卷 30, 编号 1 (2025)

BACKGROUND: The causative agent of coronavirus disease (COVID-19) continues to circulate in the population and causes severe cases. A favorable outcome depends on timely assessment of disease severity in the early stages, prompt hospitalization, and appropriate therapeutic adjustments. The complete blood count, performed during initial diagnostics, has proven to be one of the most important tools for assessing disease severity.

AIM: The study aimed to evaluate quantitative and calculated complete blood count parameters depending on disease severity at hospital admission and over time, and to identify predictors of adverse outcomes.

METHODS: A retrospective analysis was conducted of medical records from 122 patients admitted between March and July 2021 to the N. V. Sklifosovsky Research Institute for Emergency Medicine with confirmed COVID-19 (severe course) within 3 days of symptom onset. Based on outcomes, all patients were divided into 2 groups: group 1, survivors; and group 2, deceased. All patients underwent venous blood sampling at admission and on day 7 of hospitalization, with analysis performed using the ADVIA 2120i hematology analyzer. Additionally, the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic inflammation index were calculated. Quantitative and calculated complete blood count parameters were assessed relative to reference values and compared between groups over time. Statistical analysis was performed using SPSS 20.0 and MedCalc 11.5.00.

RESULTS: Compared with group 1, patients in group 2 had higher absolute leukocyte and neutrophil counts and lower lymphocyte and eosinophil counts at all time points. Platelet count showed divergent trend: in group 1, there was a tendency toward an increase by day 7, whereas group 2 demonstrated a consistent decrease. Erythrocyte sedimentation rates were comparable between the groups in the early stages of the disease, but by day 7, a marked increase and a decrease were observed in group 2 and in group 1, respectively. The most informative parameters were the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic inflammation index, which showed statistically significant intergroup differences and were consistently higher in group 2 at all time points.

CONCLUSION: Lymphocyte count and neutrophil-to-lymphocyte ratio are early sensitive bioindicators that reflect disease severity, treatment effectiveness, and prognosis in COVID-19.

BACKGROUND: The dissemination of antibacterial-resistant microorganisms and resistance genes via food products represents a significant threat to global public health.

AIM: The study aimed to conduct epidemiological monitoring of antibiotic-resistant bacteria isolated from food products in the Kyrgyz Republic through the study of their phenotypic and genotypic susceptibility profiles.

METHODS: It was a cross-sectional observational study. Microorganism species identification was performed using MALDI-TOF mass spectrometry. Phenotypic susceptibility to 35 antimicrobial agents was assessed by minimum inhibitory concentration testing. Genes conferring resistance to antimicrobial agents were detected by whole-genome sequencing.

RESULTS: The study subjects were antibiotic-resistant strains of Staphylococcus aureus (n = 16) and Enterococcus faecalis (n = 36) isolated from ready-to-eat food products in the Kyrgyz Republic between 2020 and 2023. The findings indicate a predominance of antibiotic-resistant strains in dairy and meat products as well as in water. The isolates of each species were found to belong to 3 sequence types: S. aureus (ST5, ST15, ST45); E. faecalis (ST21, ST133, ST179). According to the obtained data, all S. aureus isolates carrying the β-lactam resistance gene blaZ were phenotypically resistant to this class of antibiotics. Despite phenotypic resistance to vancomycin, linezolid, and daptomycin observed in 25% of S. aureus isolates, no genetic markers of resistance to these reserve antibiotics were identified. E. faecalis isolates carrying the tetM gene were phenotypically resistant to tetracycline, with the overall proportion of tetracycline-resistant strains reaching 83.3%. A high proportion of E. faecalis carrying the macrolide resistance gene lsaA, accounting for 31.7%, corresponds to the data on the expected phenotypic resistance of this microorganism.

CONCLUSION: The studies conducted in the Kyrgyz Republic confirm the need for monitoring the spread of antimicrobial resistance in pathogens through the food chain.

This review presents current aspects of the epidemiology, diagnosis, and prevention of viral hepatitis B with an emphasis on the laboratory profile of its latent form. Data on infection rates in household clusters across different regions are presented: 30% in the Republic of Uzbekistan and 78% in the Republic of Sakha (Yakutia), confirming the risk of intrafamilial transmission.

Trends in hepatitis B incidence in the Republic of Tatarstan were analyzed in the context of mass vaccination, showing a decline in 2023 compared with 2011.

Data on the prevalence of serologic markers of hepatitis B among blood donors and HIV-positive patients are presented for both the Russian Federation and other countries. According to data from the Federal Medical-Biological Agency for 2015–2019, hepatitis B virus markers were detected in 49.8% ± 8.2% of blood donors in the Russian Federation and in 83% of donors in the Republic of Guinea. Additionally, the frequency of anti-HBcor detection in the absence of HBsAg among donors ranged from 0% (United Kingdom) to 48% (China), and from 6% to 21% in some regions of Russia.

Screening of HIV-positive patients for hepatitis B virus infection revealed a widespread presence of its markers across various regions worldwide. The prevalence ranged from 2.3% to 32.3% in African countries, up to 12% in Colombia, 3.2% in Argentina and 3.8% in Brazil. In the Russian Federation, the prevalence of hepatitis B virus markers among HIV-positive patients was 9.4% in the Republic of Tyva and reached 79.6% in the Northwestern Federal District.

Particular attention is given to the latent form of hepatitis B in HIV-positive patients undergoing antiretroviral therapy, including regimens containing agents active against hepatitis B virus.

Dengue fever is a zoonotic, vector-borne infectious disease caused by four distinct serotypes of the dengue virus (DENV 1–4). This infection has been reported in 128 countries with tropical and subtropical climates. Clinical manifestations range from mild symptoms to dengue hemorrhagic fever and dengue shock syndrome with severe clinical manifestations. Dengue virus infection during pregnancy can lead to various complications affecting both the mother and the fetus. In severe cases of dengue fever in pregnant women, the most common complications include preterm birth and low birth weight. In contrast, infection during early pregnancy is not associated with fetal malformations or long-term consequences, but may result in miscarriage during the first trimester.

This article presents two case reports of dengue fever in pregnant women returning from an endemic region. Both patients had traveled to Thailand and reported insect bites. The disease followed an uncomplicated course and resolved with recovery. Both pregnancies resulted in the delivery of full-term healthy infants.

Today, the legitimacy of tularemia as an independent nosological entity is beyond doubt, as both its causative agent and clinical manifestations are well studied. However, this diagnosis is just over 100 years old. In the late 19th century, practicing physicians began to acknowledge the existence, within the well-known disease of plague, of a more or less distinct form of it (as S.P. Botkin referred to as “plague of mild strength,” pestis ambulans, pestis nostras, peste frustre, etc.), characterized by a relatively mild course and, at the very least, low contagiousness or even a complete absence of human-to-human transmission. The causative agent of this disease was isolated only in 1911 by American researchers G.W. McCoy and C.W. Chapin (the article on this discovery was published in 1912) from California ground squirrels (gophers) during an investigation of a “plague-like disease” in these rodents near Tulare Lake. The microorganism was named Bacterium tularense after the place of its identification. The association of this pathogen with human diseases involving intoxication syndrome and lymphadenopathy was established in 1921 by American physician and researcher E. Francis, who coined the name “tularemia.” In other words, the discovery of tularemia followed the reverse path: not from clinical observation to etiology, but from the pathogen to the clinical features of the disease. In Japan, tularemia was first described in 1924–1925 by H. Ohara under the name Yatobyo (yato meaning wild rabbits and byo meaning disease); by 1925, its identity as tularemia had been confirmed. The diagnosis was first introduced and later widely accepted in the Soviet Union in 1926. Subsequently, cases of tularemia have been reported in nearly all countries (except South America), and in 1947 the pathogen was justifiably renamed to Francisella tularensis.