Klinichescheskaya Laboratornaya Diagnostika最新文献

Bloodstream infection (BI) is the cause of high mortality. Hospital bloodstream infection (HBI) complicates hemodialysis, pneumonia, oncohematological diseases. Positive hemoculture obtaining depends on the volume of blood inoculation, the number of blood samples, the incubation time. To test the principles of microbiological culturomics in the diagnosis BI of hospital patients with a therapeutic profile. 848 hospital cardiac patients with suspected BI were included. 10 ml of blood were taken intravenously with a syringe, blood was inoculated into 200 ml of the heart-brain medium (HBM) in an anaerobic bottle. It was incubated for 7 or more days in a thermostat at +37º C. The hemocultures were obtained in 64.3% of cases with paired blood sampling with an interval of 30 minutes whereas an increase in the number of blood samples reduced the effectiveness of obtaining hemocultures to 9.1%. When incubating bottles for more than 7 days there were obtained 200 additional hemocultures containing 239 strains of microorganisms. Episodes of HBI were observed more often in the cases of the circulatory system (77.8%), including infectious endocarditis (IE) (47.0%), rheumatism (22.1%), myocarditis (14.6%). Episodes of HBI occurred more often in men with IE and coronary heart disease, in women - with rheumatism and myocarditis. Patients aged 45-75 were in the group of risk with a probability of complications of HBI up to 73.7%. When examining the blood of 848 hospital patients of cardiological profile HBI was detected in 38.3% of cases. Among clinical isolates gram-positive cocci with a great number S.epidermidis prevailed. Polymicrobial hemocultures (16.3%) were characterized by two and three associates in one blood sample. Among the hematological indicators in HBI there were: leukocytosis, increased ESR, lymphocytosis, decreased hemoglobin; increased values of fibrinogen, CRP, γ-globulin, α2-globulin, low levels of total protein and A/G coefficient. The techniques of microbiological culturomics were used. HBI was diagnosed in 38.3% of the therapeutic patients of cardiological profile. The etiology of HBI was characterized by polymicrobicity in 16.3% of cases. Hematological markers of HBI were identified.

The human body consists of various systems (blood, tissues, extracellular fluid, intracellular contents) separated by biological membranes. Physiological barriers ensure the physico-chemical composition of the internal environment remains constant and protects the body from environmental changes. The permeability of the histohematic barrier depends on the concentration of substances in the blood, the body's condition, external influences, and a number of other reasons caused by stimuli coming from the external or internal environment. Information about the state of the regulatory systems of the body has its effect on specific chemoreceptors, which leads to the emergence of local and general physiological and biochemical processes. According to their localization, they distinguish between the hematoencephalic, hemato-placental, hemato-ophthalmic, and hemato-salivary barriers. Recently, the hematosalivary barrier, through which the selective entry of substances from the blood into the oral fluid is carried out, has taken a special place in the study. Its functioning depends on the processes occurring in the body, which is carried out by selective permeability for substances that determine the composition of the main internal environment of the body - blood. Hematosalivary barrier is an important link in maintaining homeostasis, which is reflected in the metabolic parameters of oral fluid.

Over the past decade, the frequency of abdominal delivery in Russia has increased to an average of 25 %. The widespread use of abdominal delivery has not been without an increase in the incidence of complications. Among them is an infectious complication of a surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after a caesarean section, which in some regions reaches 43 %. The development of complications is facilitated by various clinical and laboratory risk factors, the analysis of which in women of the Kirov region is the subject of this article. The analysis of clinical and laboratory risk factors was carried out on the basis of the data presented in the case histories of women hospitalized in the gynecological departments of the city of Kirov. Statistical data processing was carried out on a personal computer using the R-4.0.2 statistical program and Excel spreadsheets. When assessing the relevance of the problem for the Kirov region, it was found that the frequency of caesarean section over the past 10 years from 2011 to 2021 increased from 27,0 % to 34,0 %. The incidence of infectious complications in the Kirov region can be presented as follows: infection of the surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after caesarean section - 27,0 %; peritonitis after caesarean section - 0,94 %-1,01 %; diffuse sepsis - 0,93 %-0,97 %. An important role, according to reports, in the addition of an infection of a surgical obstetric wound after cesarean section is played by the general morbidity and obstetric history in women with abdominal delivery, a detailed statistical analysis of which is presented in the materials of the article. The results of the study substantiated the problem of the development of an infection of a surgical obstetric wound after a caesarean section for the healthcare of the Kirov region, comparable to that for the healthcare of the entire Russian Federation. The analysis of clinical and laboratory risk factors showed the feasibility of using a comprehensive analysis of infection of a surgical wound after cesarean section at an early stage of its development to quickly resolve complications, reduce the duration of hospitalization of women after cesarean section, and subsequently preserve the reproductive function of a woman.

Due to the prevalence of postoperative complications in the treatment of urolithiasis, the study of the contamination of urinary calculi and the potential pathogenicity of isolated bacteria is of great importance in laboratory diagnostic practice. It has been shown that uropathogenic bacteria are found in the composition of urinary stones in 65±7.1% of cases, mainly representatives of the Enterobacteriaceae and Staphylococcaceae families. Bacteria of the generas Escherichia, Enterococcus, Staphylococcus were most frequently detected. The analysis of biofilm activity and antibiotic resistance in 50 uropathogenic strains was carried out. It was shown that all the studied strains were resistant to at least two tested drugs, and the average value of the multiple resistance index was 0.51. When cultured on nutrient agar with Congo red, it was shown that more than half of the tested strains have high biofilm activity and about 80% potential for biofilm formation. The greatest biofilm activity was observed in bacteria of the generas Escherichia, Klebsiella, Enterobacter, Staphylococcus.

The aim of the study was to assess the zinc content and identify the relationship between the concentration of this element and changes in the biochemical status of patients and markers of inflammation during burn shock. We examined 23 patients aged 45.3±16.1 years with burns of I-II-III degree, area of 31-80%. The serum concentrations of zinc, albumin, interleukin-6, C-reactive protein (CRP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined. The majority of patients (21/23) had severe hypocincemia, correlated with burn area (r=-0.53; p=0.008). A decrease in zinc levels during burn shock was associated with the development of hypoalbuminemia (r=0.52, p=0.01). The association of deviations in ALT and AST activity with changes in zinc concentration was revealed (-0.59<γ<-0.61, 0.008

Recently, buccal epithelium has been used to study age-dependent processes. This approach is of particular relevance due to its non-invasiveness. The purpose of this study is to establish the normal values of the buccal cytogram in different age groups, including athletes. 200 practically healthy volunteers of different ages were examined, who were divided into 5 groups in accordance with the WHO age classification. In addition, 125 professional athletes took part in the study. All patients underwent a comprehensive dental examination and a standard cytological examination of buccal smears. It has been established that the cytological characteristics of buccal epitheliocytes, indirectly reflecting disorders of the nuclear apparatus of the cell, did not change significantly with age, but there was a certain upward trend in the number of cells with such anomalies (micronucleus, protrusions).The number of binuclear cells and the apoptotic index also slightly increase with age. At the same time, a high positive correlation was found between the apoptosis index and senile age. In young athletes, an increase in the number of buccal epitheliocytes with a perinuclear vacuole (an early sign of cell damage) was foundAnalysis of the cytological examination results of the buccal epithelium in people a slight increase in the level of cytological abnormalities in old age, in particular, signs of apoptosis. In addition, in healthy young athletes (18 years old - 44 years old), an increase in the number of cells with signs of nuclear degradation, which most likely reflects increased mechanical stress on the maxillofacial apparatus during sports activities.