Features of the Humoral Response to Infection, Vaccination, and Revaccination during COVID-19.

IgM and IgG antibodies to the SARS-CoV-2 virus are detected in subjects who have recovered from COVID-19; IgM antibodies persist in a 1/3 of infected subjects up to 12 months from the moment of the disease, while IgG antibodies are present in the vast majority of cases (97%; medium and high levels antibodies were registered in 85% of cases). By the 12th month, 40% of those who recovered still have a very high level of IgG antibodies to the S-protein (>500 BAU/ml). In the feces, urine, and blood serum of patients with long-term persistent IgM antibodies, no coronavirus antigens were detected. After vaccination with the Gam-COVID-Vac vaccine, IgG antibodies to the S-protein are detected in 100% of cases and remain at a high level for 4 months, by the 5-6th month, the level of antibodies decreases. During revaccination, the level of IgG antibodies to S-protein reaches high values earlier than during primary vaccination, and remains high for 4 months (observation period). The blood sera of recovered and vaccinated patients have a high virus-neutralizing activity (at least 1:80), while its level is somewhat higher in recovered patients.

Effectiveness of using liquid transport media in bacteriological diagnostics of diphtheria infection.

The results of evaluating the effectiveness of the use of liquid transport media at the preanalytical stage of bacteriological diagnosis of diphtheria infection are presented. A typical toxigenic strain of C. diphtheriae biovar gravis № 665 was used. The experiments were carried out using a laboratory-prepared medium based on GRM-broth (State research center for applied biotechnology and microbiology, Obolensk), a transport system with a fleecy probe swab (DELTALAB) and a transport system ∑-Transwab ® with a polyurethane Sigma-swab (Medical Wire & Equipment Co. (Bath) Ltd.). The tampons were pooled with a 24-hour bacterial culture of C. diphtheriae, then immediately seeded on Tellurite-containing blood agar. Storage conditions were simulated for 6-24 hours: at room conditions +(20-25)° C, in the refrigerator +(4-8)° C, in a thermostat +(37±1)° C. Storage of C. diphtheriae was most optimal on two liquid transport systems in a refrigerator +(4-8)° C for 6 and 24 hours; in room conditions +(20-25)° C - there was a decrease in seeding after 6 hours and loss of pathological material after 24 hours, more pronounced on a fleecy probe swab; under thermostat conditions +(37±1)° C on both transport systems, a decrease in seeding was noted after 6 hours and a complete loss of pathological material after 24 hours. The results obtained demonstrated the efficiency of using the Amies liquid transport medium and justify the need to develop a domestic analogue of the transport system based on the Amies liquid medium for the bacteriological diagnosis of diphtheria infection.

Effect of different types of dry swabs and their storage conditions on the inoculation of Corynebacterium diphtheriae.

The results of evaluating the effectiveness of C. diphtheriae inoculation using different types of dry swabs in studies simulating various conditions of its storage at the preanalytical stage of a laboratory study for diphtheria are presented. A typical toxigenic strain of C. diphtheriae biovar gravis No. 665 was used. A commercial dry, sterile cotton swab probe (Ningbo Greetmed Medical Instruments Co., LTD, China), a commercial dry, sterile swab probe (plastic and viscose) (COPAN, Italy), tufters with a fluffy probe-tampon on a polystyrene applicator, standard (DELTALAB, SL, Spain). The tampons were pooled with a 24-hour bacterial culture of C. diphtheriae, then immediately seeded on Tellurite-containing blood agar and Corynebacagar. Storage conditions were simulated for 3 hours: at room conditions +(20-25)°C, in the refrigerator +(4-8)°C, in a thermostat +(37±1)°C. Optimal storage of C. diphtheriae on all three types of dry swabs at + (4-8) ° C; at +(20-25)° C - growth is observed when seeding from a cotton swab; in a swab with a fleecy probe-tampon, a decrease in the inoculation of C. diphtheriae was noted; when using a viscose swab - a significant loss of C. diphtheriae. At +(37±1)°C, a significant decrease in the inoculation of C. diphtheriae on all three types of tampons was noted, up to the absence of growth when using a viscose tampon. To exclude the loss of C. diphtheriae, it is necessary to observe the conditions for taking and storing biological material at the preanalytical stage of a laboratory study, which will improve the quality of laboratory microbiological studies for diphtheria infection.

Bloodstream infection in hospital therapeutic patients.

Bloodstream infection (BI) is the cause of high mortality. Hospital bloodstream infection (HBI) complicates hemodialysis, pneumonia, oncohematological diseases. Positive hemoculture obtaining depends on the volume of blood inoculation, the number of blood samples, the incubation time. To test the principles of microbiological culturomics in the diagnosis BI of hospital patients with a therapeutic profile. 848 hospital cardiac patients with suspected BI were included. 10 ml of blood were taken intravenously with a syringe, blood was inoculated into 200 ml of the heart-brain medium (HBM) in an anaerobic bottle. It was incubated for 7 or more days in a thermostat at +37º C. The hemocultures were obtained in 64.3% of cases with paired blood sampling with an interval of 30 minutes whereas an increase in the number of blood samples reduced the effectiveness of obtaining hemocultures to 9.1%. When incubating bottles for more than 7 days there were obtained 200 additional hemocultures containing 239 strains of microorganisms. Episodes of HBI were observed more often in the cases of the circulatory system (77.8%), including infectious endocarditis (IE) (47.0%), rheumatism (22.1%), myocarditis (14.6%). Episodes of HBI occurred more often in men with IE and coronary heart disease, in women - with rheumatism and myocarditis. Patients aged 45-75 were in the group of risk with a probability of complications of HBI up to 73.7%. When examining the blood of 848 hospital patients of cardiological profile HBI was detected in 38.3% of cases. Among clinical isolates gram-positive cocci with a great number S.epidermidis prevailed. Polymicrobial hemocultures (16.3%) were characterized by two and three associates in one blood sample. Among the hematological indicators in HBI there were: leukocytosis, increased ESR, lymphocytosis, decreased hemoglobin; increased values of fibrinogen, CRP, γ-globulin, α2-globulin, low levels of total protein and A/G coefficient. The techniques of microbiological culturomics were used. HBI was diagnosed in 38.3% of the therapeutic patients of cardiological profile. The etiology of HBI was characterized by polymicrobicity in 16.3% of cases. Hematological markers of HBI were identified.

Laboratory diagnosis of community-acquired bloodstream infection in therapeutic pathology.

Community-acquired bloodstream infections (CBSIs) occur in the out-of-hospital setting (44%) and increase the overall mortality from bloodstream infections (BSIs) by 7.2% per year. The development of CBSIs depends on both comorbid and polymorbid diseases and the patients' age. The causes of CBSIs are: respiratory, hepatobiliary gastrointestinal and urogenital tracts and dental interventions. The etiology of CBSIs is characterized by the isolation of coagulase-negative staphylococci (CNS) (32%), E. coli (27%). To investigate community-acquired bloodstream infection in therapeutic patients. The study included out-of-hospital patients (n=382). 4.5 ml of blood were taken intravenously into a closed vacuum system in order to obtain a buffy coat of blood, which was put on glasses for microscopy and Petri dishes with blood agar for cultivating under aerobic and anaerobic conditions. Microorganisms were identified by mass spectrometry. Microscopy of blood smears was used for rapid diagnosis of infection in the bloodstream. BSI was diagnosed in 183 (48.0%) out of 382 out-of-hospital patients. The etiology of CBSIs was studied on 297 isolated strains of microorganisms. CBSIs rather often complicated the underlying disease in women and young people. The spectrum of CBSI pathogens included aerobic and anaerobic bacteria and fungi. Gram-positive cocci with the leadership of S.epidermidis (25.7%) were more often isolated among bacteria. 70% of all isolated pathogens grew under anaerobic conditions. CBSIs were characterized by polymicrobiality (33.5%) of two to four different microorganisms in one blood culture; the species of associates of polymicrobial blood cultures are shown. Microscopic examination of blood smears revealed microorganisms in 97.1% of cases, including associations of bacteria with fungi (66.9%). CBSIs occurred after contour plastic, in diseases of the respiratory system, genitourinary system, oral cavity, skin and subcutaneous tissue. Microbiological examination of the buffy coat is an alternative microbiological method of CBSIs diagnosis, which includes microscopy and blood cultivating and has a high diagnostic efficiency (97.1% and 48% respectively). It can become an option for replacing imported blood culture automated systems.

Possibilities of practical application of different culture mediums for laboratory diagnostic of diphtheria.

The purpose of the work is to evaluate the cultural and morphological properties of colonies of clinically significant corynebacteria on culture mediums for the isolation of corynebacteria. The study used 9 culture mediums for the isolation of corynebacteria: a culture medium for the isolation of corynebacteria (Corynebacagar); Tellurite-containing blood agars on base - Culture medium № 1 GRM, Culture agar for the cultivation of microorganisms (GRM agar), Culture medium for determining the sensitivity of microorganisms to antibacterial preparations - AGV, culture agar for the cultivation of dry microorganisms (SPA), Clauberg medium II, Hoyle Medium agar (Oxoid), Blood agar base (Conda), Columbia Agar Base (Conda). The work used 7 test strains of microorganisms from the State collections of pathogenic microorganisms - C. diphtheriae biovars gravis, mitis, intermedius, belfanti and subspecies lausannense, C. ulcerans and C.pseudotuberculosis. Studies were carried out in accordance with MUK 4.2.3065-13 «Laboratory diagnosis of diphtheria infection¼. We describe culture-morphological properties of strains on all tested culture mediums the isolation of corynebacteria after 24 and 48 hours of incubation. Analysis of the results on the growth properties of culture mediums showed that all culture mediums had high sensitivity - from dilution 10-7 for all test strains. Colonies of corynebacteria were visually detected on culture mediums after 19-20 hours of cultivation. When cultivating a suspension of corynebacteria from breeding 10-6 on culture mediums, the number of colonies ranged from 95±5 to 120±10. Conclusion. All culture mediums had differential diagnostic properties that ensure the growth of corynebacteria after the day of incubation.

Comparative tests of quality of bacteriological investigation with Corynebacterium diphtheriae isolation.

The results of comparative experimental studies of identification of nontoxigenic C. diphtheriae strain by three different commercial laboratories are presented. A typical nontoxigenic strain of C. diphtheriae biovar mitis was used. For the studies, three lines of ten-fold dilutions of bacterial culture were prepared, followed by control planting on the medium and counting CFU/ml. In the experiment, tampons were pooled with a 24-hour bacterial culture of a nontoxigenic C. diphtheriae strain. Tampons were provided from three different laboratories - ∑-Transwab® with Ames liquid medium (from the first and second laboratories) and a viscose tampon with coal medium (from the third laboratory). After pooled, tampons were delivered to commercial laboratories. And as a result of the experiment, Corynebacterium spp. was identified in first laboratory (103 CFU/tamp), S. epidermidis (102 CFU/ml) - in second laboratory and nontoxigenic C. diphtheriae biovar gravis - in third laboratory. The study indicates that there is a need to the supervision of bacteriological investigations conducted in various laboratories. This will improve the quality of investigations on diphtheria infection and identify of diphtheria carrier, which is a reservoir of the causative agent of diphtheria, and will contribute to the maintenance of sanitary and epidemiological well-being in our country.

PCR-based diagnosis of whooping cough in the Russian Federation.

The aim was to determine how often the PCR method is used in different laboratories in Russia. In 2018, we conducted a questionnaire survey in diagnostic laboratories of medical organizations and the Centers of Hygiene and Epidemiology that performed PCR studies to identify microorganisms of the genus Bordetella in all 85 Russian regions. We found that in 2013 the PCR was used in 33 (38.8%) regions, but in 2017 the number of regions increased to 64 (75.3%). During 2013-2017 the study has not been applied in 21 regions. The number of PCR tests performed in the laboratories of medical organizations was significantly different. There has been an increase in the number of tests for the diagnosis of pertussis among people with clinical signs of infection and among contact persons in foci of infection. Compared to the Centers of Hygiene and Epidemiology, in medical organizations the rate of introduction of the PCR was higher. Between 2013 and 2017 the proportion of samples containing DNA B.pertussis decreased, but the proportion of samples containing DNA of other representatives of the genus Bordetella increased. Moreover, in the case of isolation DNA Bordetella spp. clinicians diagnose «Whooping cough, other unspecified organism¼, since there is no information on the species of the pathogen. Thus, in order to improve the diagnosis of pertussis, it is necessary to optimize PCR tests by including target genes that allow to identify of currently relevant DNAs of different representatives of the genus Bordetella.

Status and problems of bacteriological diagnosis of diphtheria infection in the Russian Federation.

The purpose of the work was to assess the state of bacteriological diagnosis of diphtheria infection in Russia in order to establish possible reasons for the decrease in the release of C. diphtheriae. The Reference Center for Monitoring the Pathogens of Measles, Rubella, Mumps, Pertussis and Diphtheria in 2018 in 85 subjects of Russia conducted a questionnaire of laboratories of medical organizations and the Centers for Hygiene and Epidemiology of Rospotrebnadzor, carrying out bacteriological studies for diphtheria infection. It was found that the number of studies conducted over the five-year period decreased by 1.2 times. The tendency to decrease the number of bacteriological studies for diphtheria is observed in the territories of almost all federal districts. In 99% and 29% of cases, the institutions of the FBUZ Centers for Hygiene and Epidemiology and medical organizations (MO) and use in their work documents regulating bacteriological studies for diphtheria infection. In a number of territories, the list of documents used includes documents that are invalid or do not define such studies. Most organizations use dry tampons when examining for diphtheria, however, 13.1% and 53.4% of FBUZ Centers for Hygiene and Epidemiology and medical organizations (respectively) use commercial transport environments, which does not comply with regulatory documentation. Analysis of the quality of work of bacteriological laboratories showed shortcomings at the stage of preparation of media (use of donor blood, or absence of addition of blood and potassium tellurite), Elek tests (addition of horse serum or absence of serum to the medium), setting of incomplete biochemical series (absence of tests for urease and nitrate reductase), absence of standard control strains, incomplete volume of internal laboratory quality control. Given the continuing circulation of the pathogen in various countries of the world and in our country, as well as the possibility of imported cases of infection from endemic regions, the analysis was aimed at drawing the attention of specialists to the problem of improving the quality of laboratory diagnosis of diphtheria in Russia.

Development of accelerated genodiagnosis method of pertussis and pertussis-like diseases on the basis of mPCR-RT.

The aim of the work was to develop an accelerated genodiagnosis method based on mPCR-RT for the detection DNA of B. pertussis, B. parapertussis, B. holmesii. MATERIALS AND METHODS: The study used 104 strains of microorganisms, of which: 50 strains of B. pertussis, 37 - B. parapertussis, 17 - heterologous species of microorganisms. Assessment of analytical specificity was carried out using DNA strains of various microorganisms with a concentration at least 109 GE / ml. To check the analytical sensitivity we studied a series of serial dilutions of bacterial cultures of the control strains B. pertussis № 143, B. parapertussis № 38b, B. holmesii DSM 13416 with a concentration of 5x109 - 5 µm/ml. RESULTS: Insertion sequences were chosen as diagnostic targets: for B. parapertussis - a specific fragment IS1001, for B. holmesii - a specific fragment hlIS1001, for B.pertussis - a fragment IS481. To develop a genodiagnosis method specific primers were designed and combined into a single multi-primer mixture, the composition of the reaction mixture and the amplification conditions were selected. The analytical sensitivity of the developed method for detecting pertussis and pertussis-like pathogens was 5×101 GE / ml. Verification of the developed methodology of gene diagnostics showed 100% analytical specificity. CONCLUSION: An accelerated genodiagnosis method based on mPCR-RT has been developed, it allows you to identify DNA of B. pertussis, B. parapertussis, B. holmesii, which expands the possibilities of examining patients with suspected pertussis and pertussis-like diseases in order to increase laboratory confirmation of the diagnosis.

[Inflammation markers and bloodstream infection (review of literature).]

In response to inflammation there appear «reactants of acute phase¼ which are nonspecific but they can show the disease gravity and prognosis. The markers of the acute phase are: C-reactive protein (CRP), procalcitonin (PCT), neopterin (NP), presepsin (PSP), necrosis tumor factor α (NTF-α), erythrocyte sedimentation rate (ESR), the total amount of leucocytes, neutrophils, protein fractions (α, ß2, γ-globulins), IgM. CRP concentrations rise in the presence of bacterial infections and they are significanly higher in the positive blood cultures than in the contamination or negative ones. PCT levels grow in case of gram-negative bacteremia, but the levels are normal in case of coagulase-negative staphylococci bacteremia. PCT levels are more helpful here than CRP levels with suspected bacteremia. NP levels rise in patients with bacteremia. In the presence of infection, PSP becomes more active than CRP and PCT, and PSP sensitivity is 91,4% in patients with sepsis. Patients with infectious endocarditis have high levels of NTF-α in case of staphylococci infection in blood but the levels of NTF-α are low with enterococci and corynebacterium bloodstream infection. In case of inflammation the acute phase protein level changes are infection markers including bloodstream infection but they are not specific for determining any bacteremia aetiology.

[Comparison of rayon and flocked swabs for collection and transport of deep throat swabs for detection of bacteria causing whooping cough by multiplex real-time PCR assay.]

The aim of the work was to comparison of rayon and flocked swabs for collection and transport of deep throat swabs for detection of bacteria causing whooping cough by multiplex real-time PCR assay. The study included 87 patients aged from 1 month to 37 years, hospitalized in Infectious Diseases Clinical Hospital No. 1 of the Moscow Department of Healthcare. 68 (78,2 %) people had a diagnosis of whooping cough, the main group of which consisted of children aged 1 to 12 months (median 4 months); 17 (19,5 %) - other diseases of the respiratory tract; 2 (2,3 %) - contact with sick whooping cough. The initial examination of patients was carried out on the 1 - 8th week of the onset of the disease. The material from the patients was taken at one-day interval with commercial rayon swabs and flocked swabs. Identification and differentiation of specific genome fragments of the causative agents of whooping cough in biological material was carried out by real-time PCR using the «AmpliSens® Bordetella multi-FL¼ reagent kit. The efficiency of PCR-based diagnostics of whooping cough using flocked swabs at the preanalytical stage was 83,8 %, and rayon swabs - 82,3 %. The use of a flocked swabs at the preanalytical stage increased the research efficiency by 1,5 %. Thus, when collecting biological material for PCR-based diagnostics of whooping cough it is possible to use flocked swabs.

[Definitionof anti-pertussis antibodies by immunoassay.]

Comparative analysis of efficiency of identification the anti-pertussis of antibodies of three classes (IgM, IgG, IgA) by means of four commercial test systems used for serological diagnosis of whooping cough in the Russian Federation by RIDASCREEN (R-Biohharm AG, Германия), NOVATEC (Immunodiagnostica GmbH, Germany), DRG Diagnostics (Germany), Savyon Diagnostics (Israel) is carried out. The research included 42 serums of blood of the children and adults with whooping cough hospitalized in Infectious diseases clinical hospital No. 1 of the Moscow Department of Healthcare. In work the commercial test systems - RIDASCREEN (r-Biofarm, Germany), NOVATEC (Germany), DRG (Germany), Savyon (Israel) are used, according to instructions of producers. Complete coincidence of results of a research is established in 40,5% cases, in 42,9% not complete coincidence of results on dynamics of development of one class of antibodies is revealed and in 9,5% cases the discrepancy of results on two classes of antibodies is revealed. In total discrepancies of results - 7,1%. At determination of antibodies of the class IgM in serum of blood of patients with whooping cough the greatest number of positive results is defined in the SAVYON - 83,3±6,3% (35 serums), NOVATEC - 71,4±8,2% (30 serums), RIDASCREEN - 61,9±9,7% (26 serums), DRG - 45,2±11,7% (19 serums). Class IgG antibodies in all test systems were defined at one level. Some distinctions took place in determination of IgA. The high percent of identification of IgA was in the RIDASCREEN - 59,5±10,0% (25 serums) and DRG - 50,0±11,2% (21 serums). In the NOVATEC and SAVYON this percent was lower - 45,2±11,7% and 26,2±13,9%, respectively (19 and 11 serums). Thus, the research showed that for serological researches any of these 4 test systems can be used. It is recommended to conduct diagnostic testings of serums of blood in one chosen test system for obtaining comparable results and to interpret the results received in one test system when obtaining doubtful results it is necessary to investigate serums in dynamics at the same time in one test system.

[The multidisciplinary approach to the diagnostics and surgical treatment of the lacrimal passages]. / Mul'tidistsiplinarnyi podkhod v diagnostike i khirurgii sleznykh putei.

The primary objective of the present study was to highlight the current state of research on the pathology of the lacrimal organs based on the results of the analysis of the relevant publications in the domestic and foreign scientific literature. Special attention in this review is given to the problems of diagnostics, indications for the probing, the treatment and stenting strategies. The authors report their original observations contributing to the better understanding of the anatomical features of the nasolacrimal passages. In addition, the data on the principal pathogenic agents are presented together with certain peculiarities of the surgical treatment of the pathology under consideration.

[Possibilities of application of the liquid transport medium for capture of pathological material at laboratory diagnosis of a diphtheria infection.]

The main objective of laboratory diagnosis of a diphtheria is identification of the causative agent by means of the minimum quantity of diagnostic tests for obtaining the authentic answer in the most short time. One of the major stages is capture and delivery of pathological material on which the efficiency of carrying out and timeliness of issue of the final answer depends. Considering emergence in the market of commercial liquid transport mediums, assessment of their efficiency for diagnosis of diphtheria is advisable. In the real work the pilot studies allowing to predict efficiency of use of the commercial transport liquid medium ∑-Transwab® with the liquid medium of Ames in two systems - with the standard applicator (system 1) and with the thin extended tampon for sampling from narrow cavities - urethral and nazofarengialny are conducted (system 2). In a research used a control toxigenic strain of Corynebacterium diphtheriae of a biovar of gravis No. 665. In an experiment "imitated" operating conditions of the medical organizations for storage of tampons with pathological material on diphtheria before their transportation in laboratory - on a table at the room temperature (6 and 20 hours), in the refrigerator (6 and 20 hours), in the thermostat (6 and 20 hours). After an incubation all tampons sowed the environment for primary crops of pathological material on a blood tellurite agar.. Accounting of results was carried out in 24 and 48 hours of growth. It is established that the commercial transport liquid medium of Ames can be used for capture of pathological material on diphtheria in the second half of the working day at storage in the conditions of the refrigerator. At the same time, it is necessary to consider a tampon form as the best results on a identification of the causative agent of diphtheria have been received when using a universal tampon.

[The microbiocenosis of the palatal tonsils in the practically healthy people]. / Mikrobiotsenoz nebnykh mindalin u prakticheski zdorovykh lits.

The objective of the present study was the investigation of the quantitative and qualitative composition of the cultured microorganisms isolated from the proximal parts of the palatal tonsil lacunes of the practically healthy people. The data obtained made it possible to characterize the microbiocenosis of the palatal tonsil lacunes in the practically healthy subjects at the age from 18 to 30 years. A total of 153 strains were identified with the use of mass spectrometry; they represent six genera of two phylotypes that occur in the form of associations comprised of 4-5 microorganisms with the predominance of the species of the genus Streptococcus. The results of the study expand our knowledge about the oropharyngeal microbiota and create the prerequisites for the better uundderstanding of the contribution of the microbiotic communities to the development of pathology of the upper respiratory tracts.

[COMPLEX IMMUNOGLOBULIN PREPARATION FOR THERAPY OF PERTUSSIS IN YOUNG CHILDREN].

AIM: Study the possibility of inclusion of complex immunoglobulin preparation (CIP) pos- sessing specific activity against pertussis exotoxins into complex therapy of pertussis infection in young children. MATERIALS AND METHODS: -2 groups of children with.pertussis younger than 3 years were examined. The main group (50 individuals) received CIPper os - 1 dose 1 - 2 times per day for 5 days, comparison group (34 children) received only basic therapy. Evaluation of clinical effectiveness of CIP was carried out, the content of anti-pertussis class G antibodies and total IgE in patients were studied. RESULTS: A good clinical effectiveness of the preparation was shown, as well as immune modulating activity against humoral immune response to pertussis infection. CONCLUSION: The detected positive effect of CIP on pertussis -course in children has indicated a principally novel use of this per oral drug form.

[COMPOSITION OF POPULATION OF DIPHTHERIA CAUSATIVE AGENT STRAINS IN RUSSIA].

AIM: Characteristics of clonal composition of Corynebacterium diphtheriae strain population in Russia using MLST, as well as evaluation of a possibility of using of this method during execu- tion of monitoring of diphtheria infection causative agent strains. MATERIALS AND METHODS: C. diph- theriae strains, isolated in Russia in 1957 - 2015 and sent to Gabrichevsky MRIEM reference centre for diphtheria and pertussis, were studied. Gentyping of C. diphtheriae using MLST was carried out based on sequencing of <> gene fragments. ST identification was carried out according to PubMLST Result. C. diphtheriae strains of 36 sequence-types (ST) were identi- fied on the territory of Russia - 27 previously known and 9 novel, detected for the first time. 2 sequence types ST25 and ST8 (22% and 18%) dominated. Inter-relation between phenotype. properties (toxigenicity. and biovar) and membership of C. diphtheriae strains in certain sequence- types was shown - toxigenic and non-toxigenic C. diphtheriae strains of various biovars were characterized by certain sequence-types. Changes of clonal composition of C. diphtheriae popula- tion in dynamics of epidemic process of diphtheria infection were.shown. CONCLUSION: Use of MLST allowed to characterized clonal composition of C. diphtheriae strains' population in Russia and has shown perspectives of use of this method to characterize population of diphtheria causative agent, detect epidemically significant strains and decipher foci of diphtheria infection.

[TMOSKOVHE COMPARATIVE CHARACTERISTIC OF GROWTH MEDIUMS FOR SEPARATION OF CORYNEBACTERIA].

The comparative tests of growth mediums for isolation and accumulation of diphtheria bacteria were implemented. The testing consisted of six series of growth medium "Corynebacagar" produced by the state research center of applied microbiology and biotechnology and three series of blood tellurite agar. The concluding results of identification of biological indicators of all series of growth nutrient mediums are presented The "Corynebacagar" is recommended for application in health care practice for primary inoculation of pathological material during implementation of cultural analysis on diphtheria.

[The clinical markers of infection of bloodstream in out-patients].

The sampling of270 out-patients was examined to detect principal clinical symptoms under infection of bloodstream. The principal clinical symptoms the form of complaints were collected using specially developed questionnaire. The patients mentioned most frequently low-grade fever, shivering, furuncles of skin, unstable stool (diarrhea or constipation), diseases of upper respiratory ways. The microbiological diagnostic of infection of bloodstream included microscopy and inoculation of leukocyte layer of blood sample. At microscopy of blood smears microorganisms were detected in 98.5% of cases. The positive findings were presented by associations of various morphological forms in 82.6% of cases. The hemoculture was obtained from 55.2% of patients and characterized by polymicrobility in 35.7% of cases. The greatest number of hemoculture were obtained from patients with low-grade fever and shivering (53.4%), furuncles (55.8%), unstable stool (53.6%), diseases of upper respiratory ways (53.8%) that substantiate presence of infection of bloodstream.