Vol 16, No 1 (2011)

Nosocomial infections (NIs) are the most important components of problems to assure medical care quality and to create a safe hospital environment. Today there has been a need for revision of the 1999 program document "The nosocomial infections prevention concept" that is determined by the following factors: objective processes of public health care and sanitary epidemiologic service reformation in the country; new research data on the specific features of the epidemiology and epidemic process of NIs in health care facilities (HCFs) of different profile; revaluation of the importance of a biological factor in the formation of health losses in medical personnel; new approaches to organizing and conducting epidemiological surveillance of NIs at the institutional and regional levels; introduction of new medical technologies for the diagnosis and treatment of NIs; development and introduction of new technologies to protect from infections; extensive practical introduction of molecular genetic studies and up-to-date laboratory complexes; considerable changes in the hardware provision of epidemiological diagnosis; realization of many provisions laid down in the early concept: implementation of a mass immunization program; introduction of new indoor air purification technologies, architectural designs in the construction of HCFs, etc. The aim of new concept wording is to define a strategy for the prevention of NIs for the reduction of morbidity, disability, mortality, and economic damage, by developing the theoretical foundations for morbidity control, and to introduce a scientifically sound epidemiological surveillance system and a package of effective organizational, prophylactic, antiepidemic and therapeutic-and-diagnostic measures into practice.

The epizootological situation in listeriosis has been analyzed in the Aktyubinsk Region, Republic of Kazakhstan. About 1% of rodents have been found to be infected with Listeria, which creates a powerful natural reservoir of this infection, with their total number being borne in mind.

The paper provides a rationale for the use of the unique integrated criterion for the integrated assessment of an epidemiological situation and/or human health. The above analysis is exemplified by tuberculosis infection in the Republic of Sakha (Yakutia) over 19 years (1990-2008), by employing four statistical indices: morbidity, sickliness, bacillary capacity, and mortality.

The pheno- and genotypic properties of Vibrio cholerae El Tor cultures identified during monitoring for V. cholerae in the aquatic ecosystems of Rostov-on-Don in the period 2003-2008 were studied in the extended range. In addition to known laboratory diagnostic techniques for cholera, the authors used a volume agglomeration test with antilipase diagnosticum, as well as polymerase chain reaction using specific primers to detect 30 nucleotide sequences of the genes associated with V. cholerae pathogenicity. The range of pheno- and genotypic characteristics of study V. cholerae O1 cultures was extended. There was evidence for the volume agglomeration test with a polymerase antilipase agent as a complementary test for toxicogenicity. The Vibrio cholerae O1 strains isolated from the aquatic environment were shown to confer a real and potential risk in the low cholera incidence area of Rostov-on-Don. The findings may be used to improve methodic approaches to monitoring environmental objects for Vibrio cholerae in the optimization of epidemiological surveillance of cholera at the regional level.

The surveys of the epidemic foci of acute enteric infections and the bacteriological studies of foodstuffs showed a considerable epidemiological role of vegetable salads in the spread of Sonne and Flexner dysenteries, salmonellosis, rotavirus infection, and enteric infection of unknown etiology. Potential risk factors for microbial contamination of vegetable salads were identified in the private enterprises preparing vegetable salads and delivering them to the sales outlets.

The functional state of the thiol-disulfide antioxidant system was evaluated in 45 patients with recurrent herpesvirus infection during the recurrence and inter-recurrence periods. Impaired free radical oxidation in these patients is one of the leading pathogenetic factors for structural and functional alterations in biomembranes. The study of the blood antioxidant system indicated that the patients with herpesvirus infections showed reductions in -SH groups and thiol-disulfide ratio and an increase in the number of -SS groups, which testifies to the predominance of the oxidant system over the antioxidant one.

The aim of the investigation was to study the frequency and magnitude of changes in lipid metabolic parameters in the use of various antiretroviral therapy (ARVT) regimens for 72 weeks in HIV-infected patients initiating the therapy for the first time. Lipid metabolic parameters were analyzed in 146 adult HIV-infected patients. Lipid metabolic disturbances were estimated from the variations in body build and the change in the levels of total cholesterol (TC), triglycerides (TG), high-density lipoproteins (HDL), low-density lipoproteins (LDL), and atherogenicity index (AI), which had been measured before and 24, 48, and 72 weeks after therapy. All the test antiretroviral drugs affect lipid profile just during early treatment. The most common metabolic disturbance was elevated triglycerides when ritonavir-boosted protease inhibitors, lopinavir in particular, were administered. However, in this drug group, AI was minimal (1.29) due to the significantly higher concentration of HDL. Non-nucleotide reverse HIV transcriptase generally failed to affect the level of TC, TG, and LDL, but reduced HDL concentrations, which resulted in a pronounced increase in AI (4.4) following 72 weeks of treatment. The unboosted protease inhibitors atazanavir and nelfinavir were the safest agents in terms of metabolic disturbances. None of the patients developed lipodystrophy 72 weeks after therapy. Thus, it is expedient to determine lipid metabolic parameters and body build before start of therapy and at least every 6 months in all HIV-infected patients in order to prevent lipodystrophy and/or cardiovascular diseases.

The paper reviews different types of the natural foci of tularemia in the South Federal District (SFD). It touches upon the aspects calling for further in-depth study to understand the regularities of their functioning. The synchronization of occurrence of tularemia epizootias in different subjects of SFD and in different types of the foci is associated with solar activity. The highest epizootic activity is observed in the minimum and maximum phases of solar activity.

Evaluation of the antiviral and immunomodulatory activities of a novel human leukocyte interferon formulation (an oral tablet) in patients with influenza could establish its efficacy. When the drug is used, the duration of intoxication and catarrhal syndromes and the frequency of complications reduce and the interferon status recovers in shorter periods. The findings show it possible to incorporate Interferon tablets 4000 IU into combination therapy for patients with influenza.