The problem of biological safety is extremely relevant today for all countries of the world because of the real and potential threats caused by biological agents that are dangerous to public health and the environment. Modern microorganisms are becoming increasingly aggressive towards humans, as clearly demonstrated by the COVID-19 pandemic, which has affected all aspects of people's lives and exposed the vulnerability of the healthcare system. According to the Decree of the President of the Russian Federation «On the Fundamentals of the State policy of the Russian Federation in the field of chemical and biological safety for the period up to 2025 and beyond» and the Federal Law «On Biological Safety in the Russian Federation», the main objectives of state policy are to reduce the risks of negative effects of biological factors on the population and the environment. Antimicrobial resistance, the emergence of new infections and the overcoming of interspecific barriers by microorganisms are of particular concern. Infectious disease agents with epidemic potential, such as Ebola, Zika, Marburg, Lassa, MERS-CoV and SARS-CoV viruses, continue to pose a high threat. To counteract new biological threats, Russia has created a scientific concept of future biosafety, focusing on the development of genomic epidemiological surveillance, digital transformation and mobile technologies. Effective management of epidemic processes requires constant monitoring of genetic changes in infectious agents and prompt response to new threats, which allows the VGARus platform created in Russia to monitor virus mutations. Thus, genomic epidemiological surveillance is becoming a key element of ensuring biological safety and scientific and technological development in Russia.

Relevance. The relevance of this work is determined by obtaining new data on the geography of distribution and manifestations of the epidemic process of West Nile fever in Russia as a result of exploratory scientific research and systematization of the results of long-term (since 2010) monitoring of the causative agent of this infection. Aims: assessment of the state and effectiveness of epidemiological surveillance of WNV and optimization of its methodological, scientific and practical support. Materials & Methods. We used the reporting data of the Rospotrebnadzor Directorates for the constituent entities of the Russian Federation, received by the Reference Center for monitoring the causative agent of West Nile fever, materials from scientific publications, monographic publications and dissertation research. The main research method is epidemiological. Results and discussion. The problems of monitoring the causative agent of West Nile fever are identified, which make it difficult to obtain objective data on the manifestations of epidemic and epizootic processes, the frequency of contacts of the population with the causative agent of the disease, and the possibility of developing epidemiological forecasts. The key areas for improving the monitoring system for the causative agent of West Nile fever are considered: conducting active reconnaissance surveys aimed at clarifying the nosoarea, performing an assessment zoning of the territory of Russia, establishing minimum volumes of epizootological monitoring, ensuring the readiness of medical organizations to identify and diagnose cases of diseases, strengthening organizational and control functions Directorates of Rospotrebnadzor for the constituent entities of the Russian Federation, the frequency of studies in administrative territories to study the immune layer of the population to the West Nile virus and the differentiation of the immune response to the tick-borne encephalitis virus. Conclusions. The proposed set of measures will improve the objectivity and reliability of information received within the framework of the functioning of the epidemiological surveillance system, timely adjust preventive measures and take maximum control over the development of the epidemiological situation in the territory.

Hepatitis B (HB) remains one of the serious medical and social health problems, and to assess the epidemiological situation, it is necessary to analyze the state of population immunity by collecting information on its intensity during serological studies. The aim of the work is to assess the level of population immunity against HB in the population of the Russian Federation in 2017 to 2022. Materials and methods. The results of serological monitoring for the presence of anti-HBs, provided by territorial laboratories of medical institutions of each subject of the Russian Federation in 2017 to 2022, were analyzed. The cohort of subjects in each subject of the Russian Federation consisted of persons in the age groups 3–4, 16–17, 20–29, 30–39, 40–49 years old, numbering at least 100 people each. The analysis of the obtained data for 6 years (2017–2022) was carried out using averaged data for every two years – 2017–2018, 2019–2020 and 2021–2022. The number of study cohorts during these time intervals was 88,151, 84,166 and 97,274 people, respectively. Results and discussion. The average values of the proportion of persons with immunity against HB were 69.0% in 2017–2018, 66.2% in 2019-2020 and 61.3% in 2021–2022. The highest proportion of people with protective immunity against hepatitis B was observed in the age group of 20-29 years. The proportion of children 3-4 years old who had anti-HBs detected at a concentration exceeding 10 IU/l was 65.8–72.5%, and 16–17 years old – 49.6–64.9%. The intensity of post-vaccination immunity against HB in children 16-17 years old should be considered insufficient. Conclusion. An analysis of serological studies results for the period from 2017 to 2022 showed that the potential of vaccine prevention of hepatitis B, carried out since 2006 within the framework of the priority National Project «Health», is not fully realized.

Relevance. Although meningitis is largely preventable, it still causes hundreds of thousands of deaths worldwide each year. Significant progress has been made in reducing meningitis mortality over the past three decades. The incidence of meningococcal, pneumococcal, and Haemophilus influenzae type b meningitis has declined due to the introduction of vaccination into national immunization programs in countries around the world. Aim. To determine the epidemiological manifestations of purulent bacterial meningitis (GBM) in the Russian Federation (RF) in 2023. Materials and methods. An in-depth personalized system for recording purulent bacterial meningitis cases has been established at the Russian Reference Center for Bacterial Meningitis Monitoring. Since 2010, all territories of the Russian Federation have been included in the monitoring system. In 2023, the Reference Center received information on 1,837 cases of purulent bacterial meningitis. The paper uses a descriptive and evaluative epidemiological method: retrospective analysis. Results and discussion. The incidence of GBM in the Russian Federation over a fourteen-year observation period has a downward trend. Meningococcus, pneumococcus and Haemophilus influenzae are the causes of 85% of GBM cases in the Russian Federation, while the infections they cause are potentially vaccine-preventable. Meningococcus continues to occupy a leading position in the etiology of GBM in the Russian Federation, causing 50% of all laboratory-confirmed cases. Despite a slight decrease in the incidence of meningococcal infection in 2023, its increase in the age group at risk, children under 5 years of age, by 39% was noted. In the serogroup characteristics of meningococcus, for the first time in the studied period, the predominance of meningococcus serogroup W was revealed. In 2023, the highest mortality rate from meningococcal infection was noted – 21%. The incidence rate of pneumococcal meningitis in the age group at risk, children under 5 years old, increased to 28% in 2023, and categories of adults are defined as risk groups for mortality. The incidence of meningitis caused by Haemophilus influenzae among children under 5 years old decreased by 44%, and all cases of death, with the exception of one, were noted in this age group. Conclusion. The data obtained make it possible to track the etiology of GBM, age groups and risk areas, which can serve as a basis for developing tactics to combat the disease with priority use of vaccines.

Relevance. Colorectal cancer (CRC) is the third most common cancer in the world. In the Russian Federation, high rates of neglect in late diagnosis of colon cancer have been established. The study of the complex influence of social, clinical, anamnestic and dietary risk factors in the development of colorectal cancer is valuable in identifying risk groups for effective secondary prevention. Aims. Assessment of the importance of medical and social, clinical and anamnestic, alimentary-dependent factors as risk factors for colon cancer. Materials & Methods. To analyse the regional characteristics of CRC incidence, the database "Cancer diseases in the Northwestern Federal District" for 2010-2023 was used. To investigate the risk factors for CRC, a case- control study was organised in which patients over 18 years of age with or without diagnosed intestinal pathology (colorectal cancer, inflammatory bowel disease) were included. Results and discussion. Among patients with CRC, patients with advanced forms of the disease predominated: the proportion of CRC diagnosed at stage III and IV was 54% and 17% of newly diagnosed cases, respectively. When analyzing the data, no association was found between the risk of developing CRC and the presence of chronic diseases, oncological pathology, including CRC in relatives of the 1st and 2nd degree of kinship, alcohol abuse and smoking, as well as with most alimentary-dependent factors, with the exception of fried and smoked fish. Conclusions. Colon neoplasms are detected in the population of the Northwestern Federal District at late stages and when patients seek medical care independently. Significant attention in epidemiological studies should be paid to such a factor as eating fish after certain types of heat treatment (fried and smoked). prospects for further research, in our opinion, are related to the search for informative markers to identify risk groups, in particular factors associated with altered intestinal microbiota and colonisation of the intestine with potentially oncogenic microorganisms.

Relevance. Escherichia marmotae is a recently described species of Escherichia that is considered a potential new zoonotic pathogen. The geographical distribution of this microorganism in wild animals and its genomic diversity are currently insufficiently studied. Aims. The purpose of the study was to determine the pathogenic potential of the Escherichia marmotae 16guk strain isolated from zoogenic material on Hooker Island (Arkhangelsk Region, Franz Josef Land Archipelago) and its phylogenetic relationships with previously described strains of different origin. Materials and methods. The Escherichia marmotae 16guk strain was isolated from the faeces of an arctic fox (Vulpes lagopus) near a breeding ground. The pathogenic potential of the strain was assessed on the basis of genomic sequencing data using Illumina technology, an estimate of the mean lethal dose when administered intraperitoneally to mice, and an assessment of the antibiotic resistance phenotype using the disc diffusion method. To determine the phylogenetic position of the described strain within the overall structure of the microbial population, genome-wide sequencing data deposited in NCBI GeneBank were used. The phylogenomic analysis was performed based on the distance matrix of single nucleotide polymorphisms in the core genome due Parsnp. Results. The strain is characterized by low virulence when tested on mice (LD50 was 1.3*109 K.O.E.), has resistance to ampicillin and gentamicin. A number of pathogenicity factors have been identified in the genome structure, which includes siderophores of enterobactin and aerobactin operons, fimbria type I genes characteristic of extraintestinal Escherichia strains, amyloid-like protein villi (curli) and capsular genes, as well as the ibeABC invasion factor operon. The resistome is represented by blaEC15 beta-lactamase genes and acrAD-TolC efflux pump genes. According to the results of phylogenomic analysis, the strain under study shows the greatest similarity with the genome sequences of strains circulating in New Zealand and Germany among wild animals (wild boars) and birds. The similarity of the genomes of strains distributed in distant geographical regions and the isolation of the 16guk strain within an ornithogenic ecosystem can be interpreted as a result of the spread of E. marmotae with migratory birds. Conclusions. The discovery of the Escherichia marmotae 16guk strain in one of the most remote Arctic territories demonstrates the possibility of the emergence and circulation of enterobacteria strains with significant pathogenic potential in the island territories of the high-latitude Arctic, which actualizes the need for systematic monitoring studies in this region.

Relevance. Healthcare-associated infections are a serious complication worldwide, with improper hand cleaning thought to be the main cause. Compliance with handwashing requirements is achieved in only 38% of cases. A risk management technology is the implementation of a standard operating procedure in practice, and an effective tool for analyzing non-compliance with its standards is an audit system that allows you to respond in a timely manner to existing deviations. The introduction of a system of audits of the epidemiological safety of medical technologies seems to be one of the directions of the risk-based approach to the prevention of infectious complications. Aim. To evaluate the effectiveness of hand sanitizing technology audits as a tool to reduce the risk of infections. Materials and methods. Over a three-year period, an audit of handwashing was carried out in four departments of the cardiac surgery center, during which 9924 checklists were analyzed. The audit itself took place according to the methodological recommendations we had previously developed. The audit results were processed in Microsoft Excel to form a database. Risk grading was carried out for each checklist using the risk matrix and the Percentile function in increments of 0.25 Results. During the audit, 5 items related to hand treatment technology were assessed: equipment of the workplace for hand treatment, hand treatment technology, the presence of antiseptic in areas of mandatory hand treatment, epidemiological safety during manipulation and patient care, organization of the hand treatment system. Initially, the risk in all positions was assessed as high, the implementation of corrective measures reduced the risk of infections associated with the provision of medical care to low values, and the incidence of infections in the cardiac surgery hospital decreased from 3.42 to 1.25 per 1000 patient days. Conclusion. The introduction of an audit system for hand sanitizing technology is an effective measure to reduce the risk of infection.

SARS-CoV-2 has been actively circulating in the human population since late 2019. During this time, the virus acquired more than 140 nucleotide mutations and 20 deletions per genome from the original variant identified in Wuhan. As the virus circulates, the proportion of re-infected individuals increases, but it is unclear how well neutralizing antibodies formed by infection with early variants neutralize the new Omicron variant lines. We analyzed the neutralizing activity of 286 sera from 286 adult patients with COVID-19 in 2020-2021, during the circulation of the prototypical lines and the Delta variant of SARS-CoV-2, against strains of the original lines and the Omicron ВА.1 and ХВВ.1.9. 2. About 10% of the sera of people who overexperienced COVID-19 while the prototypical strains were circulating and about 50% of people who overexperienced it while the Delta variant was circulating contain antibodies that neutralize Omicron ХВВ.1.9 was circulating in 2023. Thus, a fraction of people, regardless of age, who became infected in 2020-2021 have an antibody spectrum capable of neutralizing current and possibly related SARS-CoV-2 variants that will emerge in the near future. However, no strong positive correlation was found between IgG levels to RBD and NAТ titers to SARS-CoV-2 (R < 0.5), which may complicate serologic diagnosis of COVID-19 and lead to inappropriate assessment of human protection and the presence of an immune layer to SARS-CoV-2 in population-based studies.

Relevance. Patients with HIV infection is of the leading risk groups for tuberculosis. According to WHO, the presence of HIV infection increases the likelihood of developing tuberculosis by 26 times and is the second factor in the world after malnutrition that affects the number of cases of tuberculosis. Aims. Study of primary infection with M. tuberculosis, spread of latent infection and incidence of tuberculosis in HIV-infected patients during 8 years of observation. Materials & Methods. An analysis of the data from the register of requests to the Cabinet was carried out. We studied a cohort of persons living with HIV who first visited the TB office in 2016. We studied information about screening for latent and active tuberculosis infection. We studied information about the course of HIV infection: the date of registration at the AIDS Center, the date of receiving a positive immunoblot result, the level of CD4+ lymphocytes, the stage of HIV infection, information about taking antiretroviral therapy. Results and discussion. The study was conducted on a large array of data obtained in a cohort of patients with HIV infection who first applied in 2016 to the office for the prevention and early detection of tuberculosis of the Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health and was observed for 8 years until 2023. For evaluation of the spread of tuberculosis infection among persons living with HIV, a subgroup of 5754 people was identified for whom the test results with recombinant tuberculosis allergen -ATR, were known in 2016, which amounted to 80.8%. A total of 6,733 ATR were administered, with 15.0% of patients not presenting for evaluation, 1.0% refusing the test, and 3.2% having a medical exemption from the skin test. In this group, over 8 years (2016-2023), 38 (13.1%) people out of 291 patients with ATR(+) and 55 (1.0%) people out of 5503 people with ATR(-) fell ill. During the first 4 years of observation in 2017-2020, 91.7% of all tuberculosis cases were registered for persons living with HIV with LTBI in 2017-2023. Conclusion. The presence of LTBI in patients with HIV infection increases the likelihood of developing tuberculosis by more than 10 times, while the chance of developing tuberculosis is more than five times lower in people with LTBI who have received a full course of preventive treatment for tuberculosis. The lack of preventive therapy for tuberculosis accelerates and increases the likelihood of persons living with HIV contracting tuberculosis: during the first year of observation, 70% of all cases become ill.

Relevance. Hemorrhagic fever with renal syndrome (HFRS) and tick-borne encephalitis (TBE) are the most common natural focal diseases of viral etiology in Russia. The medical and social significance of these two infections is determined by the extensive foci of their spread, high annual morbidity rates, and the presence of severe forms of the disease can lead to permanent disability and even death. Aim. To assess the current epidemiological situation of HFRS and TBE in the Russian Federation. Conclusions. Over 23 years (from 2000 to 2022), 164,582 cases of HFRS were identified in Russia with an average annual rate of 4.9 cases per 100 thousand population, as well as 71,579 cases of TBE with an average annual rate of 2.5 cases per 100 thousand population; 668 (0.4%) and 1136 (1.6%) deaths from HFRS and TBE, respectively; 4030 (2.5%) and 9414 (13%) children under the age of 14 years among patients with HFRS and TBE, respectively. The incidence of HFRS and TBE per 100 thousand population of Russia was higher among rural residents than among urban residents. Most cases of HFRS were registered in the autumn-winter period, and TBE – at the end of June – the first half of July. Of the 85 administrative regions of Russia, cases of HFRS and TBE are registered in 42, in 18 – only HFRS, in 13 – only TBE, and in 12 regions no clinically diagnosed cases of HFRS and TBE have been identified.

The Novel coronavirus infection (COVID-19) pandemic has shown that pregnant women are at risk for infection and severe COVID- 19. Pregnant women often experience gastrointestinal symptoms both during the peak of the disease and within 90 days after recovery. This review is devoted to the study of the effect of the SARS-CoV-2 virus on the gut microbiota of pregnant women. Since many studies confirm changes in the composition of the gut microbiota in COVID-19, the dependence of the severity of the course of infection on the composition of the gut microbiota, and the persistence of the virus in the gut after recovery. The question remains whether the composition of the intestinal microbiota changes in pregnant women and newborns during COVID-19, and whether it is possible to correct the state of intestinal dysbiosis during COVID-19 with probiotics for the purpose of prevention and treatment of pregnant women and newborns.

Доктор медицинских наук, профессор, директор ФБУН «Омский НИИ природно-очаговых инфекций» Роспотребнадзора, заведующий кафедрой микробиологии, вирусологии и иммунологии ФГБОУ ВО ОмГМУ Минздрава России Николай Викторович РУДАКОВ отмечает в ноябре юбилей

Заслуженный врач Российской Федерации, доктор медицинских наук, профессор, заведующий кафедрой эпидемиологии Воронежского государственного медицинского университета имени Н. Н. Бурденко Николай Петрович МАМЧИК отмечает в ноябре юбилей