Vol 27, No 1 (2022)

BACKGROUND: Many researchers have reported numerous predictors of severe COVID-19 and poor prognosis. However, to make a quick decision, the doctor needs to have a certain set of data that he can use in routine practice to predict the outcome in patients with this disease.

AIMS: This study aimed to develop and describe a predictive model for determining an unfavorable outcome in COVID-19 patients based on age, objective, laboratory and instrumental data, and comorbid pathology.

MATERIALS AND METHODS: The study included 447 patients with a laboratory-confirmed diagnosis of COVID-19 who underwent inpatient treatment in the period from March 2020 to January 2021. Discriminant analysis was used with cross-validation to build a predictive model.

RESULTS: Based on discriminant analysis, a predictive model was developed to predict the outcome in patients with COVID-19. Evaluation of clinical findings, such as respiratory rate, heart rate, SpO2, laboratory data, and computed tomography results on admission to the hospital, showed their significance as predictors of poor outcome. The discrimination constant was 0.4435. The sensitivity of the model is 96.4%, and the specificity is 90.4%.

CONCLUSION: The developed model will help medical institutions predict the outcome of the disease when a patient is admitted to the hospital and, on this basis, optimize and prioritize the provision of necessary medical care.

BACKGROUND: Vibrio cholerae can exist in planktonic and biofilm forms. There are no unified methods for recording the formation of a biofilm and the quantitative determination of microorganisms; the known methods are laborious and do not allow an objective assessment of the concentration of V. cholerae in biofilms.

AIM: This study aimed to evaluate the method for the quantitative determination of V. cholerae in biofilm and planktonic forms based on real-time PCR.

MATERIALS AND METHODS: The concentration of V. cholerae in plankton was determined by the bacteriological method based on the number of colony-forming units per 1 ml; in biofilms, the method of imprint depletion on agar plates was used. Real-time PCR was performed using the primers and probes described in the literature for detecting the hlyA and ctx genes. V. cholerae were quantified using built-in software and standard preparations with a known concentration of bacterial cells. The results were processed in Microsoft Office Excel 2016 spreadsheets using the decimal logarithm; statistical analysis was performed using the Statistica 13.3 program.

RESULTS: During the observation period, the concentration of V. cholerae in biofilms on chitin and plastic increases as the incubation period increases. The amount of V. cholerae in the composition of biofilms and plankton on/above chitin exceeded those when used as a plastic substrate. On the 30th day, the difference was two or more orders of magnitude. The results of the two methods were reproducible and comparable; at the same stages, the concentration of V. cholerae varied within the same order of magnitude, which indicated the reliability of the PCR-RT results.

CONCLUSION: The bacteriological method is informative in the qualitative assessment of biofilms, in determining the viability of cholera vibrios. However, due to its complexity, with the impossibility of quickly determining the concentration of V. cholerae in a biofilm on chitin, it is preferable to use real-time PCR, which allows you to assess the concentration of V. cholerae in plankton and biofilm accurately and quickly.

Prevention of infections associated with the provision of medical care, there is a set of measures for epidemiological and microbiological monitoring, disinfection, and sterilization procedures in medical organizations, which allows you to monitor the circulation of microorganisms and determine markers of resistance to antimicrobial drugs and disinfectants used.

The article presents an analysis of data on the organization of disinfection and sterilization measures in medical organizations of the Ural and Siberian Federal districts based on data from the Federal Statistical Observation Form No. 27 “Information on disinfection activities” for 2021. A number of indicators are presented in dynamics over 7 years and compared with indicators of the Russian Federation. Statistical data for 2015–2021 were provided by the Departments of Rospotrebnadzor for Irkutsk, Kemerovo, Kurgan, Novosibirsk, Omsk, Sverdlovsk, Tomsk, Tyumen, Chelyabinsk regions; Altai, Transbaikal, Krasnoyarsk Territory; the republics of Altai, Buryatia, Tyva, Khakassia; Khanty-Mansi Autonomous Okrug–Yugra, and Yamalo-Nenets Autonomous Okrug. Data for the Russian Federation were provided by the Federal Center for Hygiene and Epidemiology of Rospotrebnadzor as part of the implementation of the functionality of the Ural-Siberian Scientific and Methodological Center for the Prevention of Infections Associated with the provision of medical Care.

Information provided in the article is intended for employees of Rospotrebnadzor bodies and organizations, medical organizations, educational organizations, executive authorities in the field of healthcare, and other interested persons.

The Ebola epidemic, the spread of HIV infection, the COVID-19 pandemic, climate warming, the activation of natural foci of dangerous infections, the destabilization of the situation in the world, and the threat of bioterrorism are the realities of today. Threats to biological safety are caused by the activation in the last decade of a number of biological risks, such as an increase in the probability of importation into the territory of the Russian Federation of rare or previously unknown infections, in particular polio caused by “wild” poliovirus, malaria, cholera, tuberculosis, and so forth; activation of natural foci of dangerous and especially dangerous infections; the spread of infections associated with the provision of medical care; the possibility of accidents or sabotage at facilities where work is carried out with pathogenic microorganisms, biological terrorism in all its manifestations.

Increasing the readiness of medical organizations to counter biological threats is one of the priorities for improving the biological security system of the country. The readiness of medical organizations is based on timely and effective sanitary and anti-epidemic (preventive) measures to prevent the introduction and spread of infectious diseases, including those capable of causing sanitary and epidemiological emergencies, and ensuring the safety of the population living in the adjacent territory.

This article is devoted to the issues of readiness of medical organizations to carry out measures in an emergency situation of a sanitary-epidemiological (biological) nature. Special attention is paid to the algorithm of actions of a medical worker in identifying a patient with cholera and smallpox monkeys.