Relevance. The vaccine against the SARS-Cov-2 coronavirus is considered as the most promising approach to curb (tame) a current pandemic and prevent new one. Among difficulties in vaccine creating is a right choice of immunodominant antigens providing the effectiveness and safety of vaccines. Aim is to show the usefulness of application of the global immune epitope continuum protein relationship concept in the search of vaccines against SARS-Cov-2 and discuss the possible nature of future pandemics. Materials and method. For the computer analysis of peptide (immune epitope) relationship amongst the SARS-Cov-2 structural proteins, human proteins and proteins of other viruses, the search of homologous sequences was made. All protein sequences sequences were used from databases available on the INTERNET. Results. In the SARS-Cov-2 structural proteins, especially in S-protein, there are a large number of peptide sequences homologous to human and viral proteins that may be the cause of autoimmune complications and/or heterologous immunity. Conclusion: The concept of the global immune epitope continuum of protein relationship is of value in the search of immune epitopes for the vaccines against SARS-Cov-2 and allows us to predict the possible risks in vaccines. The coronavirus breaks and pandemics may be more often than the influenza pandemics.

Relevance. Prevention of pneumococcal infection in the Russian Federation is carried out by imported polysaccharide and conjugated vaccines without taking into account the circulation of clinically significant isolates, which leads to the growth of previously rare genetic lines and serotypes that are not part of the vaccines, and does not protect against the carriage. Serotype-independent vaccines are being developed based on protective proteins and variants of whole-cell vaccines capable of providing a cross-protective effect against pneumococcus. Objective. Investigation of the protective properties of surface protein-containing antigens isolated from the immunogenic strain S. pneumoniae 6B No. 296 and their influence on key effectors of innate immunity. Materials and methods. S. pneumoniae 6B No. 296 was cultured in a semi-synthetic medium under stationary conditions at 5% CO₂ for 5-7 hours. From inactivated bacterial cells, the experimental initial protein-containing preparation was obtained - an aqueous extract (A/E), from which a 30-100 kDa fraction (FR) isolated, and from the sterile culture supernatant, the protein-containing preparation - supernatant (S/N); in the preparations, the protein content was determined. Immunobiological properties were studied after double intraperitoneal immunization of BALB/c mice. The protective activity was determined after infection with virulent strains of S. pneumoniae serotypes 6B No. 1121 and No. 3. Phagocytic activity was studied by the number of granulocytes that absorbed heat-killed FITC-labeled S. aureus cells. The expression of Toll-like receptors (TLRs) and the subpopulation structure of mouse spleen lymphocytes were investigated after staining with FITC/PE-labeled monoclonal antibodies using flow cytometry. Statistical analysis of materials was carried out using parametric and non-parametric methods using the software package «Statistica for Windows», ver. 7.0 (Stat Soft, Inc). Results. The protective effect of FR upon infection with virulent strains of homologous (6B No. 1121) and heterologous serotypes (3 No. 3) was established; S/N protected mice when infected with strain 3 No. 3. All the studied drugs led to an increase in the number of phagocytic cells (the greatest effect was observed upon immunization with FR and S/N) and stimulated the expression of TLR2 and TLR4 positive cells (there was an increase in the number of TLR2-expressing cells during immunization with FR compared with A/E). When studying the immunophenotype of mouse lymphocytes, it was noted that the preparations induced the expression of effectors of innate and adaptive immunity. Conclusions. As a result of the studies, it was shown that the protective surface protein-containing fraction with MM 30-100 kDa is from tested experimental preparations the most active stimulator of innate and adaptive immunity, and requires further study to determine the possibility of using the serotype-independent pneumococcal vaccine in the development.

Relevance. Klebsiella pneumoniae strains may have different virulence factor genes and cause nosological forms such as pneumonia, urinary tract infection, liver abscess, and neonatal sepsis. The purpose of this work is to conduct a phylogenetic analysis of the nucleotide sequences of the uge gene detected in K. pneumoniae strains. The purpose of this work is to conduct a phylogenetic analysis of the nucleotide sequences of the uge gene detected in K. pneumoniae strains. Materials & Methods. A total of 66 bacterial cultures identified in 2019 were examined. 45 bacterial cultures were isolated from fecal samples, 20 - from cervical canal samples, 1 - from the pharynx. Results. The uge gene was detected in 60.61% of Klebsiella pneumoniae strains isolated during bacteriological screening. Conclusions. The Klebsiella pneumoniae nucleotide sequences of the uge gene obtained in the course of this study differ from the analogous ones belonging to hypervirulent strains, which can be used to assess the pathogenic potential of isolates detected in hospitals and the epidemic situation in medical departments, as well as to develop approaches to predict the incidence rate of Klebsiella etiology infections based on molecular epidemiology methods. 

Relevance. In 2016, a resolution was adopted at the 69th World Health Assembly, the goal of which is to eliminate parenteral hepatitis in the world by 2030. In the Republic of Sakha (Yakutia), as in the Russian Federation as a whole, it is necessary to determine the starting positions for the prevalence and incidence of hepatitis B, C, and D, as the leading factors in the development of hepatocellular carcinoma. Aim: to give a clinical and epidemiological characterization of hepatocellular carcinoma in the Republic of Sakha (Yakutia) at the initial stage of the program for the elimination of viral hepatitis for subsequent analysis of its effectiveness. Materials & Methods. A clinical and epidemiological analysis of morbidity, mortality, cumulative survival in hepatocellular carcinoma in the Republic of Sakha (Yakutia) over a 10-year period (2009-2018) was carried out. Predictors for the development of hepatocellular carcinoma were analyzed based on primary medical records and a survey of 125 patients. Results and discussion. The incidence rate of hepatocellular carcinoma in the Republic of Sakha (Yakutia) over the past 10 years is 2.0 3.9 times higher than the corresponding indicator in the Russian Federation. The highest mortality from the studied pathology is noted in the Central and Polar zones of the republic. According to the materials of the cancer registry, the median cumulative survival of patients with carcinoma was 13.7 months from the date of diagnosis, which is significantly higher than ten years ago. The main risk factors have been identified, among which the leading role is played by infection with hepatitis C, B, and D. viruses. Also, alcohol abuse, diabetes mellitus, overweight, and smoking are important. Conclusion. The Republic of Sakha (Yakutia) is a hyperendemic region of the Russian Federation in terms of the incidence of hepatocellular carcinoma with a predominance of the male population in its structure. The rate of decrease in the incidence of liver cancer in the country will depend on the effectiveness of the regional program for the elimination of viral hepatitis and the decrease in the incidence of cirrhosis of the liver of non-infectious etiology.

Relevance. The heterogeneity of the epidemic cluster B0/W148 in Russia is described for the first time. Aim of investigation was to create an epidemic model of tuberculosis strains B0/W148 spreading in Siberian Federal District (SFD) and Far Eastern Federal District (FEFD) and to identify the genetic relationship between the studied strains. Results and discussion. A comparative study of single nucleotide polymorphism (SNP) distribution in genomes of 20 strains from the SFD and FEFD and similar data in 62 strains from other regions of Russia was carried out. Based on Bayesian phylogenetic analysis was proposed epidemiological model of the emergence and spread of highly transmissible strains the B0/W148 cluster of M. tuberculosis in Russia. Siberian and Yakutian subclusters were identified and characterized by the simulation results.

Relevance. In the Yaroslavl region, the Central Federal District of Russia, endemic for tick-borne encephalitis (TBE), specific TBE vaccination has been routinely carried out for more than 20 years. Therefore, the evaluation of the results of long-term universal immunoprophylaxis the population has a practical and scientific interest. Purpose: To study the epidemiology of tick-borne encephalitis in the context universal vaccine in 2008-2019. Results and discussion. According to the results of long-term immunization, by 2019 19.1% of the population was vaccinated, while vaccine coverage for the children living in endemic areas of the region reaches 68-83%. The article noted a 2.9-fold decrease in the incidence of TBE in 2013-2018 compared with 2008-2012. The average long-term level was 0.69 per 100 ths people. TBE was recorded among the unvaccinated population, mild febrile forms prevailed - 56.8%, however, the proportion of focal forms of the disease remained high (36.3%). Deaths from TBE in the period from 2013-2018 did not have. Thus, in the absence of specific treatment for TBE, vaccine prophylaxis is of great medical and social importance for the Yaroslavl region endemic for TBE. Conclusion. Vaccine coverage in the population of Yaroslavl region, children living in endemic areas and natural immunization in natural foci of TBE contributed to the formation of a significant level of collective immunity of the population to TBE, reducing the incidence of in the last 5 years.

Relevance. Cardiac surgery is a direction that is currently being actively developed. The number of operations performed on an openheart is growing annually, and the number of postoperative complications, including infectious ones, is correspondingly increasing. The purpose of the work is to identify the frequency of surgical site infections (SSI) in open-heart surgery, to study the leading risk factors, to identify possible sources of infection. Materials and methods. Basic information was obtained from medical records, as well as using the medical information system, which allows to track the patient's repeated hospitalization in the hospital, and the laboratory information system. Additional forms have been developed to account for intraoperative risk factors. The follow-up period was 3 years (2016-2018). A total of 433 surgical interventions and their outcomes were analyzed, the duration of follow-up f o r patients was 1 year from the time of surgery. Identified 19 cases of SSI. Results and discussion. The frequency of SSI in open-heart surgery was 4.4 per 100 operations (2.6-6.7). Up to 74% of all SSI occurred in the period up to 30 days from the moment of surgery. The relative risk index was calculated for such factors as the length of stay in the intensive care unit in the postoperative period, the timing of drainage of the postoperative wound, and diabetes mellitus. It has been established that for cardiosurgical operations on the 1st class of wounds, diabetes mellitus is a significant risk factor for SSI. The analysis pathogens in patients with acute respiratory infections and the microbiological landscape of the departments made it possible to establish cases of possible infection of patients in the hospital, and in some cases put forward an assumption of endogenous infection. Conclusions. An epidemiological investigation, the development, and implementation of anti-epidemic measures require a complete consideration of possible risk factors, the participation of cardiac surgeons in identifying, and analyzing each case of SSI, and the mandatory exchange of information about the outcome of the disease between medical organizations that are involved in the management of a cardiac surgical patient in the postoperative period.

Relevance. During serological diagnosis of rubella by enzyme immunoassay (detecting IgM), it is possible to obtain an indefinite or false-positive result. In this case, is needed an additional confirmatory test. It can be carried out by immune blotting, which allows detecting antibodies to specific rubella antigens. To date, in the Russian Federation, there is no such kit of reagents, which makes its development quite actual. Aim. The aim of this research was the development of a Russian test kit for detecting IgM-antibodies to individual rubella virus antigens by immune blotting (Western blot format). Materials and methods. Production of immunosorbent for a new test kit included electrophoresis of the native rubella virus lysate in a polyacrylamide gel to separate proteins by molecular weight and transfer (blotting) of separated proteins onto a nitrocellulose membrane. Investigation of sensitivity and specificity of the new test kit was carried with standard panels of serums containing and not containing IgM to the rubella virus, and with clinical samples characterized by the ELISA method. Results and its discussion. As a result of this work, was designed a Russian test kit that allowed detection IgM-antibodies to individual rubella virus antigens by immune blotting. This test kit has analytical sensitivity and specificity -100%, diagnostic sensitivity - at least 99.61% and diagnostic specificity - and at least 99-99%. The diagnostic efficiency is not less than 99.5%. Conclusion. The developed test kit has high rates of analytical and diagnostic sensitivity and specificity, as well as high diagnostic efficiency. It is intended for confirmatory research in the diagnosis of rubella infection.

Background. Beginning with the middle of the XX century some observations about cases of meningococcal urethritis have appeared. The number of articles for such subjects has promptly increased in the last decade of XXI. The epidemiological features of meningococcal urethritis are slightly understood. Aims. A review of the latest publications on meningococcal urethritis is presented. Particular attention is given to outbreaks of meningococcal urethritis caused by the new genetic clade USNmCU of N.meningitidis, which occurred in several US states in 2013-2016. Conclusions. The isolates from patients were non-capsulated and belonged to the CC-11 clonal complex, the most virulent among N.meningitidis strains of serogroups B, C, Y, W. The orogenital transmission of clade strains has been proven. It is assumed that N.meningitidis acquired genes for anaerobic growth as a result of genetic recombination during co-presence with N. gonorrhea on the mucous membranes and became to be able to colonize the urogenital tract. The urethritogenic meningococcal clade is the result of the adaptation of the capsular strain of meningococcus serogroup C of the clonal complex CC-11, which is responsible for outbreaks of generalized meningococcal infection in MSM communities. The urethritogenic strains are considered as representatives of the emergent clade of N. gonorhoeae. Their ability to be transmitted through direct sexual contact is unknown. The epidemiological role of the clade in the spread of meningococcal infection is discussed. It is necessary to develop the researches concerning the epidemiological features of meningococcal urethritis and its additional role as the source of meningococcal disease. 

Relevance. Specific epidemiology of sapronotic (soilborne, waterborn) bacteria is characterized from the ecological point of view. The characteristic feature of soil-borne, water-born pathogens is an ability to exist autonomously in the environment. Aims. This analytical review is focused on hydrobionts and crops as alternative hosts for several soilborne and waterborne pathogenic bacteria (Vibrio, Legionella, Yersinia, Listeria monocytogenes). Conclusions. Published experimental results evidence capabilities of human and animal pathogens to colonize protozoan and plant tissues. Novel approaches are discussed to minimize risks of infection spreading.

In this review, the manifestations of the tick-borne encephalitis (TBE) evolution in different aspects, which are traced over the 80 years since the discovery of TBE virus, are highlighted and systematized. The evolution of infection is expressed in a change in the properties of the etiological agent (changing of the genetic structure of the pathogen populations in certain territories, phenomenon of changing in the dominant subtype, changing in virulence), the epidemiology and ecology of TBE (period of marked increase in incidence, changing in the endemicity of territories, level of population immunity, the appearance of foci TBE in suburban areas and cities, changing in the range of certain types of ticks and the appearance of «tick-mutants»), as well as the clinical picture of TBE (phenomenon of pathomorphosis, growing relevance of mixed infections transmitted by ticks). The analysis of the possible causes of evolutionary transformations is carried out, among which the main ones are natural factors (climate change), anthropogenic factors, namely disturbance of natural landscapes due to human activities and environmental pollution by some pesticides, and additional ones -impact of vaccination. Purpose of the article: characteristics of the main manifestations and probable causes of the evolution of TBE over 80 years. Conclusions: The review for the first time provides information about the main issues of this problem, identifies changes and transformations that affect pathogens and vectors, and, as a result, entails changes in the epidemiology and clinical picture of this disease, which are traced in different territories.

Relevance. The group of non-tuberculous mycobacteria includes more than 200 species, of which about 50 are causative agents of mycobacterial infection or mycobacteriosis, which is clinically and radiologically similar to tuberculosis. Mycobacteriosis is a multidisciplinary, insufficiently studied, problem. The purpose of the article is to summarize modern ideas about this disease. Conclusion. The review provides information on the main aspects of the considered problem: the environmental features and diagnostics of non-tuberculous mycobacteria are determined, the epidemiology of this disease is described, the possibility of the variability of the clinical manifestations of mycobacteriosis, including among immunocompromised patients and the example of infection associated with the provision of medical care. Particular attention is paid to the growing need to develop regulatory documents regarding the prevention, diagnosis, and treatment of infections caused by non-tuberculous mycobacteria in the Russian Federation.