Vol 27, No 3 (2022)

BACKGROUND: No studies have examined the course and outcomes of coronavirus disease 2019 (COVID-19) in patients with advanced HIV infection, which prompted this analysis.

AIM: To identify predictors of the adverse outcomes of COVID-19 in patients with HIV at the stage of secondary diseases to develop a predictive model of outcomes. This will help simplify the decision-making on the management of patients with COVID-19 and HIV infection at advanced stages.

MATERIALS AND METHODS: This single-center study included 300 patients aged >18 years with HIV infection at advanced disease stage and moderate-to-severe COVID-19 requiring in-patient treatment.

RESULTS: The mortality rate was 27.3% (95% CI, 22.7%–32.4%). Factors reflecting respiratory failure, immunodeficiency, decreased levels of protein and albumin, and increased levels of urea became unfavorable. A predictive model of adverse outcomes of COVID-19 in patients with advanced HIV infection has been obtained.

CONCLUSIONS: The proposed predictive model can help a practical healthcare doctor make a quick, informed decision on hospitalization of a patient in the intensive care unit and active therapeutic actions.

BACKGROUND: Cholera belongs to the group of infections, and the fight against it is regulated by the WHO International Health Regulations (2005). To date, several test systems have been developed for the polymerase chain reaction (PCR) detection of Vibrio cholerae strains. However, no PCR test systems have been registered for detecting V. parahaemolyticus DNA in clinical material in Russia.

AIM: To conduct clinical trials and evaluate the performance of the “Reagent kit for identification of V. cholerae and V. parahaemolyticus by multilocus allele-specific PCR” (kit of reagents “Vibrio-screen FL”) for the state registration of the specified medical device.

MATERIALS AND METHODS: The study presents the results of the clinical trials for the reagent kit “Vibrio-screen FL” that has been developed to optimize the means and methods of identification and differentiation of pathogens of dangerous infections based on data on the diversity of genomes. Clinical trials were conducted at the Head Center of Hygiene and Epidemiology of the FMBA of Russia (license from 02.12.2013 No. ФС-99-01-008342; permission of the Ministry of Health from 16.05.2013 No. 300n) in accordance with the program of clinical trials No. 20.ПМКИ-042/10.20 from 23.09.2020 (Clinical Trial Certificate No. 01.AK-042/10.20 dated 12.10.2020). The clinical trials of the developed reagent kit “Vibrio-screen FL” used clinical strains of microorganisms of the genus Vibrio and other microorganism species as target analytes. Bacteriological method and multilocus PCR with hybridization-fluorescence detection were used.

RESULTS: The reagent kit “Vibrio-screen FL” is a medical device for professional use in clinical laboratory diagnostics. The analytical sensitivity of the reagent kit “Vibrio-screen FL” was at least 10⁶ copies of the SecY gene when determining belonging to the genus Vibrio; to the species V. cholerae, at least 10⁶ copies of the hlyA gene; and to the species V. parahaemolyticus, at least 10⁶ copies of the vppC gene. When determining the analytical specificity, no non-specific reactions with DNA samples of other microorganism species were found. A medical device for in vitro diagnostics “A reagent kit for the identification of V. cholerae and V. parahaemolyticus by multilocus allele-specific PCR (Vibrio-screen FL)” meets the requirements of the intended use, which allows it to be used for the differentiation of V. cholerae and V. parahaemolyticus strains isolated from a cultured clinical samples by multilocus allele-specific polymerase chain reaction with hybridization-fluorescent detection. The registration certificate No. РЗН 2021/13360 from 08.02.2021 was received. By the order of Roszdravnadzordated 08.02.2021 No. 1041, a reagent kit Vibrio-screen FL by the Rostov-on-Don Anti-Plague Institute of Rospotrebnadzor was admitted to distribution on the territory of the Russian Federation.

CONCLUSIONS: The reagent kit “Vibrio-screen FL” is a high-quality, effective, and safe diagnostic medical device for in vitro diagnostics with sufficient diagnostic sensitivity and specificity to identify specific fragments of Vibrio spp., V. cholerae, and V. parahaemolyticus nucleic acids. These allows it to be used in clinical laboratory diagnostics for epidemiological analysis and registration of diseases caused by pathogenic vibrions.

BACKGROUND: The spread of microbial resistance to antibiotics is a recent global problem, which has become more acute in recent years because of a significant increase in the consumption of antibiotics, against the background of the COVID-19 pandemic. A direct consequence of the spread of antibiotic-insensitive strains of pneumococci limits the treatment options for such patients and deterioration of the prognosis.

AIM: To determine whether sex is a factor associated with the development of diseases caused by antibiotic-resistant strains of Streptococcus pneumoniae.

MATERIALS AND METHODS: Using the electronic databases PubMed, ScienceDirect, and Google Scholar, a search was conducted for articles published from January 1980 to December 2020, and studies in English and Russian were selected. The selection of articles and meta-analysis was based on the recommendations of the PRISMA Group and MOOSE. After combining the data, the odds ratio (OR) was calculated with a 95% confidence interval (95% CI). Heterogeneity was assessed.

RESULTS: After applying the exclusion criteria, 41 publications covering 16635 patients with invasive and non-invasive forms of pneumococcal infection were selected for analysis. Of these, 36 case-control studies and 5 cross-sectional studies were identified. Accordingly, the sex of the patient does not affect the frequency of isolation of pneumococcal strains insensitive to penicillin (odds ratio [OR]=0.92, 95% confidence interval [CI] 0.82–1.03, I²=7%), resistant to penicillin (OR=0.85, 95% CI 0.67–1.07, I²=1%), and insensitive to erythromycin (OR=0.80, 95% CI 0.51–1.24, I²=0%). Male sex is associated with pneumococcal resistance to levofloxacin (OR=1.85, 95% CI 1.03–3.33, I²=0%).

CONCLUSIONS: The sex of the patient is not a factor associated with the isolation of S. pneumonia strains insensitive and resistant to penicillin and erythromycin. Moreover, the male sex probably increases the chance of isolation of levofloxacin-resistant pneumococci in adults with invasive pneumococcal infections.

The study outlines the principles of functioning of a universal adaptive legal model of socially useful behavior of a person during epidemics (pandemics). The study explore the legal and doctrinal sources, materials of meetings (congresses) of authorities, members of the public, related to the field of countering the development of epidemics, published during the existence of the USSR (1922–1991) and in modern Russia. The construction of a universal legal model of socially useful behavior of an individual should be organized based on the conditions that contribute to ensuring the individual’s compliance with formal requirements (empirical perception of risk, degree of trust in formal rules, and presence and strength of the influence of factors-obstacles). The following principles of functioning of the desired model were proposed: (1) the principle of a single source of origin, non-contradiction and factual validity of the application of special rules of conduct when threatened with the spread of dangerous diseases, (2) the principle of scientific validity of additional restrictions, prohibitions, and obligations, (3) the principle of systematic preventive work, and (4) the principle of rational planning for the preparation and use of human and material resources of public organizations of volunteers to prevent epidemiological emergencies.