The review article summarizes and systematizes scientific data on the pathogens of new respiratory infections discovered in the early XXI century – Human metapneumovirus (HMPV), Human bocavirus (HBoV), Human coronavirus (HCoV). Groups of microorganisms with which they act as associates are identified: other viruses (HMPV – HRSV, Rhinovirus, Adenovirus, HCoV; НBoV– Rhinovirus, HRSV, Rotavirus, Norovirus; HCoV – Influenza virus, Adenovirus and HRSV), and also some bacteria (HMPV – S. pneumoniae, H. influenzae type b; НBoV – S. enteritidis, C. jejune; HCoV – M. pneumoniae, K. pneumoniae). The clinical and epidemiological features of combined forms of infections are analyzed: predominance of moderate course, with risk of complications, risk groups (young children), seasonality (autumn-winter). The complexity of verification of these infections from other viral infections based on the clinical picture is established.

Background. Extensively drug-resistant tuberculosis (XDR-TB) is a threat to community health. Goal. The estimation of the prevalence of extensively drug-resistant tuberculosis in Omsk region, along with the clinical and epidemiological description of patients with XDRTB. Methodology. A retrospective descriptive epidemiologic research of tuberculosis morbidity in Omsk region in 2006–2017 was conducted.Results. The prevalence of extensively drug-resistant tuberculosis in Omsk region in 2006–2017 was stable at 35.6 per 100ths population with Tinc.=1.0%. The prevalence of extensively drug-resistant tuberculosis in Omsk region was 13.6 per 100ths population (n = 267). Among patients with XDR-TB the majority was of young working age 25–44 years (63.2%), male gender (80.9%), officially unemployed (75.6%), ill for at least 3 years (57.0%), suffering from infiltrative pulmonary tuberculosis (69.2%) and HIV-infected (31.8%). The resistance to seven first and second line antituberculosis drugs was found in 10.1% of patients with XDR-TB. Conclusions. The optimisation of approaches to the organization of additional measures for the prevention of extensively drug-resistant tuberculosis is needed.

Relevance. Biofilms of bacteria, in particular, pathogens of purulent-septic and enteral diseases, play an important role in the development of the infectious process, resulting in 60–70% of its chronic and recurrent forms. About 60% of nosocomial infections are caused by bacterial biofilms. In biofilms, the bacteria themselves make up only 5–35% of its total mass, the rest is an extracellular polymer matrix consisting of exopolysaccharides, DNA and proteins, which prevents the penetration of antimicrobial agents into biofilms. Resistance of bacteria in biofilms to antibiotics is 10–1000 times higher than the established concentrations for planktonic bacterial cells. The permeability in biofilms of different antibiotics differs. Bacteria P. aeruginosa have a high, as well as rapidly acquired resistance to most antibiotics, as well as the ability to form biofilms in the foci of inflammation.

Goal of the study are a comparative study of the antibacterial activity of antibiotics and the bacteriophage composition of lytic groups of KMV-likevirus, PB-1 likevirus, N4-likevirus and phiKZ-likevirus against plankton cultures of clinical and hospital strains of P. aeruginosa, detection and study of the frequency of biofilm formation by bacteria P. aeruginosa and the preventive action of lytic bacteriophage compositions on them, as well as its ability to destroy bacterial biofilms.

Materials and methods. The object of the study was the composition of bacteriophages of P. aeruginosa isolated from various sources of the external environment consisting of strains of bacteriophages of lytic groups KMV (PaUfa-1), PB-1(PaUfa-4), N4(PaUfa -3, 6, 7) and phiKZ(PaUfa-15)-like viruses, which do not contain genes for drug resistance, lysogenicity and toxigenicity, at a concentration of 5 x 107 PFU/ ml, analogous to phage concentration in therapeutic and prophylactic preparations of bacteriophages and 277 clinical and hospital strains of P. aeruginosa bacteria, allocated (2016-2017), in the cities of Moscow, Voronezh, Volgograd, Nizhny Novgorod, Krasnodar, St. Petersburg.

Results and discussion. A study of the sensitivity of 277 clinical and hospital strains of P. aeruginosa bacteria to various groups of antibiotics showed that it is within the range of 53.5–80%. The width of the spectrum of antibacterial activity of the composition of bacteriophages of P. aeruginosa lytic groups CMV (PaUfa -1), PB-1(PaUfa -4), N4(PaUfa -3, 6, 7) and phiKZ(PaUfa -15)-likevirus planktonic cultures of hospital and clinical strains, was 89.97% (from 82 to 100%). Of the 42 clinical strains of P. aeruginosa bacteria, 33 strains (78.6%) formed biofilms, the remaining 9 strains showed less pronounced biofilm formation. After preliminary preventive treatment with a composition of bacteriophages of biofilm of strains of P. aeruginosa bacteria, 64.3% of them did not form of biofilm, in 35.7% of strains this ability decreased by 92.0–96.8%. The composition of the lytic bacteriophages KMV (PaUfa-1), PB-1(PaUfa-4), N4(PaUfa-3, 6, 7) and phiKZ(PaUfa-15)-ikevirus, even in a single treatment, destroyed biofilms of various strains P. aeruginosa with destruction from 23 to 100%. High antibacterial activity (an average of 89.97%) of the composition of the lytic bacteriophages P. aeruginosa KMV(PaUfa-1), PB-1(PaUfa-4), N4(PaUfa-3, 6, 7) and phiKZ(PaUfa-15)-like virus in the plankton cultures of P. aeruginosa bacteria falls insignificantly in biofilms (0–77.0%), the activity of antibiotics in biofilms is reduced by 10–1000 or more (decrease in penetration by 90.0–99,9999%).

The results of various methods of Puumala virus inactivation, including ultraviolet rays (UV), β -propiolactone (BPL) and formalin are presented. Immunogenicity of vaccine preparations obtained using these virus inactivation methods did not differ significantly in the experiments on BALB/c mice. Essential advantage of UV and BPL in relation to formaldehyde is the short time of virus inactivation.

1 million 824 thousand people died in the Russian Federation in 2017, including 457 thousand from ischemic heart disease (IHD). IHD caused more than a quarter of deaths in Russia. Goal. The article analyzes the impact of implementation of clinical guidelines in cardiology in medical practice in the United States and the Russian Federation on the dynamics of mortality from ischemic heart disease and its outcomes in different age groups. Results. The results showed that the implementation of clinical guidelines (CG) increased the rate of mortality reduction from coronary heart diseases in Russia and the United States, which may indicate a positive impact CG on the quality of medical care. Conclusions. A higher level of mortality from coronary heart disease in Russia compared to the United States may be due to less commitment of doctors to the principles of therapy and diagnosis of various forms of coronary heart disease, set out in clinical guidelines.

The pneumococcal infection is an important issue due to its prevalence, numerous severe complications, high mortality rate and disability. However modern vaccination allows preventing of the pneumococcal infection and reduces the severity of clinical complications. This article presents the analysis of the morbidity and mortality indicators from community-acquired pneumonia and the effect of pneumococcal vaccination on its dynamic in the at-risk groups within the adult population of the Aldan area and the city of Aldan of the Sakha Republic (Yakutia). In the Aldan area pneumonia morbidity persistently exceeds the national Russian average: in 2015 – 1.5 times (499.3 per 100,000 population) and in 2016 – 1.2 times (500.8 per 100,000 population). The morbidity indicators in Aldan are comparable to the national values. The community-acquired pneumonia mortality rates in the Aldan area were 20.55 per 100,000 population in 2015, and 18.5 per 100,000 population in 2016; these values are, respectively, 4.3 and 3.8 times higher than the national average. In the city of Aldan the community-acquired pneumonia mortality rates were 9.87 per 100,000 population in 2015 and 15.8 per 100,000 population in 2016, which is more than double the national average in the Russian Federation. Pneumococcal vaccinations of the adult population using the conjugate vaccine Prevenar 13 have been observed to lower the pneumonia morbidity and respiratory infections; the vaccinations also reduced the number of hospitalizations due to condition exacerbations or decompensations among adult patients with chronic lung disorders, cardiac insufficiency, and diabetes.

Relevance.Тhe Ural Federal district (Ural Federal district) is a highly endemic tick-borne viral encephalitis (TBEV) territories in the Russian Federation. The epidemiological situation on the TBEV is studied in Sverdlovsk and Chelyabinsk regions and slightly shown in the Kurgan region. There is no information about the evolution TBEV, the structure of immunity population, vaccine prevention in the Kurgan region. The article presents the dynamics epidemiological situation on TBEV in the Kurgan region over a 30-year period.

Materials and methods: Used expedition reports, viral encephalitis named after the Academy of medical Sciences of the USSR for 1983–2007, as well as materials of medical institutions of the Kurgan region 2007–2017. For population immunity used: hemagglutination test (HAI-test), neutralization test (NT). To identify specific antibodies – IgG, IgM, antigen of TBEV, sets of reagents of ELISA from «Vector-Best» were used. To immunotypicalli and genotypically Strains and isolates RNA of TBEV isolated in 1983–2007, used precipitation in agar (RDPA) and by RT-PCR technique in real time with genotypespecific probes.

Results and discussions: Kurgan region is a highly TBEV endemic area. the morbidity rate – 18,3 per 100 thousand people 1983. Maximum elevation – 44.1 in 1996 to and decrease to 13.5 in 2000–2012. The immune part of the population according hemagglutination tests, on epidemiologically significant territories is 15–20%, (66% NT), in the regions with sporadic incidence is 8%, (21–50% NT), in non-endemic territories – 3%. At the present stage, the region marked the expansion of nosoareal TBEV due to the previously less significant Eastern regions. In Kurgan region vaccination coverage against TBE 39.3%. The clinical efficacy of vaccination was manifested in an increase in fever forms of TBE disease and a decrease in meningeal and focal forms of the disease. In the period 2004–2012 the number of vaccinated patients was 20.3% of the total number of patients.

Сonclusions. Evolution of tick-borne encephalitis manifested the expansion of nosoareal TBEV, increase seasonal activity of ticks, the TBEV Siberian subtype is absolutely dominating.

Introduction.The chronic hepatitis C is essential for health care of the Siberian federal district in the territory of which now the incidence of the specified pathology significantly exceeds similar indicators across the Russian Federation. Materials and methods. The retrospective analysis of an epidemiological situation onе the chronic hepatitis C in the Siberian federal district for 2006–2015 included case rate assessment with use of official statistical materials. For integrated assessment of an epidemiological situation indicators of a case rate of the chronic hepatitis C and statistical criteria are used: a standard deviation and rate of a gain of a case rate and also an algorithm of calculation of an integrated indicator in the form of presentation coefficient. A genotypical variety of a virus of hepatitis C (HCV) during 2001‒2017 was studied according to the Irkutsk regional clinical consulting and diagnostic center on the basis of the analysis of 13236 PCR-positive blood samples of the sick. The chronic hepatitis C living in the territory of the Irkutsk region. Results and discussion. Assessment of the movement of a case rate of the chronic hepatitis C for the surveyed long-term period on the federal districts of Russia from the West on the East taped its body height in the designated direction. Complex assessment of indicators of a case rate in the administrative territories which are a part of the Siberian federal district in some cases significantly differs from its standard estimates and the most safe territories the Republic of Buryatia and the Omsk region. The Republic of Tyva moved from the first to the eighth rank place. Integrated approach of studying of the key epidemiological indicators allows to carry out deeper comparative assessment of the situation. In distribution of the main genotypes of HCV significant depression of the first and augmentation of the third of genotypes of the chronic hepatitis C originator is observed in recent years.

Key Russian experts representing applied medicine, scientific and educational organizations related to the vaccination hold the meeting on June 13 in Moscow. The main issue of the agenda was the discussion of the new approaches to vaccination of pertussis. It was noted that it is still a topical question for public health worldwide including Russia. The experts comprised the list of the unresolved questions related to pertussis surveillance and prevention. The most important fact is a continuing spread of pertussis due to the decrease of immune response 5–7 years after any type of pertussis vaccine, and a growing number of the people who have not suffered from pertussis before. Increase of pertussis incidence among one year old children as well as schoolchildren and adults attests for the circulation of pathogen and continuous spread of the disease. This makes necessary an introduction of additional pertussis vaccination boosters. The data of epidemiological surveillance in the countries which already introduced the second booster against pertussis for 4–7 year old children (more than 50 countries) shows essential epidemiological effect and decrease of pertussis incidence at the age from 4 to 10 years old, and has already demonstrated indirect protection for one year old children. The experts made final recommendations for Russia regarding the improvement of pertussis surveillance on regional and federal levels. Certain possible strategies of anti-pertussis vaccination were offered in accordance with the developing vaccines and technologies.

The report includes a historical panorama of flu epidemics and pandemic from Hippocrates to the present day. An in-depth analysis of the pandemics and epidemics of the 20th and 21st centuries is given. The characteristics of the influenza virus, its epidemiology and the system of infection surveillance are presented. In the historical, scientific and practical aspects, relevancy for specific prevention of influenza has been considered.

An overview of influenza virology, epidemiology and evolution history peculiarities is given. Data from international influenza survey and own study results are presented demonstrating influenza virus high pandemic potency due to its ability to change constantly. Using the examples of seasonal influenza minor but constant changes, virtual pandemic hazard is discussed. Based on the international surveillance data and using mathematical model findings, vaccination is considered to be most effective preventive measure, and justification for quadrivalent influenza vaccine apply, especially in young persons is presented.

Ways for vaccines improvment are described. WHO criteria and domestic requirements for influenza vaccines quality are presented. The multicenter, double-blind, randomized trial in parallel groups of the first Russian quadrivalent vaccine is described in details. Multicenter study for assessment of vaccine safety, reactogenicity and immunogenicity was performed in 612 volunteers aged 18-60 years in the epidemic season 2016-2017.. In the study conducted , it was demonstrated that the first Russian quadrivalent influenza vaccine has a high tolerability and safety profile and meets the criteria for the immunogenicity of inactivated influenza vaccines.

The review presents a clinical expert meta-analysis of compliance with the basic requirements for safety and efficacy Of subunit influenza vaccine containing polymer Polyoxidonium (PO) as an adjuvant (PO-AG). The results of the meta-analysis convincingly demonstrate that a reduced HA dose in combination with the adjuvant PO is safe and low reactogenic and induces a humoral immune response comparable to that of other inactivated vaccines without adjuvant. PO-AG is safe and effective vaccine against influenza.