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Development of an INDEL typing system for ctx+ strains of Vibrio cholerae from the seventh pandemic 为第七次霍乱弧菌大流行中的ctx+菌株开发INDEL分型系统
Pub Date : 2024-07-19 DOI: 10.17816/eid631523
S. Vodopyanov
A bioinformatic analysis of 2105 full-genome sequences of toxigenic ctxAB+tcpA+ strains of Vibrio cholerae O1 El Tor from open databases was carried out in order to search for INDEL loci for molecular typing. Based on the convenience criterion for allele size identification, eight INDEL loci were selected. Three loci have been described previously, and five were identified as a result of this work. The designed primers formed amplicons ranging in size from 67 to 390 base pairs, which made it possible to confidently identify them during gel electrophoresis. The distribution of alleles formed 11 unique INDEL clusters, which we designated A-K. Based on the number of strains within the clusters, three types of clusters were identified: major (A, B and C) made up 89% of the total number of sequences studied, intermediate (D, E, F, G and H) 10.5% of the genomes. Three minor clusters ̶ I, J and K were represented by single strains. Four clusters united strains isolated in the 20th century (A - 1941, F - 1957, G - 1993, E - 1999, respectively), and seven clusters - in the 21st century in the period from 2003 to 2016. In the period from 2019 to 2023, representatives of INDEL clusters were active: A, B, D and E. The study of the timing of circulation suggested that representatives of different clusters have different epidemic significance, which was manifested in the absence of isolation of strains of some clusters in recent years. A comparative study of INDEL typing with SNP typing in the in silico analysis of 378 genomes of strains isolated on the African continent indicates that the proposed INDEL typing method is not inferior to SNP typing in terms of resolution.
对开放数据库中 2105 株致病性 ctxAB+tcpA+ 霍乱弧菌 O1 El Tor 的全基因组序列进行了生物信息学分析,以寻找用于分子分型的 INDEL 位点。根据等位基因大小鉴定的便利性标准,选出了八个 INDEL 位点。其中三个基因位点之前已有描述,另外五个基因位点是本次研究的成果。设计的引物形成的扩增子大小从 67 个碱基对到 390 个碱基对不等,因此可以在凝胶电泳中确定它们。等位基因的分布形成了 11 个独特的 INDEL 簇,我们将其命名为 A-K。根据簇内菌株的数量,确定了三种类型的簇:主要簇(A、B 和 C)占所研究序列总数的 89%,中间簇(D、E、F、G 和 H)占基因组的 10.5%。I、J 和 K 三个小群由单一菌株代表。四个集群联合了 20 世纪分离的菌株(分别为 A - 1941、F - 1957、G - 1993、E - 1999),七个集群联合了 21 世纪 2003 至 2016 年分离的菌株。在 2019 年至 2023 年期间,INDEL 群的代表处于活跃状态:对流行时间的研究表明,不同群组的代表具有不同的流行意义,这表现在近年来一些群组的菌株未被分离出来。在对非洲大陆分离的 378 个菌株基因组进行硅分析时,对 INDEL 分型和 SNP 分型进行了比较研究,结果表明,拟议的 INDEL 分型方法在分辨率方面并不逊色于 SNP 分型。
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引用次数: 0
Severe course of leptospirosis (clinical case) 钩端螺旋体病的严重病程(临床病例)
Pub Date : 2024-04-22 DOI: 10.17816/eid627890
D. Efremov, Ainur R. Khuramshin, Vladimir B. Beloborodov
The article describes a clinical case of severe leptospirosis. Patient K., was admitted to the neurosurgical department on 26.11.2023 with a diagnosis of «Closed craniocerebral injury dated 22.11.2023. Severe brain injury. Linear fracture of the occipital bone. Eyelid hematoma. An abrasion of the upper eyelid on the right». On 29.11.2023, an objective examination drew attention to an increase in body temperature to 39.50 C, subictericity of the sclera and skin, conjunctival injections. There is a hemorrhagic rash on the skin of the trunk and limbs. Hemodynamics is unstable, episodes of arterial hypotension. Laboratory examination revealed mild anemia, signs of hepatic-renal insufficiency, hyperbilirubinemia, increased concentrations of creatine phosphokinase, C-reactive protein, procalcitonin. Hepatic-renal insufficiency increased in dynamics, the level of creatine phosphokinase and procalcitonin increased. Additionally, the differential diagnostic search was aimed at identifying infectious diseases: hemorrhagic fever with renal syndrome, leptospirosis, malaria, viral hepatitis. Immunoglobulins of class M to Leptospira interrogans were detected (11.12.2023). The patient received antibacterial therapy, extracorporeal detoxification operations, artificial ventilation, infusion therapy, correction of the hemostasis system were performed in parallel. Against the background of complex treatment, the patient's condition was stabilized, and the patient was discharged from the hospital on 61 days with restoration of health.
本文描述了一例严重钩端螺旋体病的临床病例。患者 K 于 2023 年 11 月 26 日入住神经外科,诊断为 "2023 年 11 月 22 日闭合性颅脑损伤。严重颅脑损伤。枕骨线性骨折。眼睑血肿。右上眼睑擦伤"。2023 年 11 月 29 日,客观检查显示体温升高至 39.50 摄氏度,巩膜和皮肤变薄,结膜注射。躯干和四肢皮肤上有出血性皮疹。血流动力学不稳定,出现动脉低血压。实验室检查发现轻度贫血、肝肾功能不全症状、高胆红素血症、肌酸磷酸激酶、C 反应蛋白、降钙素原浓度升高。肝肾功能不全的动态变化增加,肌酸磷酸激酶和降钙素原水平升高。此外,鉴别诊断的目的是确定传染病:出血热伴肾综合征、钩端螺旋体病、疟疾、病毒性肝炎。检测到了针对钩端螺旋体的 M 类免疫球蛋白(11.12.2023)。患者同时接受了抗菌治疗、体外排毒手术、人工通气、输液治疗、止血系统矫正等治疗。在复杂的治疗背景下,患者的病情趋于稳定,61 天后康复出院。
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引用次数: 0
Manifestation of epidemic process, clinical and epidemiological characteristics of adult patients in the early period of the COVID-19 epidemic in Russia 俄罗斯 COVID-19 流行病早期流行过程的表现、成年患者的临床和流行病学特征
Pub Date : 2024-04-18 DOI: 10.17816/eid628868
A. Fomicheva, Nikolay N. Pimenov, Svetlana V. Komarova, A. Urtikov, Artur R. Sakhautdinov, D. Strelkova, G. Nekludova, S. Rachina, S. N. Avdeev, V.P. Chulanov
Aims: to study the epidemic process, clinical and epidemiological features of adult patients with COVID-19 identified during the first and second periods of the rise and decline in the incidence of new coronavirus infection in Russia. Materials and methods: this study included patients aged ≥18 years with a confirmed diagnosis of COVID-19, identified in the periods from 03/02/2020 to 30/06/2020 (n=286 205) and from 11/01/2020 to 01/31/2021 (n=1 655 022) in Russia. Results: at the early stage of the COVID-19 epidemic in Russia, there were defined 2 periods of rise and fall in incidence: March - August 2020 and September 2020 - May 2021. The median age of patients with COVID-19 in the first period was 50.0 [37- 62] years, in the second – 52.0 [39-64] years. The share of females was 55.5% and 60.1%, respectively. The distribution of patients in the first and second periods was: mild - 63.0% and 74.4%, moderate - 29.0% and 20.1%, severe - 4.9% and 3.5%, extremely severe – 3.1% and 2.1%, respectively. In the first period, the structure of cases was dominated by people in the age group 50-59 years (20.5%), in the second - 60-69 years old (20.5%). The median duration of the period from the onset of symptoms to diagnosis was 4 days in both periods, of the disease was 16.0 [12-21] and 13 [10-17], of hospitalization was 15.0 [12-20] and 13.0 [10-18]. The rate of hospitalizations was 48.4% and 25.6% in the first and second periods, rate of transfers to the ICU - 7.8% and 10.3%, IMV - 5.6% and 7.7%, respectively. In both periods, the median age of the deceased was 73 [66-82] years, with a higher proportion of men in all age groups except 18-29 and 70+ years. One or more chronic diseases, male gender increased the likelihood of death (OR=10.2 and OR=1.3 in the first period; OR=16.0 and OR=1.6 in the second, respectively). Conclusions: in the early period of the COVID-19 epidemic in Russia, related to the spread of the “wild” strain of SARS-COV-2 and genetically closely related lines, differences in the manifestations of the epidemic process and clinical and epidemiological characteristics of patients were revealed. In the second period there was a decrease in the frequency of the heavy and extremely severe COVID-19, a decrease in the frequency and duration of hospitalizations, but a slight increase in the frequency of ICU and IMV was noted.
目的:研究俄罗斯新型冠状病毒感染发病率上升和下降的第一和第二个时期发现的COVID-19成年患者的流行过程、临床和流行病学特征。材料和方法:本研究包括俄罗斯在 2020 年 2 月 3 日至 2020 年 6 月 30 日(n=286 205)和 2020 年 1 月 11 日至 2021 年 1 月 31 日(n=1 655 022)期间确诊的年龄≥18 岁的 COVID-19 患者。结果:在俄罗斯 COVID-19 流行的早期阶段,确定了两个发病率上升和下降的时期:2020年3月至8月和2020年9月至2021年5月。第一阶段 COVID-19 患者的中位年龄为 50.0 [37-62] 岁,第二阶段为 52.0 [39-64] 岁。女性比例分别为 55.5%和 60.1%。第一和第二阶段患者的分布情况分别为:轻度--63.0%和 74.4%,中度--29.0%和 20.1%,重度--4.9%和 3.5%,极重度--3.1%和 2.1%。在第一阶段,病例主要集中在 50-59 岁年龄段(20.5%),第二阶段则集中在 60-69 岁年龄段(20.5%)。在这两个时期,从出现症状到确诊的中位持续时间为 4 天,发病时间分别为 16.0 [12-21] 和 13 [10-17],住院时间分别为 15.0 [12-20] 和 13.0 [10-18]。第一和第二阶段的住院率分别为 48.4% 和 25.6%,转入重症监护室的比例分别为 7.8% 和 10.3%,IMV 分别为 5.6% 和 7.7%。在这两个时期,死者的年龄中位数均为 73 [66-82] 岁,除 18-29 岁和 70 岁以上外,其他年龄组的男性比例均较高。一种或多种慢性疾病、男性性别增加了死亡的可能性(第一阶段 OR=10.2 和 OR=1.3;第二阶段 OR=16.0 和 OR=1.6)。结论:在 COVID-19 在俄罗斯流行的早期阶段,与 SARS-COV-2 的 "野生 "菌株和遗传上密切相关的菌株的传播有关,流行过程的表现形式和患者的临床和流行病学特征存在差异。在第二阶段,COVID-19 重症和极重症的发病率有所下降,住院治疗的频率和时间也有所减少,但 ICU 和 IMV 的发病率略有上升。
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引用次数: 0
Dynamics of Streptococcus pneumoniae serotype structure in children for the period 2016-2022 2016-2022 年间儿童肺炎链球菌血清型结构的动态变化
Pub Date : 2024-04-16 DOI: 10.17816/eid627518
I. Protasova, I. Feldblium, N. V. Bakhareva, Ludmila Vasilevna Zinovieva, S. Sidorenko
Background. The need for microbiological monitoring of the distribution of pneumococcal serotypes is associated with changes that occur during routine immunization of children with pneumococcal vaccines. Aim. To characterize the changes in the serotype structure of S. pneumoniae obtained from healthy preschool children from 2016 to 2022. Materials and methods. Nasopharyngeal isolates of pneumococcus (n=265) were obtained from 1250 healthy children under 6 years of age attending kindergartens. Serotype structure of S. pneumoniae was performed using PCR. Results. During 2016-2018, the prevalence of pneumococcal carriage was decreased from 27.3% to 17.3%, and by 2022 it was increased again to 25.6%. At the same time, the correspondence of S. pneumoniae serotypes to the antigenic composition of the 13-valent pneumococcal vaccine was decreased from 48.8% to 9.4%, and to the composition of the 20-valent vaccine – from 75.6% to 39.1%. The proportion of “non-vaccine” types of pneumococcus, accordingly, increased from 22% in 2016 to 61% in 2022. Among the “non-vaccine” serotypes/groups, 15AF, 6CD, 23A and 35F/47F were predominated, and new variants were also discovered: 23B and 35B. The serotypes included in the 13-valent conjugate vaccine were detected, as a rule, among unvaccinated children and were represented by variants 19F, 6A and 6B, 23F. Throughout the observation period, pneumococci of serotypes/groups 15BC, 11AD and 10A were detected with high frequency. Conclusions. During 2016-2022, due to the elimination of a significant part of the “vaccine” S. pneumoniae serotypes, there was a significant decrease in the compliance of circulating pathogen variants with the antigenic composition of the used conjugate vaccines. At the same time, new types that are detected with high frequency are not included in existing pneumococcal vaccines which necessitates the creation of new immunobiological drugs.
背景。在儿童接种肺炎球菌疫苗的常规免疫过程中,肺炎球菌血清型的分布会发生变化,因此需要对其进行微生物监测。目的描述 2016 年至 2022 年期间从健康学龄前儿童身上获得的肺炎球菌血清型结构的变化。材料与方法。从 1250 名就读于幼儿园的 6 岁以下健康儿童中获得肺炎球菌鼻咽分离株(n=265)。采用 PCR 技术对肺炎球菌进行血清型结构分析。结果显示2016-2018年期间,肺炎球菌携带率从27.3%降至17.3%,到2022年又增至25.6%。同时,肺炎球菌血清型与 13 价肺炎球菌疫苗抗原成分的对应关系从 48.8% 降至 9.4%,与 20 价疫苗成分的对应关系从 75.6% 降至 39.1%。因此,"非疫苗 "类型肺炎球菌的比例从 2016 年的 22% 增加到 2022 年的 61%。在 "非疫苗 "血清型/群中,15AF、6CD、23A 和 35F/47F 占主导地位,同时还发现了新的变种:23B 和 35B。在未接种疫苗的儿童中,通常会检测到 13 价结合疫苗所含的血清型,其代表是 19F、6A 和 6B、23F 等变种。在整个观察期间,15BC、11AD 和 10A 血清型/群的肺炎球菌检出率较高。结论。在 2016-2022 年期间,由于大部分 "疫苗 "肺炎球菌血清型被淘汰,循环病原体变种与所用结合疫苗抗原成分的符合性显著下降。同时,在现有的肺炎球菌疫苗中并不包括高频率检测到的新类型,这就需要创造新的免疫生物学药物。
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引用次数: 0
CLINICAL CASES OF LEGIONELLIosis IN THE KRASNODAR REGION DURING THE NEW CORONAVIRUS INFECTION COVID-19 PANDEMIC, DIFFICULTIES IN DIAGNOSIS 克拉斯诺达尔地区在新柯洛纳韦病毒感染 COVID-19 潘病期间发生的结节病临床病例,诊断困难
Pub Date : 2024-04-09 DOI: 10.17816/eid627123
M. Avdeeva, Lyudmila P. Blazhnyaya, D. Moshkova, M. I. Kulbuzheva, Ilina Savitskaya, Angelina Podsadnyaya, Natalya Kirilenko, Elena Yakovchuk, Oksana Chernyavskaya, Polina Mamonova
The high incidence of community-acquired pneumonia against the backdrop of continued registration of COVID-19 requires early differential diagnosis, due to different patient management tactics. Among community-acquired pneumonias, legionella diseases deserve special attention. The difficulty of clinical diagnosis of legionellosis during the COVID-19 pandemic leads to untimely prescription of specific antibacterial therapy, which worsens the prognosis of the outcome of the disease. The work provides clinical examples that draw the attention of specialists to the features of clinical, laboratory and radiological manifestations of legionellosis, as well as the important role of epidemiological data for the differential diagnosis of legionellosis from the new coronavirus infection COVID-19.
在 COVID-19 持续注册的背景下,社区获得性肺炎的发病率居高不下,这就需要尽早进行鉴别诊断,因为患者的管理策略各不相同。在社区获得性肺炎中,军团菌病值得特别关注。在 COVID-19 大流行期间,军团菌病的临床诊断困难重重,导致无法及时处方特异性抗菌治疗,从而恶化了疾病的预后。该著作提供的临床实例提请专家注意军团菌病的临床、实验室和放射学表现特征,以及流行病学数据在军团菌病与新型冠状病毒感染 COVID-19 的鉴别诊断中的重要作用。
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引用次数: 0
Fibrosing cholestatic hepatitis as a variant of the course of hepatotropic viruses’ infection 纤维性胆汁淤积性肝炎是致肝病毒感染过程中的一种变体
Pub Date : 2024-04-09 DOI: 10.17816/eid627312
V. Syutkin, V. Chulanov
Fibrosing cholestatic hepatitis (FCH) is a special variant of the history of infectious hepatitis, with a rapid progressive deterioration of liver function; usually develops in immunosuppression; it has also been reported in immunocompetent patients with viral hepatitis B and C. The diagnosis of FCH is based on histological examination of liver tissue, which reveals the predominance of damage to hepatocytes with their pronounced ballooning over a weak inflammatory reaction, pericellular and perisinusoidal fibrosis, and also intracellular and tubular cholestasis. Analysis of the literature confirms the authors' assumption that pathological changes in the liver, described as FCH, can develop in different conditions under the influence of various infectious agents. Despite the availability of effective antiviral therapy for hepatitis B and C, the outcomes of FCH are often unfavorable, especially in cases not associated with solid organ transplantation. Currently, due to the emergence of a large number of drugs that selectively act on the immune system, the development of new areas of medicine in hematology, rheumatology, oncology, transplantology, and infectious diseases, doctors in these specialties are increasingly faced with unexpectedly severe forms of liver damage on specific therapy. The authors believe that there is an underestimation by doctors who do not work at Liver Transplantation Centers of the possibility of developing FCH in patients with viral hepatitis B and C, both in the clinic of infectious and internal diseases.
纤维化性胆汁淤积性肝炎(FCH)是传染性肝炎病史的一种特殊变异,肝功能迅速进行性恶化;通常在免疫抑制情况下发病;也有报道称免疫功能正常的乙型和丙型病毒性肝炎患者也会发生 FCH。FCH 的诊断依据是肝组织的组织学检查,检查结果显示肝细胞主要受损,在微弱的炎症反应、细胞周围和窦周纤维化以及细胞内和肾小管胆汁淤积的基础上,肝细胞明显膨胀。文献分析证实了作者的假设,即在各种感染病原体的影响下,肝脏会在不同条件下发生病理变化,即 FCH。尽管对乙型肝炎和丙型肝炎有有效的抗病毒疗法,但 FCH 的治疗结果往往并不理想,尤其是与实体器官移植无关的病例。目前,由于出现了大量选择性作用于免疫系统的药物,以及血液学、风湿病学、肿瘤学、移植学和传染病学等新医学领域的发展,这些专业的医生在接受特定治疗时越来越多地面临意想不到的严重肝损伤。作者认为,不在肝移植中心工作的医生低估了乙型和丙型病毒性肝炎患者发生 FCH 的可能性,无论是在传染病诊所还是在内科疾病诊所都是如此。
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引用次数: 0
In vitro study of the bactericidal activity for new derivatives of quaternary ammonium salts based on pyridoxine against gram-positive/gram-negative bacteria 基于吡哆醇的季铵盐新衍生物对革兰氏阳性/阴性细菌的体外杀菌活性研究
Pub Date : 2024-04-08 DOI: 10.17816/eid624847
M. Agafonova, Elizaveta D. Kobylinskaia, E. S. Bulatova, Alina S. Biktimirova, S. Sapozhnikov, N. Shtyrlin, Y. Shtyrlin
Background: preventive care and successful treatment of infectious diseases (including hospital-acquired infections) are among the most important tasks of modern healthcare. There are not many effective antiseptics and disinfectants to solve this problem. Quaternary ammonium salts are currently one of the promising classes of disinfectants but their use is limited by the ability of microorganisms to develop resistance to these compounds. Modification of QAS with substituents of various natures is a possible way to solve this problem. Aims: in this work a bactericidal activity comparative analysis for two original quaternary ammonium compounds based on pyridoxine was carried out in comparison with benzalkonium chloride. Materials and methods: the bactericidal activity of 0.1% and 0.2% aqueous solutions of original QACs based on pyridoxine were studied against two widespread pathogens: S. aureus and E. coli. Antibacterial activity data were obtained using a standard in vitro test (bactericidal activity test on a metal surface, exposure time 1, 5 and 15 minutes). In addition to standard conditions, antibacterial efficacy was also studied under protein loading conditions (adding BSA solution to the surface). Results: for the studied compounds the RF (reduction factor - reduction lgCFU of microorganisms) was on average ≥ 3. Complicating the model conditions in the form of protein load led to a decrease in efficiency by 1-3 orders. We have also observed an interesting effect of exposure time-dependent specificity reversal to the S. aureus and E. coli. Conclusions: The obtained results showed high activity of the studied compounds (corresponding to the effectiveness criterion RF≥3 for commercial compounds used in this field).
背景:预防和成功治疗传染病(包括医院感染)是现代医疗保健最重要的任务之一。要解决这一问题,有效的防腐剂和消毒剂并不多。季铵盐是目前最有前途的消毒剂之一,但由于微生物对这些化合物产生抗药性,其使用受到了限制。用不同性质的取代基修饰季铵盐是解决这一问题的可行方法。目的:本研究对两种基于吡哆醇的原始季铵盐化合物与苯扎氯铵进行了杀菌活性比较分析。材料和方法:研究了 0.1%和 0.2%基于吡哆醇的原始季铵化合物水溶液对两种常见病原体的杀菌活性:金黄色葡萄球菌和大肠杆菌。抗菌活性数据是通过标准体外测试(金属表面杀菌活性测试,接触时间为 1、5 和 15 分钟)获得的。除标准条件外,还在蛋白质负载条件下(在表面上添加 BSA 溶液)研究了抗菌功效。结果:对于所研究的化合物,RF(减少因子-微生物的减少量 lgCFU)平均≥ 3。以蛋白质负荷的形式使模型条件复杂化会导致效率降低 1-3 个数量级。我们还观察到一个有趣的现象,即金黄色葡萄球菌和大肠杆菌的特异性逆转与暴露时间有关。结论:研究结果表明,所研究的化合物具有很高的活性(与该领域使用的商用化合物的有效性标准 RF≥3 相对应)。
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引用次数: 0
INVESTIGATION OF A FOCUS OF BRUCELLOSIS AMONG ANIMALS AND PEOPLE IN THE REPUBLIC OF TATARSTAN 鞑靼斯坦共和国人畜布鲁氏菌病病灶调查
Pub Date : 2024-04-08 DOI: 10.17816/eid626812
Olga Nazarova
Over the past 3 years, the Russian Federation has seen an increase in the incidence of newly diagnosed brucellosis. The problem of brucellosis remains important in regions with developed livestock farming; however, cases of diseases in animals and humans can also be recorded in other regions of the country. The article describes an outbreak of brucellosis in a peasant farm in the Novosheshminsky municipal district of the Republic of Tatarstan, affecting 148 heads of cattle and 4 farm employees. The disease was caused by Brucella abortus. An analysis of maps of the epizootic and epidemiological survey of the outbreak, acts on the sanitary and epidemiological survey, and sanitary and hygienic characteristics of the working conditions of workers was carried out. Data from the case histories of 4 peasant farm workers with brucellosis are also presented. The most likely cause of the epizootic was the unauthorized import of cattle, and human diseases were caused by non-compliance with working conditions and personal protective measures for farm workers. Conclusion: Cases of brucellosis in our days are more often recorded in endemic areas. However, with defects in veterinary and sanitary control in any territory, epizootics are possible, which pose a serious danger both in terms of the damage they cause to the national economy and the possible infection of people, primarily belonging to professional risk groups. The disease does not have pathognomonic symptoms and can be suspected only if doctors are alert, evaluate the results of preliminary and periodic medical examinations with laboratory examinations of “at-risk” populations, and subject to a thorough collection of epidemiological history.
在过去三年中,俄罗斯联邦新诊断出的布鲁氏菌病发病率有所上升。在畜牧业发达的地区,布鲁氏菌病仍然是一个重要问题;但在国内其他地区,也有动物和人类发病的记录。 文章描述了鞑靼斯坦共和国新谢什明斯基市地区一个农民农场爆发的布鲁氏菌病,148 头牛和 4 名农场员工染病。该病由流产布鲁氏菌引起。对疫情流行和流行病学调查图、卫生和流行病学调查行为以及工人工作条件的卫生和健康特征进行了分析。此外,还提供了 4 名患有布鲁氏菌病的农场工人的病史数据。 这次流行病最有可能的原因是未经许可进口牛只,而人类疾病则是由于农场工人不遵守工作条件和个人防护措施造成的。 结论目前,布鲁氏菌病病例多发生在流行地区。然而,如果任何地区的兽医和卫生控制存在缺陷,就有可能发生流行病,这对国民经济造成的损害和可能感染的人群(主要是职业风险人群)都构成了严重威胁。这种疾病没有明显的症状,只有当医生提高警惕,通过对 "高危 "人群进行实验室检查来评估初步和定期体检的结果,并彻底收集流行病学史料时,才能怀疑这种疾病。
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引用次数: 0
Predicting COVID-19 Outcomes in Patients at Advanced Stages of HIV Infection: A Model-based Approach 预测 HIV 感染晚期患者的 COVID-19 结局:基于模型的方法
Pub Date : 2024-03-11 DOI: 10.17816/eid627198
Anna E. Tsygankova, V. Chulanov, A. Gerasimov, E. Volchkova, Anton A. Privalenko, Viktoriya A. Bakhtina, Vladimir A. Habudaev, D. Baimukhambetova
Abstract Background: Today clinicians and their decisions extensively rely on specific treatment algorithms. These algorithms include prognostic models to identify high-risk patients requiring hospital admission and clinical monitoring. Our paper suggests a prognostic model to forecast COVID-19 outcomes in patients with advanced HIV disease, considering the high risk for unfavorable outcome and the need of a specialized approach [2]. Objective: The objective is to develop a prognostic model combining predictors of unfavorable COVID-19 outcome in patients with advanced HIV disease. Materials and methods: The study is based on 500 medical records of patients with advanced HIV disease admitted for confirmed COVID-19 from March 1, 2020 through December 31, 2022 for inpatient treatment at the Infectious Diseases Hospital in Moscow. Results: Each of the 500 patients was evaluated for 167 predictive markers for unfavorable COVID-19 outcome, outlining 50 indicators that varied significantly across the subgroups of advanced HIV disease patients with COVID-19 depending on favorable or poor outcome. Oxygen therapy was the most significant factor showing strong correlation with poor outcome in advanced HIV patients with COVID-19. Subsequently, predictors were selected stepwise in order to enhance predictive accuracy of the resulting model by adding more factors. The resulting model included 7 factors, e.g. oxygen therapy requirements, CD4+ count under 50 cells/μL, manifest CMV infection characterized by lung damage, elevated lactate dehydrogenase, urea, and fibrinogen levels, as well as unspecified encephalitis. using available data in calculations, a prognostic scenario and a ROC curve were built to assess practical significance of the obtained prognostic model. The area under the ROC curve was 90.9%, thus confirming prediction accuracy and overall practical significance of the model. Conclusions: The suggested prognostic model enables to assess potential outcomes in patients with HIV and COVID-19 co-infection admitted to hospital at advanced stages of disease, as well as to plan adequate therapies based on the obtained results. Keywords: HIV, COVID-19, SARS-CoV-2
摘要 背景:如今,临床医生及其决策广泛依赖于特定的治疗算法。这些算法包括预后模型,用于识别需要入院治疗和临床监测的高危患者。考虑到晚期艾滋病患者出现不良预后的风险较高,需要采用专门的方法,我们的论文提出了一种预测 COVID-19 预后的模型[2]。目的:目的是建立一个预后模型,将晚期艾滋病患者 COVID-19 不利结局的预测因素结合起来。材料和方法:研究基于莫斯科传染病医院自 2020 年 3 月 1 日至 2022 年 12 月 31 日期间因确诊 COVID-19 而住院治疗的 500 名晚期艾滋病患者的病历。结果:对这500名患者中的每一位进行了167项COVID-19不良预后预测指标的评估,列出了50项指标,这些指标在COVID-19晚期HIV病患者的不同亚组中有显著差异,取决于预后好坏。氧疗是与 COVID-19 晚期艾滋病患者不良预后密切相关的最重要因素。随后,为了通过增加更多因素来提高模型的预测准确性,对预测因子进行了逐步筛选。最后得出的模型包括 7 个因素,如氧疗需求、CD4+ 细胞计数低于 50 cells/μL、以肺损伤为特征的明显 CMV 感染、乳酸脱氢酶、尿素和纤维蛋白原水平升高以及不明脑炎。ROC 曲线下的面积为 90.9%,从而证实了该模型的预测准确性和整体实用意义。结论所建议的预后模型可用于评估艾滋病病毒和 COVID-19 合并感染晚期入院患者的潜在预后,并根据所获得的结果制定适当的治疗方案。关键词HIV、COVID-19、SARS-CoV-2
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引用次数: 0
In honor of the 100th anniversary of the Department of Infectious Diseases at the First Moscow State Medical University named after I.M. Sechenov (Sechenov University) 纪念以 I.M. 谢切诺夫命名的莫斯科第一国立医科大学(谢切诺夫大学)传染病系成立 100 周年
Pub Date : 2024-03-11 DOI: 10.17816/eid627067
V. Chulanov, E. Volchkova, V. A. Malov, Natalia Yurchenko
The article is dedicated to the 100th anniversary of the Department of Infectious Diseases of the First Moscow State Medical University named after I.M. Sechenov (Sechenov University). It examines the key biographical information about the department heads and the achievements of the teams at various historical stages. Currently, the department aligns with the educational policies of Sechenov University up to 2030. New educational programs are being created for students, both in Russian and English languages. New teaching methodologies are being implemented, talented students are being engaged in a student research on infectious diseases, interdisciplinary Olympiads are being held, and conditions are being formed to enhance student involvement in research and development activities to prepare competitive professionals with new professional competences (research, interdisciplinary, digital), capable of advancing science and new technologies.
这篇文章是为纪念莫斯科第一国立医科大学传染病系成立 100 周年而撰写的。文章研究了系主任的主要履历和团队在各个历史阶段取得的成就。目前,该系与谢切诺夫大学到2030年的教育政策保持一致。正在为学生制定俄语和英语的新教学计划。新的教学方法正在实施,优秀学生正在参与学生传染病研究,跨学科奥林匹克竞赛正在举行,正在创造条件加强学生参与研究和开发活动,以培养具有新的专业能力(研究、跨学科、数字化)、能够推动科学和新技术发展的有竞争力的专业人才。
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引用次数: 0
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Epidemiology and Infectious Diseases
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