Vol 25, No 5 (2020)

BACKGROUND: The Incidence of acute intestinal infections (AII) is generally maintained at a high level. Significant progress made in the field of laboratory diagnostics allowed us to proceed to a detailed study of the etiological structure of AII, and as a result, it was found that in recent years the role of pathogens of a viral nature has significantly increased, but a detailed study of the characteristics of these infections requires further research.

AIMS: To study the structure and clinical and laboratory features of intestinal infections of viral etiology in adult hospitalized patients in the Altai Territory.

MATERIAL AND METHODS: From 2017 to 2020, a single-stage study was conducted of 67 patients of an infectious hospital with AII of viral etiology, aged from 18 to 76 years, hospitalized in the infectious departments of the “City Hospital No. 5”, Barnaul. In order to determine the structure of AII, the polymerase chain reaction (PCR) method with hybridization-fluorescence detection “AmpliSens ® AII screen-FL”, bacteriological and serological methods were used. Taking into account the results of laboratory examination (molecular-genetic, bacteriological and serological), all patients were divided into 3 groups: group 1 ― 45 patients with viral monoinfection (67.2%), group 2 ― 9 patients with viral mixed infection (13.4%) and group 3 ― 13 patients with combined viral ― bacterial etiology (19.4%). Data processing and graphical representation were performed using computer programs Statistica 10.0 (Russian version) (Russia), Excel 2010 (Windows 10).

RESULTS: As a result of the study, it was found that among the AII of viral etiology, 67.2% had monoviral AII and 32.8% had mixed AII-mixed viral (13.4%) and viral-bacterial etiology (19.4%). Among monoviral AII dominated norovirus infection (in 52,9%). Noted that the differences of clinical and laboratory parameters of the monoviral and mixed-viral infections have not been found, and there were no differences in groups of monoviral infections: rotavirus, adenovirus and norovirus, which is consistent with earlier data. As well as co-infection of salmonellosis, in combination with one and/or several viruses, more often occurred with febrile syndrome, watery diarrhea and abdominal pain.

CONCLUSION: Thus, in adult patients in the conditions of an infectious hospital, mono-and mixed-virus infection (in combination with two or more viruses or bacteria) was detected in the structure of viral AII by PCR. There was no statistically significant difference in clinical and laboratory parameters in the study groups due to the insufficient sample size and the feasibility of conducting further studies using a similar protocol with a larger number of patients.

BACKGROUND: In the South Ural region of Russia, the group of ITTB and TBE occupies the leading rank positions in the structure of infections that are ecologically associated with ixodic ticks. At the present stage, studies aimed at studying non-specific pathological biochemical processes that determine the degree of oxidative damage to cell membranes and organelle membranes, the reactivity of the body, its reserve-adaptive potential under the influence of a number of endogenous and exogenous factors are becoming particularly relevant. One of the most significant metabolic processes of this kind is the free radical oxidation of lipids and the oxidative modification of proteins.

AIMS: To give a clinical and epidemiological characteristic and to study the role of oxidative stress in the pathogenesis of various clinical forms of tick-borne infections in an endemic region (on the example of the Chelyabinsk region).

MATERIAL AND METHODS: The study was conducted at the clinical base of the Department of Infectious Diseases of the Southern State Medical University in the MAUZ GKB No. 8 in Chelyabinsk. The study randomly included 105 patients with tick-borne encephalitis, ixodic tick-borne borreliosis and mixed infection who were hospitalized in the hospital in the period from May to October 2018–2019. The diagnosis was verified by standard immunological methods (ELISA). Modern molecular genetic methods (PCR-RV) were used in the etiological diagnosis of ICD. Material for the study: leukocyte fraction and blood serum. The content of carbonyl products of oxidative modification of proteins was estimated by their reaction with 2.4-dinitrophenylhydrazine, followed by spectrophotometric registration of the interaction products-dinitrophenylhydrazones. When determining the content of primary and secondary products of lipid peroxidation, a method based on the phenomenon of rearrangement of double bonds into diene conjugates during the peroxidation of polyunsaturated fatty acids was used. Statistical processing of the obtained results was carried out by standard methods of nonparametric statistics using the Statistica 8.0 for Windows software package.

RESULTS: In the structure of infections transmitted by ixodic ticks, ixodic tick-borne borreliosis was most often registered (50.5%), tick-borne encephalitis was observed in 44.8% of cases, mixed infection ― in 4.7%. Borrelia miyamotoi DNA was detected by PCR-RV in 8.6% of biological samples (blood serum, leukocyte fraction). When analyzing the results of oxidative modification of proteins and lipid peroxidation, a reliable picture of oxidative stress is observed, which is more pronounced in patients with ixodic tick-borne borreliosis.

CONCLUSION: The revealed changes in the study of oxidative stress in patients with tick-borne encephalitis and ixodic tick-borne borreliosis not only indicate the prospects of developing new approaches to the pathogenetic therapy of tick-borne infections, providing for the use of antioxidants in complex therapy, but also suggest a greater effectiveness of direct-acting lipophilic antioxidants that limit diene conjugation, and thereby prevent the accumulation of secondary cytotoxic products of lipid peroxidation.

Acute stages of parasitic diseases are rare diagnosed and therefore, clinicians have limited knowledge of their clinical features. We describe five autochtnonous acute cases of opisthorchiasis in Moscow region acquired from eating raw ides (L. idus). The most frequent clinical symptoms were febrile, eosinophilic syndrome with cholestasis. The patients were positive for IgG antibodies to Opisthorchis felineus. Eggs of O. felineus were found in one patient. As egg production O. felineus starts 1 month after exposure and opisthorchiasis cases in Moscow region have low numbers of worms, the sensitivity of microscopy is low. Therefore we consider opisthorchiasis in all patients of unexplained acute fever, pain in upper right abdominal quadrant, and eosinophilia with cholestasis, when patients confirm the ingestion of raw fish. We recommend one day of praziquantel 25 mg/kg TID to patients infected with O. felineus. In previous publications describing the autochtnonous cases of opisthorchiasis in Moscow region the authors supposed that cases of local infection will be found again in Moscow region and this is just a matter of time. The cases reported here confirm that this infection is endemic in Moscow region. The local people living close to rivers especially those who eat raw fish are at risk of infection O. felineus. There is a clear need to undertake special studies pertaining to the ways of promoting people living in Moscow region become aware of opisthorchiasis and to be motivated in preventive measures and treatment.