Vol 25, No 2 (2020)


Preventive vaccination of pneumococcal disease under the dissemination of COVID-19

Nikiforov V.V., Orlova N.V., Suranova T.G., Mironov A.Y., Polezhaeva N.A.


Under the coronavirus disease 2019 (COVID-19) pandemic, special attention should be paid to minimize the morbidity risk of all infections controlled by specific prophylaxis. During preparation for the epidemic season, the organization and conduct of vaccination against influenza and pneumococcal infection is a particularly crucial task of public health. Priority immunization should be provided to patients from epidemiological and social risk groups. This article presents an overview of the data on pneumococcal infection vaccination efficiency in various population groups as well as on its reasonability for preventing superimposed infection development in COVID-19 infection. In addition to children and decreed groups of the adult population, vaccination against pneumococcal infection is indicated for patients with chronic diseases. This enables us to reduce the risk of complications in case of a new coronavirus infection. Particular attention should be paid to immunizing medical personnel, who are at high risk of infection, play a significant role in controlling the pandemic, and need protection. With the continuous spread of COVID-19, vaccination is necessary in compliance with additional measures to ensure safety (patient routing, disinfection intensification in vaccination rooms, etc.).

Epidemiology and Infectious Diseases. 2020;25(2):48-55
pages 48-55 views


The clinical characteristics of coronavirus disease 2019 in mild and ordinary female patients

Jiang Y., Li Y., Yuan D., Hou G.


AIMS: the aim of study was to explore the clinical characteristics of coronavirus disease 2019 in mild and ordinary patients, providing guidance for clinical diagnosis and treatment.

MATERIALS AND METHODS: Sixty-four patients with positive results of nucleic acid testing were divided into two groups, called the youth group and the older group, to be compared the differences of clinical characteristics.

RESULTS: Sixty-nine cases showed normal or decrease in white blood cell count (WBC). One case decreased in lymphocyte count (LYMPH). Seven cases decreased in lymphocyte proportion (LYMPH%). Seven cases increased in C-reactive protein (CRP). Sixteen cases increased in alanine transaminase (ALT). Nineteen cases increased in aspartate transaminase (AST). One case increased in lactic dehydrogenase (LDH). Six cases decreased in creatine kinase (CK). Three cases increased in globulin (GLOB). Thirty-eight cases decreased in serum creatinine (CRE). Five cases decreased in blood urea nitrogen (BUN). The lung CT scanning results showed no statistic difference between two groups (p > 0.05). The level of WBC, NEUT, LDH, BUN, potassium (K+) showed statistic difference between two groups (p ˂ 0.05).

CONCLUSIONS: Age was a risk factor in COVID-19. In the course of future diagnosis and treatment, blood test might play an increasingly important role.

Epidemiology and Infectious Diseases. 2020;25(2):56-64
pages 56-64 views

Sensitivity of influenza viruses to specific drugs in Russia during 2017−2020. The rare finds and perspective antivirals

Breslav N.V., Krasnoslobotsev K.G., Mukasheva E.A., Kirillova E.S., Rosatkevich A.G., Kolobukhina L.V., Burtseva E.I.


BACKGROUND: The article presents the results of studying the effectiveness of anti-influenza drugs in Russia in the period 2017−2020. The sensitivity of circulating strains of influenza viruses A(H1N1)pdm09, A(H3N2) and B to neuraminidase inhibitors – oseltamivir, zanamivir and rimantadine was determined. The analysis of scientific articles by both domestic and foreign researchers on new promising chemotherapy drugs for influenza viruses was carried out.

AIMS: study of the sensitivity of influenza viruses circulating strains to specific anti-influenza drugs in the framework of monitoring in the period 2017–2020.

MATERIALS AND METHODS: The study was conducted within the framework of epidemiological surveillance of the influenza viruses circulation using the collection of the influenza etiology and epidemiology laboratory with the following criteria for selecting strains isolated from pregnant women, patients with complicated flu infection and severe acute respiratory infection (SARI), lethal outcomes, as well as patients undergoing treatment with specific drugs. Virological, immunological, and molecular genetic methods were used in the study, and following drugs substances were used: oseltamivir carboxylate, zanamivir, and rimantadine.

RESULTS: For the period 2017−2020, the sensitivity of 541 influenza A and B viruses epidemic strains to anti-influenza drugs was studied. Most of the studied strains remained sensitive to neuraminidase inhibitors. The exceptions were: in 2017/2018 — 5 strains of the influenza A(H1N1)pdm09 virus resistant to oseltamivir and 2 strains of the influenza B virus, one with reduced sensitivity to oseltamivir, the second — to zanamivir; in 2019/2020 — influenza A(H1N1)pdm09 virus strain with reduced sensitivity to both drugs.

In the 2018/2019 season, an influenza A/Moscow/246/2018 A(H1N1)pdm09 strain was found to be sensitive to rimantadine.

CONCLUSIONS: The main and most common genetic markers of influenza viruses resistance to specific drugs are: for oseltamivir — substitution H274Y in the influenza A(H1N1)pdm09 virus NA; for rimantadine — substitution S31N in the influenza A(H1N1)pdm09 and A(H3N2) viruses M2 protein. Taking into account the low frequency of strains with reduced sensitivity to drugs with antineuraminidase activity, can confidently approve that they remain the drugs of choice for the treatment and prevention of influenza infection.

Epidemiology and Infectious Diseases. 2020;25(2):65-77
pages 65-77 views

Comparative assessment of the frequency and risk factors of purulent-septic infections in adult patients after various types of open and closed heart surgery

Sergevnin V.I., Kudryavtseva L.G.


BACKGROUND: The widespread increase in the number and types of cardiac surgery necessitate the study of frequency and risk factors of postoperative purulent-septic infections (PSIs).

AIM: to provide a comparative assessment of the PSI frequency and risk factors in adult patients after various types of cardiac surgery.

MATERIALS AND METHODS: Based on the cardiac surgery hospital materials, medical records of 4.815 patients over 18 years of age, who underwent open (n = 1.540) and closed (n = 3.275) heart surgeries within 1 year, were analyzed. The typical and prenosological forms of PSIs were taken into account in accordance with the epidemiological standard of case definition.

RESULTS: The incidence rates for typical and prenosological PSI forms amounted to 39.6 and 72.7 per 1000 surgeries after open heart surgery, respectively, and 3.1 and 3.9 after minimally invasive endovascular surgical interventions, respectively. The main clinical forms of PSI after open and closed heart surgeries were surgical site infections, nosocomial pneumonia, urinary tract infection, and bloodstream infection. In an open heart surgery, the maximum incidence rates for typical and prenosological forms of PSIs were recorded after surgeries on the aorta and less often after heart valve replacement or coronary artery bypass grafting. The increased incidence rate after aortic surgery was mainly due to urinary tract infection and nosocomial pneumonia. In the case of closed heart surgery, no statistically significant differences were detected between the incidence rates of PSIs after coronary artery stenting, cardiac arrhythmia and carotid artery stenosis surgery, and other interventions. The duration of both the surgery itself and the subsequent patient stay in the intensive care unit was found to be important as risk factors for PSIs after cardiac surgery.

CONCLUSION: The incidence rate of PSIs after open heart surgery is significantly higher than after closed heart surgery, which is mostly associated with the duration of surgical intervention and the subsequent patient stay in the intensive care unit.

Epidemiology and Infectious Diseases. 2020;25(2):78-87
pages 78-87 views

Annual influenza vaccination of patients with cardiovascular diseases and changes in hemagglutinin antibody titers: 3-year follow-up data

Platonova E.V., Deev A.D., Gorbunov V.M., Nazarova O.A., Belova O.A., Furman N.V., Dolotovskaya P.V., Mironova A.A., Dovgalevsky P.Y., Loukianov M.M., Boytsov S.A.


BACKGROUND: Seasonal influenza vaccination is recommended for patients with cardiovascular diseases. Low vaccination coverage among these patients is due to insufficient knowledge about vaccine efficiency and its regular annual use.

This work aimed to study the repeated 6-month changes in hemagglutinin antibody titers (AT) for 3 years in patients with cardiac pathology in a comparative study of influenza preventive vaccination.

MATERIALS AND METHODS: Analysis of ATs obtained based on the hemagglutination-inhibition test (HAI) was performed in 235 of 817 participants in a prospective follow-up. Blood sampling was performed at baseline, before the vaccination, and 6 months after, and at the same term in unvaccinated patients in the 2012–2013 and 2014–2015 seasons, respectively. The seropositive and seronegative responses to vaccination or acute respiratory or influenza infection were used, according to the reference values of seroconversion and seroprotection and the fact of seroconversion. Multiple regression analysis with a logarithmic scale was used to assess the vaccine effectiveness indices.

RESULTS: With vaccination coverage of at least 40% against seasonal influenza within 3 years, the trends of a decrease in seropositive and an increase in seronegative responses in the vaccination group and its reverse nature in the comparison group were determined by traditional analysis. Using logarithmic calculation, an increase in HAI AT seroconversion was revealed over a 3-year follow-up period. It was characterized by a homogeneous serological response at annual vaccination and heterogeneous with a higher serological response in cases without vaccination (p = 0.002 for H1N1 and p = 0.005 for H3N2, respectively). This trend can be determined by a higher and more stable prevaccination level of HAI AT than the same residual level of AT among unvaccinated patients.

CONCLUSION: During long-term cardiac studies, the logarithmic calculation in interpreting the results of HAI AT overcomes the limitations of the traditional analysis of assessing the efficiency of the annual influenza vaccine. Further serological programs are required to better understand the role of routine seasonal influenza vaccination in preventing morbidity and mortality of patients with cardiovascular diseases.

Epidemiology and Infectious Diseases. 2020;25(2):88-101
pages 88-101 views


Development of a program for automated recording of the results of polymerase chain reaction studies in real time in the conditions of a massive intake of biological material during the COVID-19 pandemic

Vodopyanov A.S., Khomyakov Y.N., Pisanov R.V., Furina A.Y., Lopatin A.A., Noskov A.K.


With regard to the rapid spread of the latest coronavirus infection (COVID-19) in the Russian Federation in 2020, 70 workplaces were organized in Antiplague Center of Rospotrebnadzor and were seconded by specialists from the Rospotrebnadzor research antiplague institutes. However, the round-the-clock three-shift mode of operation significantly complicates the organization and documentation of the studies and increases the risk of errors.

Subsequently in Antiplague Center of Rospotrebnadzor, we have conducted the work to automate the most problematic stages of conducting polymerase chain reaction (PCR) studies for the latest coronavirus infection and to develop an algorithm for real-time monitoring of the results.

The development of our own software solutions was carried out in Python 3.8.2.

The initial data for automation were.xlsx files automatically generated by the thermocycler software and typical tabular templates filled in at the sample analysis and RNA extraction stages. The software we developed consolidated the data into a single “file register” to detect potential errors simultaneously (e.g., the presence of duplicates, differences in the lists of samples at different stages, etc.). Using the Python scripting language provides cross-platform functionality (the ability to work in any operating system) and allows you to easily and quickly modify the system when changing any parameters or input file structure. Thus, 7 days were spent on the development and commissioning of this software complex, which is particularly important when working in an emergency and high alert mode.

Therefore, using the approach we developed made it possible to more quickly detect technical errors, discordant results, and samples requiring re-examination, which in turn reduced the time for issuing results.

Epidemiology and Infectious Diseases. 2020;25(2):102-108
pages 102-108 views

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