Relevance. MN (malignant neoplasms) of the lungs ranked first in the world in the structure of mortality from all MN among both sexes in 2020. Despite the significant contribution to the development of MN (including MN of the trachea, bronchi, lungs (ICD-10 – C33, С34)) of production factors, their influence is underestimated.

Aim. To analyze the morbidity and mortality rates from the trachea, bronchi, lungs MN in men in the age range from 40 to 65 years in 2010–2020.

Materials and methods. Data on the number of tracheal, bronchial, and lung MN detected for the first time in life among men in the age range from 40 to 65 years, as well as the number of deaths, were obtained from the Cancer Registry of the P. A. Herzen medical Institutebranch of the Federal state budgetary institution «NMIC of radiology» of the Ministry of health of Russia. The method of descriptive cross-sectional epidemiological study was used. A division was carried out by quartiles of standardized (world standard) indicators of the incidence of tracheal, bronchial, lung MN per 100 thousand male population in the subjects of the Russian Federation in 2020. Statistical processing – MS Office Excel 2019, Statistica 10.

Results. Irkutsk, Orenburg, Rostov region, Moscow,federal districts of the Russian Federation were selected for the study (based on the quartile division). Long-term analysis (10-year period) of morbidity and mortality from MN of the trachea, bronchi, lungs in men aged 40 to 65 years in the Federal District, selected subjects and the Russian Federation as a whole, showed a moderately pronounced downward trend. Despite this, the indicators remain at a high level.

Conclusion. The influence of harmful production factors on the development of MN is recognized in the Russian Federation in a very small number of cases, and therefore the true incidence rate is higher than the registered one. It is necessary to significantly improve the quality of detection of occupational diseases, as well as to optimize preventive measures aimed at preventing the harmful effects of production factors on the health of workers. Further detailed study of the role of individual factors of harmful industries on the development of tracheal, bronchial and lung diseases is required.

Relevance. In recent decades, large outbreaks of scarlet fever have been reported in European and Asian countries. Severe forms of the infection have become more frequent and the number of complications has also increased.

Aim. To assess the incidence of scarlet fever in the Russian Federation using the official statistical sources, to identify the clinical features of scarlet fever among adults.

Materials and methods. Analysis of the level and dynamics of the long-term incidence of scarlet fever in the entire population and among different age groups in Russia from 1890 to 2021 was performed based on the data of annual statistical forms. A clinical and epidemiological descriptive retrospective census study was conducted using data from the case histories of patients diagnosed with “scarlet fever” in The Infectious Disease Clinical Hospital No. 2 Moscow Healthcare Department from 2010 to 2022.

Results. Three major cycles (40-50 years) can be distinguished in the long term with regard to incidence. In 1986, the rise in incidence was noted after 30 years since the previous one and it was less intensive. In the first cycle, rates increased gradually over almost 10 years beginning from 1891. In subsequent years, the incidence remained high (220-280 per 100,000), decreasing markedly to 50-60 per 100,000 population only by 1917-1918. The second cycle, from 1918 to 1942, was characterized by increasing rates (up to 462 per 100,000 population). In the third cycle (1946 - 1981), incidence rate reached a peak by 1955 (531.8 per 100,000 population), and started to gradually decrease afterwards. There were cycles lasting 3–6 years in in this period The fourth cycle (1982-1991) was not so large. In recent years (2007–2021), the incidence decreased 7.3 times (from 45.4 to 6.2 per 100 thousand). The average incidence rate during this period was 29.8 per 100 thousand. In 2022, the incidence of streptococcal infection increased 2.8 times (including scarlet fever – 3 times). The incidence increases were observed in the group 0-14 years and 14 and older (from 298,2 to 34,1 and from1,6 to 0,1respectively). As in the previous years (fourth cycle), children aged 3-6 years were the main contributors to the incidence of scarlet fever (the average incidence rate – 452,1 per 100,000). The average age of patients admitted to the hospital was 24 years (18–45 years). There was an increase in the average age of patients since 2017. During the study period, the number of hospitalized adults with scarlet fever decreased by half. In most cases (98.56%) the patients had a moderate condition at admission and only 3 had a severe condition (1.44%). The most common comorbid diagnoses were ENT-organs infections (9%), urinary tract infections (3.35%) and Wolf-Parkinson-White syndrome (2.87%). Scarlet fever had a complicated course of infection in 19 patients (9.09%). In the treatment were used cephalosporin (52.63%) and penicillin (41.63%).

Conclusions. This study demonstrated a stable downward trend in the incidence of scarlet fever in the population of the Russian Federation in recent years until 2021. In 2022, the incidence increased 3 times (18.7 per 100 thousand). The number of hospitalizations among adults with scarlet fever and the number of patients with complications have decreased. The average age of patients by 5 years have increased. The treatment was carried out in accordance with clinical recommendations and the antibiotic resistance of the pathogen.

Relevance. Vaccination of the child population against pneumococcal infection (PI) has been carried out in the Republic of Tatarstan according to the national calendar of preventive vaccinations since 2014. The vaccination scheme includes vaccination with PCV-13 conjugated pneumococcal vaccine.

Aim. Study of the the frequency of bacterial transmission and the serotype landscape of S. pneumoniae isolated from healthy children- bacterial carriers of preschool age in the Republic of Tatarstan (RT).

Materials and methods. During the period from 2016 to 2022, 1,426 children from Kazan and the districts of the Republic of Tatarstan were examined. Examination of nasopharyngeal smears was carried out by the classical bacteriological method. Serotyping was performed using molecular genetic methods (PCR).

Results. The detection rate of S. pneumoniae among healthy preschool children varied in different years from 29.5 to 63%, averaging 38.5%. In urban children, the incidence of pneumococcal transmission was significantly higher than in rural children (p<0.01). Also, when analyzing the serotype landscape, mixed colonization by several serotypes was observed. As of January 1, 2021, the immune layer to the pathogen PI among preschool children was 81.7%. Monitoring of the serotype landscape of S.pneumoniae strains circulating in the RT showed the dominance of vaccine serotypes (67.2%), of which 44.4% are PCV13 serotypes. The proportion of non–vaccinated serotypes is 26%, untyped - 6.8%. Unvaccinated serotypes 35B (21.3%) and 23A (13.6%) dominated in vaccinated children, as well as serotypes not included in the PKV-13 vaccine cocktail, but included in the PPSV-23 polysaccharide vaccine not used for vaccination of children, namely 11AD (15.3%) 9LN (9.6%). In unvaccinated children, on the contrary, vaccine serotypes included in PCV-13 prevailed: 6ABCD (17.3%), 19F (20.9%), and unvaccinated serotypes 11AD, 9LN, 35B, 23A were detected with lower frequency 11,8%, 10,0%, 4,2%, 7,3% accordingly.

Conclusion. Data on the regional features of the pneumococcal serotype landscape can be the basis for expanding the vaccine cocktail due to the dominant serotypes: 9LN,11 AD, 35B, 23A.

Relevance. This study is related to the study of the etiology, pathogenesis and clinic of inflammatory bowel diseases (IBD). In a number of patients with IBD who are refractory to anti-inflammatory/immunosuppressive therapy, there are signs of current or transferred yersiniosis infection, not diagnosed by routine methods.

Aim. According to the scientific literature and the results of our own research, to identify the presence and assess the nature of the influence of yersinia on the occurrence and development of IBD.

Materials Methods. In our study, we conducted a bacteriological examination of feces by polymerase chain reaction (PCR) in patients with a diagnosis of IBD (UC and CD) in the acute phase (MMDAI ≥ 4 points for UC and Best index ≥ 150 points for CD), as well as immunological diagnostics using enzyme immunoassay (IFA) in the version of line-blotting (IB). Using the results obtained, clinical and instrumental semiotics were evaluated in subgroups of individuals suffering from IBD with confirmed yersiniosis ("IBD+ IER+") and without it ("IBC+ IER–"). We also assessed the role of intestinal infection by determining the effectiveness of initial antibacterial therapy in the treatment of exacerbation of IBD.

Results. A significant part (in the case of our sample – 45%) of patients with IBD, when examined by high-tech methods, demonstrate the presence of markers of a transferred or current yersiniosis infection. Its role in the initiation and development of autoimmune intestinal inflammatory process requires further clarification.

Conclusions. In 45% of patients with IBD, high-precision examination reveals markers of transferred or current yersiniosis infection. Routine clinical methods for the diagnosis of yersiniosis have low sensitivity and do not allow us to convincingly assess the role of this bacterial agent as a trigger factor for the onset or recurrence of IBD. There is a tendency for greater manifestation in the debut of IBD in patients with markers of systemic yersiniosis. The fact of improvement against the background of empirical antibacterial therapy in 24% of patients with IBD, achievement of early clinical remission in 57% of patients receiving antibiotic therapy, indicates a significant role of bacterial enterocolopathogens in the genesis of chronic intestinal inflammation in a number of patients.

Relevance. Employees of medical organizations (MO), by virtue of their official duties, are at the group risk of morbidity of a new coronavirus infection.

Aim. Evaluation of the manifestations of the COVID-19 epidemic process and the epidemiological effectiveness of the use of the Gam-Covid-Vac vaccine among employees of a multy-speciality medical organization.

Materials and methods. The incidence of COVID-19 among the staff of MO was studied for the period from March 2020 to December 2021. The latent epidemic process was evaluated avccording to the results of routine serological examination of employees for antibodies of classes IgM and IgG to SARS-CoV-2. The epidemiological effectiveness of immunoprevention was determined by comparing the incidence with the coverage of employees who has a completed course of vaccination.

Results. During the study period, 47.7% of employees of medical organizations had a clinically apparent form of COVID-19. In addition, according to the results of a routine serological examination, it turned out that 46.5% of employees had a subclinical form of infection. An increased level of morbidity was observed in the autumn period. The incidence of medical workers was in 2.2 times higher than other employees, medical staff of the hospital – in 1.7 times higher than polyclinics. The epidemic process was more intense in the group of nurses than doctors and junior medical staff. The epidemiological efficacy of the Gam-Covid-Vac during the first months of using vaccine has been established. Vaccinated people have a more mild course of COVID-19 in comparison with unvaccinated people.

Conclusion. In this way, the main manifestations of the COVID-19 epidemic process in employees of a multy-speciality medical organization were identified and the epidemiological effectiveness of the Gam-Covid-Vac vaccine in the first months of using vaccine was established

Relevance. Serological studies play an important role in assessing the spread of SARS-CoV-2 and formation of post-infection and post-vaccination immune response.

The Aims aim of the study was a comparative assessment of seroprevalence and concentration of antibodies to SARS-CoV-2 at 3–6 months after infection or vaccination.

Materials & Methods. For the presence of total IgM and IgG antibodies to RBD fragment of the SARS-CoV-2 S protein, the blood sera of 1331 people aged 18-70 years were examined, of which 334 had COVID-19 3–6 months before the study, 305 did not have COVID-19 and were vaccinated (using Sputnik V, Russia, or Sinopharm, PRC) 3–6 months before the study, 692 people were not ill and were not vaccinated. A quantitative assessment of IgG antibodies to the full-size S-protein of SARS-CoV-2 was performed for 435 samples.

Results. The proportion of seropositive individuals 3–6 months after COVID-19 or after vaccination did not differ: 92.5% and 93.8% of the corresponding group had antibodies. Among the non-ill and unvaccinated, 45.7% also had specific antibodies, which indicates a high level of asymptomatic infection with SARS-CoV-2. The group of vaccinated was also examined immediately before the introduction of the vaccine, and 39.7% of them already had specific antibodies due to asymptomatic infection with SARS-CoV-2. The median concentration of antibodies in the group of COVID-19 was statistically significantly higher than in asymptomatically infected (50.9 AE/ml versus 29.1 AE/ml). The largest proportion of seropositive individuals (100.0%) and the highest concentration of antibodies (110 AE/ml) were detected in the group of vaccinated who had pre-existing antibodies.

Conclusion. Infection with the SARS-CoV-2 is characterized by a high frequency of subclinical course. Asymptomatic infection induced a weaker immune response compared to symptomatic COVID-19 or vaccination. Hybrid immunity caused by natural infection with SARS-CoV-2 and subsequent vaccination was the most persistent and pronounced.

Relevance. Osteoporosis is a multifactorial disease with a high level of disability, which is a serious health problem worldwide. High prevalence and disability rates are associated not only with the peculiarities of the course of this pathology, but also with the untimely diagnosis and initiation of therapy. Therefore, it is extremely relevant to search for specific and accessible markers of osteoporosis, such as molecular genetic markers or single-nucleotide polymorphisms, analysis of which will help identify risk factors for disease development before clinical symptoms manifest during patient examinations.

Aims. This study is aimed at finding risk factors for the development of HCG in patients with gastritis and the relationship of polymorphisms of various genes with the development of this pathology.

Materials and methods. A search was made for the association with osteoporosis of singlenucleotide polymorphisms of the genes: COL1A1, CYP2R1, ESR1, LCT, LRP5, VDR in residents of the Russian Federation (n = 669). Polymorphic markers of candidate genes were selected for research based on the presence of associations with osteoporosis according to previously conducted studies published in the RSCI, PubMed, Web of Science, MEDLINE, Scopus databases, as well as on the results of monitoring polymorphisms included in the panels of genetic predisposition to osteoporosis of companies engaged in genetic testing in the Russian Federation. Two groups were formed for the study: the main (case) – 234 patients with an established diagnosis of Osteoporosis, the control – 435 patients selected using a random number generator from conditionally healthy individuals from the Basis Genomic Group database (Basis Genomics LLC). The groups were comparable in age and gender (p > 0.05).Statistical analysis was carried out using the StatTech v. 3.1.6. program (developed by Stattech LLC, Russia). The nature of the distribution of quantitative data was checked by the Shapiro-Wilk, Kolmogorov-Smirnov criteria, the statistical significance of differences in 2 independent groups was assessed using the Mann-Whitney U-test. The ꭓ2 Pearson criterion was used to evaluate the associations of alleles of selected genes with the risk of osteoporosis.

Results and discussions. Analysis of the maps of 669 patients showed that for residents of the Russian Federation, the polymorphism rs3736228 of the LRP5 gene can be used as a genetic marker of osteoporosis, since there were significant differences in the frequency of occurrence of CT and TT allele variants in the group of patients with osteoporosis and in the control group. Results of studies of single-nucleotide polymorphisms COL1A1_rs1800012_G/T, CYP2R1_rs10741657_A/G, ESR1_rs2234693_C/T, ESR1_rs9340799_A/G, LCT_rs4988235_C/T, VDR_rs1544410_A/G, VDR_rs2228570_C/T in residents of the Russian Federation The federations did not show significant differences between the groups, therefore, in the future, the results of studies of these polymorphisms to assess the risk of osteoporosis in patients should be evaluated with caution.

Conclusions. According to the results of the study conducted on residents of the Russian Federation, only one of the eight alleles in candidate genes for the risk of osteoporosis showed a significant relationship in patients in the Russian Federation. It has been shown that variants of TT and CT polymorphism rs3736228 of the LRP5 gene are the risk genotype for osteoporosis.

Relevance. M. kansasii are one of the main nontuberculous bacteria pathogens causing mycobacterial infections in most European countries (including Russia). An important problem in the treatment of mycobacteriosis is the resistance of their pathogens to antibacterial drugs (ABDs). Bedaquiline (Bdq) is one of the new ABDs, the effectiveness of which is shown, in particular, in the most common mycobacteriosis – tuberculosis.

Aim. To characterize the features of drug sensitivity of M. kansasii isolated from respiratory material at the Moscow Scientific and Practical Center for Tuberculosis Control (MNPC BT).

Materials and methods. A total of 76 M. kansasii cultures have been studied. The MIC spectrum of Bdq was determined for M. kansasii, MIC50, MIC90 (the concentrations of Bdq providing inhibition of the growth of 50% and 90% mycobacterial strains, respectively) and ECOFF (epidemiological cut-off value) – the MIC value characterizing the upper limit for the «wild» population type, which was determined using the ECOFFinder statistical calculator – EUCAST. The drug sensitivity of M. kansasii to the main ABDs used in general practice for the treatment of the corresponding mycobacterioses was also evaluated.

Results. It was found that the MIC of Bdq in relation to M. kansasii were distributed in the range of 0.003-2.0 (mcg/ml), the growth of most strains (73.7%) was be inhibited by the concentration of Bdq0.015 mcg/ml. Among all studied strains of M. kansasii, the number of isolates resistant to Bdq were 2 (2.6%). The data obtained are generally consistent with the data of other authors and show that Bdq can currently be an effective drug for the treatment of mycobacterial infections caused by M. kansasii.

Conclusion. The results of the study, as well as literature data, indicate that M. kansasii is currently usually sensitive to Bdq. However, in some cases, resistance to this drug is already developing.

Relevance. Currently, there is no registered vaccine against the hepatitis B virus (HBV) mutant G145R worldwide, which justifies the need to develop a new generation of vaccines due to large-scale immunization against hepatitis B and the accumulation of escape mutants of the virus.

The aim of the study was a comparative assessment of the immunogenicity, reactogenicity and safety of Bubo®-Unigep (trivalent hepatitis B recombinant yeast vaccine) and the drug Hepatitis B recombinant yeast vaccine.

Materials and methods. To assess the main characteristics of the new trivalent vaccine Bubo®-Unigep (CJSC NPC «COMBIOTECH»), a doubleblind, comparative, randomized, multicenter clinical trial was conducted in two parallel groups in previously unvaccinated individuals in an adult healthy population (n = 166) according to a protocol developed by the contract research organization «R&D Pharma».

Results. The assessment of hematological and biochemical parameters during screening and the administration of vaccine preparations showed that in the individuals included in the study, the studied indicators were within the boundaries of the normal range. According to the criteria for assessing safety and efficacy, both drugs had low reactogenicity, no serious adverse events were registered. The results of a comparative analysis of the concentrations of antibodies to HBsAg determined after a full course of immunization with Bubo®-Unigep vaccine or recombinant yeast Hepatitis B vaccine showed that both drugs effectively induced a humoral immune response (anti-HBs) with seroprotection rates of 96.3% and 92.6%.

Conclusion. The inclusion of the relevant HBV serotypes (ay and ad) and the mutant antigen G145R in the composition of the new polyvalent vaccine Bubo®-Unigep contributes to the expansion of the spectrum of specificity of the immune response, and, consequently, more effective vaccination of hepatitis B.

Relevance. Over the past two decades, due to the effectiveness of anti-epidemic measures, the incidence of infectious diseases in the Republic of Dagestan (RD) has been declining. However for some nosologies it is considerably higher than the Russian Federation average.

Objective. To analyze the incidence of infectious diseases in RD in 2019–2022 in order to identify areas for preventive and anti-epidemic measures to be strengthened.

Material and methods. The data on morbidity taken from federal statistical observation form No. 2 «Information on infectious and parasitic diseases», State reports on sanitary and epidemiological well-being of the population for 2019, 2020, 2021, 2022, prepared by Rospotrebnadzor and the Department of Rospotrebnadzor for Dagestan Republic were analyzed. A descriptive epidemiological method was used, which does not require statistical data processing.

Results and discussion. In 2022, in the Republic of Dagestan, the infectious disease incidence was 7492.2 per 100 thousand of the population, which is 22.2% lower than in 2021, but higher than the long-term average (6149.4). In 2022, compared to 2021, there was a decrease in the incidence of 10 nosoforms of infectious diseases in the RD and 6 in the Russian Federation. Along with a decrease in morbidity, there is an increase in morbidity, in particular Sonne dysentery by 5.1 times, аcute intestinal infections (established etiology) by 39.3%. chronic hepatitis B by 97.9%, chronic hepatitis C by 2.14 times, whooping cough by 5.1 times, chicken pox by 18.6%, mumps by 2.2 times, brucellosis by 24.4%, HIV-infection by 36.3%, influenza 43.4 times. In the structure of infectious and parasitic diseases in 2022, as in previous years, acute infections of the upper respiratory tract and аcute intestinal infections prevailed.

Conclusions. Despite the ongoing systematic work aimed at reducing the incidence of infectious diseases and the progress made in improving the situation with a number of infections, more measures are needed to combat acute intestinal infections, hepatitis B and C, HIV-infection, brucellosis.

Relevance. It is known that antitoxic immunity saves from diphtheria, but does not prevent the carriage of Cd (tox+). Asymptomatic carriers of Cd (tox+) play a major role in maintaining the epidemiological process of diphtheria infection.

Aims. Characteristics of the population composition and specifics of the kinetic reactions of Cd (tox-) and Cd (tox+) simultaneously functioning among people.

Results. The functional features of the specific kinetic reactions of individual populations play an important role in the existence of microbial populations in human biotopes. The introduction of the corinephage tox+ gene into the symbiotic individual Cd (tox-) promoted the synthesis of the toxin and the adaptive stability of the Cd (tox-) population in the environment. Metabolites Cd (tox-) - autostabilizers of microbial growth form microecological symbiotic systems of human biotopes.

Conclusions. The use of the metabiotic drug Kodivac from symbiotic Cd (tox-) allows: to treat long-term carriers of Cd (tox+); reduce circulation of Cd (tox+) in the population; together with small doses of diphtheria toxoid to create protection against diphtheria; form symbiogenesis in human biotopes, suppressing dysbiotic inflammatory reactions.

Relevance. Community-acquired pneumonia and chronic obstructive pulmonary disease (COPD) remain a serious public health problem in all respects today.

Aims. To summarize the studies of domestic authors on the study of the effect of pneumococcal polysaccharide vaccine on various parts of the immune system and their relationship with the clinical course of the disease in patients with COPD and community-acquired pneumonia. We also consider it necessary to discuss the possible mechanisms of therapeutic effects after the introduction of a monovaccine against S. pneumoniae, as well as when it is combined with vaccines against Haemophilus influenzae type b infection, and the effectiveness of various vaccination regimens, including complex ones.

Conclusions. Convincing arguments are presented proving that the introduction of vaccines against respiratory infections can have not only a reventive value, but also a therapeutic effect, accompanied by a transient restoration of the immune system parameters, as well as a reduction in the contamination or elimination of S. pneumoniae in patients with chronic pathology of the bronchopulmonary system.