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.

Immune and microbiological disorders in women with infectious and inflammatory pathology of the cervix.

Penetration into the female genital tract of infectious agents is associated with the cause of the onset of cervicitis. In most cases, these are sexually transmitted diseases (STDs). A high level of viral and bacterial load in the study of clinical material from women with infectious and inflammatory pathology (IVP) of the cervix affects the activity of innate immunity reactions. The total number of examined patients was 76 patients of reproductive age, of which 36 women with cervical IVP and 40 women made up the comparison group. The imbalance of microbiocenosis can be accompanied by immune and microbiological disorders. The aim of the study was to study immune and microbiological disorders in women with infectious and inflammatory pathology of the cervix. To achieve the goal, the following tasks were set: to identify the relationship between the expression level of TLR2 and TLR4 genes in the epithelial cells of the cervical canal of women in which UPM is determined. To determine the species spectrum and etiological significance of the microbiota of bacterial biofilm of the cervical mucosa in the pathogenesis of cervicitis in women of reproductive age. It has been established that the determination of indicators of innate immunity, such as interferons, in blood serum and the expression of TLR2 and TLR4 receptors, with the study of their balance, taking into account the pro-inflammatory and anti-inflammatory properties in IVP of the cervix, has an important prognostic value. An increase in the level of the immune response in the form of hyperstimulation of antigens of IVP pathogens leads to the chronization of the inflammatory process in the urogenital tract, to scarring of tissues, which can play an important role in the development of infertility and termination of pregnancy in women of reproductive age.

[Peptide imunofan and moxifloxacin combined effects on toxigenic strain Clostridium difficile in vitro.] / Cочетанное действие пептида имунофана и моксифлоксацина in vitro на токсигенный штамм Clostridium difficile.

Moxifloxacin and imunofan peptide concentrations - dependent Clostridium difficile growth rate was analyzed in vitro. In the course of our study, it was revealed imunofan peptide at concentrations 0.05, 0.25 µg/ml has antimicrobial characteristics against toxigenic C. difficile strain. At the same time, with the peptide and the antibiotic combined interaction, we observed moxifloxacin concentration 0-1.5 MIC stimulates C. difficile growth, regardless of the imunofan concentration. Concentrations of maximum growth inhibition for C. difficile were also established with the combined effects peptide imunofan and antibiotic moxifloxacin - 1.5 µg/ml and 2.5 MIC, respectively.

Emergence of Candida auris in Russia.

This paper reports the emergence of Candida auris infections in an intensive care unit at a hospital in Moscow. Forty-nine cases were diagnosed in 2016-2017, and the risk factors and antifungal susceptibilities are described. The 30-day all-cause mortality for 19 bloodstream infections in patients who did not receive appropriate antifungal therapy was 42.1%. Phylogenetic analysis of the internal transcribed spacer and D1-D2 regions and K143R substitution in the ERG11 gene indicated that the studied C. auris strains were of South Asian origin. This first reported series of C. auris infections in Russia demonstrates the rapid dissemination of this species, and the need for international surveillance and control measures.

[Microflora metabolites of different habitats in bronchopulmonary diseases].

PURPOSE: To investigate the content and profile of metabolites of bronchopulmonary and intestinal microflora, especially such as short chain fatty acids (SCFA) in various biological substrates in patients with lung malignant tumors on the background of COPD. Estimate their diagnostic and tactical implication. MATERIALS AND METHODS: The study involved 98 patients with diseases of the bronchopulmonary system. According to the basic nosology patients were divided into two main groups: COPD (38 patients), and lung cancer in combination with COPD (hereinafter LC) (60 patients). The diagnosis was verified by modern methods of examination. Group of norm included 30 healthy individuals. Groups matched by gender and age. The microbiological examination of sputum and feces was conducted in the studied groups of patients. SCFA in sputum and feces of patients with COPD and LC were identified by GLC method. In healthy individuals the SCFA investigation was performed in bronchial washings, obtained during bronchoscopy in 20 people, the SCFA investigation in feces was performed in 30 people. RESULTS: Study of the content and profile of short-chain fatty acids (SCFA) in patients with COPD and lung cancer (LC) in various biosubstrates indicate on the obvious changes in microbiocenosis ofbioptate (bronchopulmonary and intes- tinal), characterized by the dominance of residual and facultative anaerobic microorganisms in the spectrum. Except that more pronounced changes are ascertained at LC. Also, changes of the SCFA parameters in the sputum may indicate on the alterations in the metabolism of epithelial cells of the lower respiratory tract (LRT). Unidirectional change the SCFA in sputum and feces can indicate on either translocation of microflora in the LRT out of the intestine, and on the possible systemic changes in themetabolism of epithelial tissue in the oncological process. The identification of SCFA by GLC method in various biological substrates can be used in examination of patients with lung cancer for diagnostic purposes (for objectification of microecological violations), as well as to evaluate the prognosis of the disease and its complications.

[Perspectives of tigecycline treatment of surgical site infections in oncologic patients].

Criteria of tigecycline (Tygacil) use for the treatment of surgical site infections in oncologic inpatients were developed. High efficacy of tigecycline in vitro and in vivo against multiresistant hospital strains persistent in the surgical department of the gastrointestinal oncologic division was shown.

[Adequate empiric therapy of nosocomial fungal infections in oncologic patients of intensive care units].

The results of a 3-year experience with voriconasole in oncologic practice are presented. Rational schemes for the use of caspofungin and mycofungin in the treatment of oncologic inpatients and the criteria of their use in the therapy of fungal nosocomial infections were developmed. Good clinical and microbiological efficacy of caspofungin and mycofungin against Candida non-albicans was shown.

[Modern antifungals in therapy of nosocomial mycosis in oncologic patients].

Rational position of voriconazole in the treatment of oncologic inpatients was shown and the criteria of its use in the algorithms of the therapy and prophylaxis of nosocomial fungal infections were developed. The clinical trial enrolled 50 patients with oncologic pathologies. The patients were divided into two groups of possible invasive candidiasis risk. The patients of one group were treated with fluconazole (Diflucan) and those of the other group were treated with voriconazole (Vifend). The spectrum of the hospital fungal flora was determined and susceptibility of 310 clinically important opportunistic fungi was investigated. All the isolates of Candida albicans and C.tropicalis were susceptible to amphotericin B, fluconazole and voriconazole and 79 and 50% of the isolates were susceptible to intraconazole respectively. As for the C.krusei isolates, 67% was susceptible to amphotericin B, 50% was susceptible to fluconazole, 100% was susceptible to voriconazole and none of the strains was susceptible to intraconazole. By the clinical efficacy voriconazole was superior to fluconazole and comparable with amphotericin B, while superior to it by the number of the side effects and by the cost of the treatment course. It was concluded that voriconazole should be considered as the main agent in the antifungal therapy of oncologic patients.

[Comparative study on the efficacy of cefuroxime, amoxycillin/clavulanic acid and fosfomycin in prophylaxis of nosocomial infections in oncologic patients after surgical operations].

Rational antibiotic prophylaxis and antibacterial therapy of nosocomial infections is an actual problem in surgery. Improvement of antimicrobial chemotherapy and prophylaxis of nosocomial infections is of special importance in urgent cases in oncologic units. Data on the design of rational schemes for antibacterial prophylaxis of nosocomial infections developing during the postoperative period in patients with cancer of the urinary bladder as one of the unfavourable complications of the main disease treatment are presented. The use of fosfomycin in the schemes of the antibiotic prophylaxis was shown to be more efficient vs. the use of the traditional beta-lactam antibiotics.

[Gramnegative opportunistic microflora as etiological factor of secondary infection in patients with pulmonary tuberculosis].

The results of the laboratory diagnoses of respiratory tract secondary infections in patients with pulmonary tuberculosis within a period of 12 months in a tuberculosis clinic were generalized. The species composition of the causative agents of lower respiratory tract secondary infection and the frequency of their detection in various clinical speciments (sputum, bronchial washings) were determined. The data on resistance of the opportunistic gramnegative bacilli (enterobacteria, pseudomonads, Acinetobacter spp.) isolated from the patients with pulmonary tuberculosis to various groups of antibacterials are presented.

[Rational use of antibiotics in mucoviscidosis pediatric cases with an account of local microbiological monitoring].

The results of local microbiological monitoring of bronchial secretion in 482 children with mucoviscidosis observed within 2000-2004 in the Republican Centre of Mucoviscidosis are presented. The results provided development of recommendations for rational use of antibiotics in the treatment of infectious processes in pediatric patients with mucoviscidosis. Since the emergence of MRSA in such patients is low, it is recommended to use antistaphylococcal betalactams (oxacillin, cefazolin, amoxycillin/clavulanate) for the treatment of infections due to S. aureus. For the treatment of infections due to some other pathogens, except S. maltophilia, the most active betalactams were carbapenems (imipenem and meropenem). Ciprofloxacin was active against numerous etiological agents causing low respiratory tract infections in children with mucoviscidosis except S. maltophila and A. xylosoxidans subsp. xylosoxidans. For the treatment of infections due to P. aeruginosa, P. aeruginosa muc. and K. pneumoniae the most active aminoglycosides were amikacin and tobramycin (for P. aeruginosa and P. aeruginosa muc.), while gentamicin was not active in such cases. As for antibiotics of other groups, high activity against S. aureus in the treatment of children with mucoviscidosis was recarded with the use of vancomycin, fusidic acid and rifampicin. Azithromycin and co-trimoxazole were active against H. influenzae. Chloramphenicol was active against S. maltophilia, B. cepacia and H. influenzae in the treatment of such patients.

[Rational antimicrobial pharmacotherapy of secondary infections in patients with pulmonary tuberculosis].

The results of 3-year (2002-2004) local microbiological monitoring of secondary infections due to opportunistic microflora that complicated the treatment of the main disease in patients of a regional (Moscow) tuberculosis hospital are presented. The monitoring revealed the leading microorganisms, the etiological agents of the secondary lower respiratory tract infection in the patients with pulmonary tuberculosis. The level of their resistance to the up-to-date antimicrobials was determined. Recommendations for optimization of antibacterial therapy of patients with pulmonary tuberculosis complicated by secondary lower respiratory tract infection due to opportunistic microorganisms were developed and validated.

[Respiratory tract mycotic infection in phthisiological practice: species composition and susceptibility of the Candida clinical isolates to antifungal agents].

The results of the laboratory diagnosis of respiratory tract candidiasis in patients with tuberculosis of the respiratory organs within 2-year observation in a tuberculosis clinic were generalized. The species composition of 327 isolates of the pathogens of the respiratory tract mycotic infection and the frequency of their detection in the specimens of various clinical material from patients with pulmonary tuberculosis were determined. The data on the resistance of the Candida spp. isolates to 6 antifungal drugs are presented. The number of the strains resistant to azol drugs (intraconazol and fluconazol) amounted to 10% of the total number of the Candida spp. isolates.

[Significance of local (regional) microbiological monitoring in the treatment of hospital infections in oncologic patients].

Infection is the main cause of severe complications and death in oncologic patients. The paper presents the results of a 3-year (2002-2004) local (regional) microbiological monitoring of hospital infections that complicated the main disease in patients of a regional oncologic hospital (Moscow region). The 3-year monitoring revealed the leading microorganisms being the etiological agents of the hospital infections. The dynamics of the resistance of the main hospital microflora to the antibiotics used in the hospital within the above mentioned period was studied. The results served as the basis for recommendations on optimization of the antibacterial therapy of oncologic patients with infectious complications under conditions of a regional oncologic hospital.

[Large intestine dysbacteriosis and therapy efficacy in patients with respiratory tract tuberculosis in sanatoria]. / Vliianie disbakterioza tolstoi kishki na éffektivnost' lecheniia bol'nykh tuberkulezom organov dykhaniia v usloviiakh sanatoriia.

Long-term chemotherapy of tuberculosis leads to dysbacteriosis of the large intestine, that significantly decreases tolerance of tuberculosis drugs, provokes persistence of tuberculosis intoxication and retards involution of tuberculosis process in the lungs. Recovery of the bifidoflora and lactoflora due to the use of an original sour-milk drink developed by the authors was stated in 65 and 55% of the patients respectively. Moreover, it promoted higher tolerance of the chemotherapeutics since its composition includes amino acids, vitamins B, C, D and E, enzymes and microelements. It should be indicated that the drink was used simultaneously with the chemotherapy and did not require its discontinuation. Therefore, it is recommended that the scheme of the treatment of patients with pulmonary tuberculosis in sanatoria should include corrigating agents and in particular probiotics containing live bifido- and lactobacteria having no contraindications and side effects, and providing elimination of intestinal dysbacteriosis.

[3-Year experience of use of cefepime (Maxipime) for the treatment of hospital infections in a specialized surgical hospital]. / Trekhletnii opyt primeneniia tsefepima (Maksipima) dlia lecheniia gospital'nykh infektsii v usloviiakh spetsializirovannogo khirurgicheskogo statsionara.

Microbiological and clinical monitoring for 3 years (from 2001 to 2003) confirmed high clinical and microbiological efficacy of cefepime (Maxipime, Bristol-Myers-Squibb) in the treatment of infectious complications in patients with solid tumors in an oncologic hospital. It should be noted, however, that high efficacy of cefepime and wide ranges of the indications to its use do not allow to consider it as an agent for the treatment of all possible complications in such patients. The drug is not active against enterococci, not always clinically sufficiently effective in the treatment of Pseudomonas aeruginosa infections, it is impossible to use cefepime in monotherapy of suspected anaerobic infections. Therefore, widespread uncontrolled use of cefepime should be prohibited. It should be prescribed strictly by the indications with the account of the pathogen susceptibility, the infection severity and the recommended doses and regimens. The use of cefepime is undoubtedly valid when other antimicrobials fail or when empirical antimicrobial therapy of severe cases is required, including those under intensive care.

[Microflora of the voice prostheses]. / Mikroflora golosovykh protezov.

The study was made of the condition of voice prostheses Provox and Blom-Singer in 27 patients wearing them. The prostheses were to be replaced by new ones as they lost impermeability for water. The prostheses were used for 6 months to 2 years. At the prosthesis removal from the tracheoesophageal bypass it was found that the esophageal flange and protective valve were contaminated with fungi and pathogenic bacteria. The valve was deformed, had limited motility and did not close tightly the esophageal opening of the prosthesis as the result of which liquid leaked into the airways. Bacteriological examination identified C.albicans, C.krusei, C.glabralis in 11 patients. Nistatin, flucostat, fluconasol, amphotericin were used in antifungal therapy. Prophylactic use of these drugs against fungi prolonged use of the prostheses 2-fold.