Vol 28, No 4 (2023)

BACKGROUND: Awareness of dental workers about the epidemiology of blood-borne infections (HIV, hepatitis B virus [HBV], and hepatitis C virus infections) and knowledge about actions to take if accidents occur in the workplace such as contact with blood and other biological fluids are a key link in the prevention of these infections.

AIMS: To assess awareness and adherence of dental personnel to the algorithm of postexposure prophylaxis of occupational infections with blood-borne pathogens.

MATERIALS AND METHODS: This descriptive crosssectional study enrolled the dental staff of public and private dental clinics in Kazan, Russia. A survey of 173 dental staff was conducted in February–March 2023. The rates of incidents caused by contact with blood and their nature among dental staff were determined, and the frequency of correctly performed algorithm of actions during an incident was calculated. The frequency of the implementation of measures for the prevention of occupational infections with blood-borne pathogens was estimated. Categorical data were described as absolute values and proportions (%).

RESULTS: In total, 65 specialists (37.6%) had encountered incidents such as contact with blood at the workplace. These incidents were significantly more common among women than among men: 44.7% (55/123) vs. 20.0% (10/50), respectively (p=0.002). The last incident in 50 respondents was associated with skin damage (needlestick injury or cut exposure); in 17 participants, their mucous membranes were exposed to blood (including two people with a mixed characteristic of incident: skin damage + exposure of their mucous membranes to blood). After contact with blood, local treatment was carried out correctly (according to Russian recommendations) in 18.0% of the participants with skin damage and 70.5% with blood exposure to mucous membranes. After the incident, 58.5% of the participants (38/65) reported to the head of the department or clinic, and a third of the respondents (23/65, 35.4%) recorded a case of contact with blood in the incident log. Nearly all respondents always use gloves (172/173, 99.4%) when they work in the dental office. Moreover, 64.2% of the respondents (111/173) always use safety glasses or screens. Nine respondents (9/173, 5.2%) do not use personal eye protection. Others (53/173, 30.6%) wear safety glasses/screens only when performing certain procedures. In addition, 85.0% (147/173) of the respondents have been vaccinated against HBV, 18 have not been vaccinated (10.4%), and 8 (4.6%) do not know their vaccination status.

CONCLUSIONS: The results of this study present the necessity of raising awareness among dental staff regarding the epidemiology and prevention of blood-borne infections to reduce the risk of occupational infections.

BACKGROUND: Drug resistance to anti-tuberculosis drugs directly affects the disease course. However, a high percentage of multidrug resistance in patients with HIV infection not only worsens the disease course but also forces the development of new strategies for managing such patients.

AIMS: To characterize drug resistance to anti-tuberculosis drugs in patients with HIV infection.

MATERIALS AND METHODS: The study recruited patients with newly diagnosed tuberculosis by molecular genetic research methods and bacterial research methods in the Orenburg Regional Clinical Tuberculosis Dispensary.

RESULTS: For 2018–2022, the proportion of people with HIV infection who are resistant to isoniazid by 14.6%, rifampicin by 28.85%, moxifloxacin by 717.39%, and amikacin by 104.25% has increased. The reduction in the choice of drugs and possibility of effective anti-tuberculosis therapy in people with HIV infection are also complicated by the detection of a multidrug-resistant culture in 20.34% of the examined patients and multidrug resistance in 39.6%. In over 5 years, the percentage of gene mutations of mycobacteria responsible for resistance to anti-tuberculosis drugs has increased.

CONCLUSIONS: The results of this study indicate the need to search for new solutions and prevent resistance to existing anti-tuberculosis drugs and for the development of new drugs effective for use as first- and second-line drugs.

BACKGROUND: Plasmodium falciparum is the most prevalent and pathogenic malaria parasite associated with severe illness and death. In nonendemic countries like the Russian Federation, P. falciparum malaria is a relatively rare but potentially fatal disease found in travelers returning from countries with high malaria burden.

AIMS: This review aimed to analyze the recommendations for managing severe P. falciparum malaria in different World Health Organization (WHO) malaria-endemic regions and considered their adherence to WHO guidelines.

MATERIALS AND METHODS: Countries with the highest number of indigenous P. falciparum malaria cases from four WHO regions were identified, and malaria treatment guidelines were searched using databases.

RESULTS: Intravenous administration of artesunate is the mainstay of treatment for severe P. falciparum malaria. Most guidelines lack a mechanism for referring patients with severe malaria, between different levels of health facilities, and lack specific criteria for intensive care unit admission.

CONCLUSIONS: Mefloquine, artemisinin, combination products containing mefloquine, should be used with caution in cerebral malaria because of neuropsychiatric and cognitive complications. Understanding how guidelines and recommendations for the clinical management of malaria are adopted in different epidemiological settings will help contextualize the value and validity of recommendations for the treatment of severe malaria.

BACKGROUND: Disinfection and sterilization activities are integral parts of the epidemiological safety system in healthcare aimed at preventing healthcare-associated infections. The quality of disinfection and sterilization activities affects healthcare efficiency and the safety of both patients and healthcare professionals. Continuous monitoring of key disinfection and sterilization indicators is an important constituent of a healthcare-associated infection surveillance system implemented in healthcare institutions, organizations, and bodies of Rospotrebnadzor (Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing).

AIM: To analyze data on the disinfection and sterilization activities implemented in healthcare institutions of the Ural and Siberian Federal Districts.

MATERIALS AND METHODS: Based on the information obtained from State Federal Statistical Monitoring form No. 27 “Information on disinfection activities” for 2015–2022 presented by the Rospotrebnadzor offices of the respective Russian Federation constituents, long-term average annual and Russia’s nationwide average figures were compared. The rating of the quality of disinfection and sterilization measures in the healthcare institutions of the Ural and Siberian Federal Districts was analyzed using Statistica 10, and the most significant groups of indicators were selected for analysis.

RESULTS: The resulting rating scores and their long-term annual kinetics suggest that the steadiest quality indicators of the disinfection and sterilization activities were observed in healthcare institutions in the Khakass Republic, Tyumen, and Omsk Oblasts.

CONCLUSIONS: Continuous monitoring of key disinfection and sterilization indicators in healthcare institutions allows the development of task-oriented preventive activities and their adjustment to changes in the epidemiologic situation in the region.

Kaposi’s sarcoma is the most common acquired immunodeficiency syndrome-defining malignancy. With the introduction of highly active antiretroviral therapy into practice, the incidence of Kaposi’s sarcoma has declined significantly. However, cases associated with late diagnosis of HIV infection are still recorded. Herein, we present the clinical case of a patient with HIV infection and generalized Kaposi’s sarcoma with multiple lesions in the skin, mucous membranes, and organs. If the lesions in the skin and mucous membranes did not cause difficulties, distinguishing pulmonary lesions from disseminated tuberculosis and cytomegalovirus infection is difficult. Extremely severe Kaposi’s sarcoma with an unfavorable outcome is caused by severe immunosuppression and, apparently, an inflammatory immune reconstitution syndrome. In autopsy, in addition to the skin and oral mucosal lesions, foci in the epiglottis, larynx, trachea, lungs, colon, duodenum, peribronchial, mesenteric lymph nodes, liver, spleen, and lumbar muscles were noted. Diagnosing internal organ involvement in Kaposi’s sarcoma is not easy and requires the involvement of specialists in various fields.