[Mycobacterium abscessus complex representatives in patients with bronchopulmonary pathology: prevalence, peculiarities of cultivation and identification.]

More and more publications appear in the modern literature on the increase in the prevalence of non-tuberculous mycobacteria (NTMs), in particular, representatives of M. chelonae / Mycobacterium abscessus complex (MABSc). The paper presents data on the current classification of M. chelonae / Mycobacterium abscessus complex and its main representatives. The main data on the possible sources and ways of infection of MABSc patients in hospital are presented. The main features of cultivation on various nutrient media and their possible identification using modern methods are also indicated. The main risk factors for the development of mycobacteriosis in patients and the possible clinical picture are described. The prevalence of MABSc representatives in the structure of non-tuberculous mycobacteria isolated from clinical material from 483 patients from the Samara region was assessed for examination for tuberculosis, and the prevalence from 933 patients with cystic fibrosis (CF) from 55 regions of the Russian Federation from 2016 to 2019 was estimated. In total, as a result of the study, 316 NTM strains (65.4%) were isolated and identified in the first group of patients. M.abscessus was isolated and identified 10 strains and 5 strains - M.chelonae, which amounted to 3.2% and 1.6%, respectively, of all NTMs. In general, MABSc representatives were isolated in 3.1% of the examined patients. As a result of a screening study of patients with CF, 14194 microorganism strains from 933 patients were isolated and identified. Altogether M. abscessus was isolated and confirmed from 14 patients of different ages. Thus, the prevalence of MABSc among the examined patients with CF in the Russian Federation was 1.5%.

Clinical releveance of hemorrhagic component of endobronchial inflammation in severe chronic obstructive pulmonary disease exacerbation.

AIM: The study aimed at investigating the relationship between severe exacerbations of chronic obstructive pulmonary disease and hemorrhagic component of endobronchial inflammation. MATERIALS AND METHODS: Clinico-endoscopic characteristics of 118 patients presenting with severe infectious exacerbation of chronic obstructive pulmonary disease, bloody expectorations and endoscopically confirmed hemorrhagic component of endobronchial inflammation have been analyzed. All patients underwent a series (5-6) of bronchoscopic examinations accompanied by collection of bronchoalveolar lavage specimens to reveal the presence of acid-resistant mycobacteria and to determine the bacterial flora. The exclusion criteria were the concomitant pulmonary or extrapulmonary pathologic conditions which could lead to hemorrhagic endobronchial manifestations. The other direction of the study was to investigate a correlation between jugulation of the exacerbation and dynamics of such endobronchial symptoms as mucosal edema and hyperemia, quality of bronchial secretions and hemorrhagic component of endobronchial inflammation. RESULTS: All patients were found to have diffuse endobronchitis of severity grade II (39.83%) or III (60.17%) by Lemoine. The neoplastic and tuberculosis genesis of the hemorrhagic component of endobronchial inflammation and its clinical equivalent, the bloody expectorations, had been ruled out. In 50.85% of cases the hemorrhagic component of endobronchial inflammation could not be accounted for by hemolytic properties of cultured microorganisms. The mucosal edema and hyperemia remained stable during jugulation of the exacerbation. Unlike the improvement of quality of bronchial secretions, faster reversal of the hemorrhagic component of endobronchial inflammation showed statistical significance. CONCLUSION: The hemorrhagic component of endobronchial inflammation can represent a non-obligatory manifestation of severe exacerbation of chronic obstructive pulmonary disease, and its relief is the earliest endobronchial sign of incipient remission from severe COPD exacerbation.

[The laboratory diagnostic in patients with mucoviscidosis: A review.]

The mycobacterioses as a group of diseases conditioned by non-tuberculosis mycobacteria, acquire even greater significance for patients from various risk groups. The patients with cystic fibrosis along with patients with other genetic diseases, consist risk group of infection with non-tuberculosis mycobacteria. The diagnostic of mycobacterioses in patients with cystic fibrosis has a number of peculiarities both at the stage of processing clinical material and the stage of identification of separated microorganisms. The review presents modern data about possibilities of laboratory diagnostic of with regard to characteristics of epidemiology, risk factors, contamination screening, material decontamination, methods of cultivation and identification of non-tuberculosis mycobacteria in patients with cystic fibrosis. The data is presented concerning increasing of morbidity of mycobacterioses up to 6-13% among patients with cystic fibrosis in developed countries. The low level of prevalence of mycobacterioses among patients with cystic fibrosis in the Russian Federation is demonstrated. The risk factors of development of mycobacterioses from point of view of contamination with various microorganisms, particularly with fungi of species Aspergillus are described. The technique of two-stage decontamination of phlegm and possible limitations of its cultivation in automated systems and possibilities of using 1% solution of chlorhexidine and sodium dodecyl sulfate for decontamination are described. Besides standard techniques, a technique of separation of mycobacteria is presented based on inoculation of material on medium for selective separation of Burkholderia cepacia complex. The possibilities of identification of mycobacteria using MALDIToF mass-spectrometry. The review was based on sources from such international and national data bases as Scopus, Web of Science, RINC.

[Anogenital warts: a new way of solving the common problem of urology (results of long-term follow-up)].

AIM: To evaluate the effectiveness of combined use of the imiquimod 5% cream and vaccination against human papillomavirus (HPV) using a quadrivalent recombinant vaccine to achieve long-term clinical remission of chronic HPV infection manifested by anogenital warts. MATERIAL AND METHODS: The study comprised 36 patients, including 22 men, aged 26.4+/-4.1 years, who had from 1 to 5 anogenital warts. Participants of the study were vaccinated by quadrivalent recombinant vaccine under a 3-dose scheme 0-2-6 months co-administered with imiquimod 5% cream three times per week up to 16 weeks. The follow-up period was 2 years. RESULTS: Complete disappearance of genital warts within 1 year from baseline was observed in 34 (94.4%) patients. Two patients with anogenital warts after 1 year were treated for 1 year 3 months and 1 year and 4 months with Solcoderm which lead to the complete disappearance of genital warts. There were no recurrences of genital warts during the 2 years of follow-up. CONCLUSION: Vaccination with a recombinant quadrivalent vaccine concurrently with using imiquimod 5% cream results in prolonged clinical remission of chronic HPV infection manifested by anogenital warts in at least 94.4% of the cases (2 year follow-up).