humoral immunity to COVID-19 in medical workers is important in terms of planning both anti-epidemic measures and predicting the effectiveness of the response to vaccination to SARS-CoV-2

Natural Focality of Lyme Borreliosis, Granulocytic Anaplasmosis, and Monocytic Ehrlichiosis in Humans in the Republic of Tatarstan

Objective of the study is to investigate natural focality of Ixodidae tick borreliosis, granulocytic anaplasmosis, monocytic ehrli-chiosis in humans in the Republic of Tatarstan. Materials and methods. Utilized were the data from tick studies conducted between 2010–2015. Applying immune-enzymatic analysis, investigated were the blood sera from residents (donors) of Kazan and municipal districts of the Republic of Tatarstan for the presence of specific antibodies to borreliosis, ehrlichiosis, and anaplasmosis pathogens. Results and conclusions. For the first time ever, the data on spontaneous carriage of Ehrlichiosis pathogens in Ixodidae ticks have been obtained. The information received is an indicative of the active circulation of Borrelia, Ehrlichia and Anaplasma in the territory of the region and of necessity to expand the research on the “novel” for the Republic nosological forms of natural-focal infections

Overview of Hantavirus Infections in the World, the Epidemiological Situation on Hemorrhagic Fever with Renal Syndrome in the Russian Federation in 2021, and Forecast for 2022

The paper presents a description of the epidemiological situation on Hantavirus infection incidence in the countries around the world. Comparative analysis of the intensity and dynamics of the epidemiological process of hemorrhagic fever with renal syndrome (HFRS) in the Russian Federation by Federal Districts in 2021 has been carried out and forecast of the HFRS incidence for 2022 prepared. The study has revealed that tense situation on incidence of hantavirus diseases was observed in the world in 2021. On the territory of the Russian Federation, there was a decrease in the HFRS incidence in 2021 (by 1.7 times compared to 2020). However, the results of epidemiological analysis of the HFRS incidence, epizootiological data and laboratory studies in certain Federal Districts of the Russian Federation indicate that the epidemiological situation on HFRS remains tense. High risk of HFRS infection is predicted in a number of regions of the country due to the favorable natural and climatic conditions in the winter period of 2021–2022 with a heavy snow cover, which contributed to the under-snow reproduction of small mammals, the main carriers of HFRS. The presence of infected rodents testifies to a high likelihood of complication of the epidemiological situation in areas of increased epidemic risk of HFRS

Клинико-эпидемиологические особенности заболеваемости инфекциями, связанными с оказанием хирургической и онкологической помощи

Introduction. In the Russian Federation there is a constantly updated register of infections associated with surgery and the treatment of oncological diseases reporting which is mandatory. Massive expenses and detriment to patients’ health caused by these infections prompted the authors to run a retrospective epidemiological analysis of the morbidity registered in the population of the city of Kazan during the period under review. This paper presents a study of patterns of the emergence and spread of nosocomial infections.This study aims to examine the clinical and epidemiological characteristics of infections associated with surgery and the treatment of oncological diseases registered in the population of the city of Kazan.Materials and methods. Authors analysed the Emergency Notifications for an Infectious Disease (form 058/u) as well as the data from the Rospotrebnadzor Federal Statistical Record Form №2. The paper presents the morbidity annual dynamics, structure and spatial characteristics and describes key pathogens of HAIs.Results and discussion. On the basis of the data obtained the authors give clinical and epidemiological characteristics of the annual dynamics of the morbidity characterised by recurrent rises during the year with the top incidence in the autumn. Neonatal PSI infections dominate the HAIs incidence structure (52.8%). St. aureus is the priority HAI pathogen (26.5% of cases) in the city of Kazan.Conclusion. Microbiological monitoring of emerging HAIs is an efficient tool for managerial decision making and the development of an algorithm for anti-epidemic measures in the departments and the hospital as a whole for the reduction of risk of infection.Введение. В связи с постоянной регистрацией на территории Российской Федерации инфекций, связанных с оказанием хирургической и онкологической помощи, и с высоким экономическим ущербом и ущербом для здоровья пациентов проведен ретроспективный эпидемиологический анализ заболеваемости, регистрируемой у населения города Казани в течение отчетного периода, изучены закономерности возникновения и распространения внутрибольничных инфекций.Целью данного исследования явилось изучение клинико-эпидемиологических особенностей инфекций, связанных с оказанием медицинской хирургической и онкологической помощи, зарегистрированных у населения города Казани.Материалы и методы. Анализу были подвергнуты экстренные извещения об инфекционном заболевании (форма 058/у), а также данные формы федерального статистического учета № 2 Роспотребнадзора. Определены внутригодовая динамика, структура заболеваемости, пространственная характеристика, обозначены основные возбудители ИСМП.Результаты и обсуждение. На основе полученных материалов дана клинико-эпидемиологическая характеристика внутригодовой динамики заболеваемости, которая характеризовалась периодическими подъемами в течение года с максимальной регистрацией заболеваемости в осенний период. В структуре заболеваемости ИСМП преобладали ГСИ инфекции новорожденных (52,8  %). Приоритетным возбудителем ИСМП в г. Казани являлся St. аureus (26,5 % случаев).Заключение. Микробиологический мониторинг за возникновением ИСМП является действенным инструментом для принятия управленческих решений и разработки алгоритма противоэпидемических мер в отделениях и стационарах в целом по снижению риска заболеваний