Cases of Q fever detected in residents of the novosibirsk region hospitalized with suspection of infections transmitted by ticks

Coxiella burnetii is the causative agent of Q fever (coxiellosis), which, in addition to acute manifestations, often occurs in a latent form, is prone to chronic course and, in the absence of antibiotic therapy, has a high risk of disability or death. As a result of the presence of a wide range of clinical manifestations specific to other infectious diseases, the use of laboratory test methods (LTM) is required to make a diagnosis. The presence of Q fever anthropurgic foci in the Novosibirsk region was described in the 90s of the last century, but due attention to its laboratory diagnostics is not paid in this region. The aim of the study was to identify genetic and serological markers of the causative agent, C. burnetii, in patients of the Novosibirsk region who were admitted for treatment with fever with suspected tick-borne infections (TBIs). DNA marker of the causative agent of Q fever was detected in blood samples by real time PCR in 9 out of 325 patients. In three patients, the presence of C. burnetii DNA was confirmed by sequencing of the IS1111 and htpB gene fragments. In ELISA tests, antibodies against the causative agent of coxiellosis were detected in the blood sera of 4 patients with positive results of PCR analysis. Contact with tick was registered in 7 out of 9 patients who had C. burnetii DNA and lacked markers of other TBIs. Six people were infected in the Novosibirsk region, two suffered from tick's bite in Altai, and one case was from the Republic of Kyrgyzstan. Thus, a complex approach using both PCR analysis and ELISA provided the identification of markers of the Q fever causative agent in patients admitted with suspected TBIs, thereby differentiating it from other infections. Contact with ticks in most cases suggests that infection with C. burnetii had a transmissible pathway.

Characterization of the complete genome sequence of the recombinant norovirus GII.P16/GII.4_Sydney_2012 revealed in Russia

Noroviruses (the Caliciviridae family) are a common cause of acute gastroenteritis in all age groups. These small non-envelope viruses with a single-stranded (+)RNA genome are characterized by high genetic variability. Continuous changes in the genetic diversity of co-circulating noroviruses and the emergence of new recombinant variants are observed worldwide. Recently, new recombinant noroviruses with a novel GII.P16 polymerase associated with different capsid proteins VP1 were reported. As a part of the surveillance study of sporadic cases of acute gastroenteritis in Novosibirsk, a total of 46 clinical samples from children with diarrhea were screened in 2016. Norovirus was detected in six samples from hospitalized children by RT-PCR. The identified noroviruses were classified as recombinant variants GII.P21/GII.3, GII. Pe/GII.4_Sydney_2012, and GII.P16/GII.4_Sydney_2012 by sequencing of the ORF1/ORF2 junction. In Novosibirsk, the first appearance of the new recombinant genotype GII.P16/ GII.4_Sydney_2012 was recorded in spring 2016. Before this study, only four complete genome sequences of the Russian GII.P16/GII.3 norovirus strains were available in the GenBank database. In this work, the complete genome sequence of the Russian strain Hu/GII.P16-GII.4/RUS/Novosibirsk/NS16-C38/2016 (GenBank KY210980) was determined. A comparison of the nucleotide and the deduced amino acid sequences showed a high homology of the Russian strain with GII.P16/GII.4_Sydney_2012 strains from other parts of the world. A comparative analysis showed that several unique substitutions occurred in the GII.P16 polymerase, N-terminal p48 protein, and minor capsid protein VP2 genes, while no unique changes in the capsid VP1 gene were observed. A functional significance of these changes suggests that a wide distribution of the strains with the novel GII.P16 polymerase may be associated both with several amino acid substitutions in the polymerase active center and with the insertion of glutamic acid or glycine in an N-terminal p48 protein that blocks the secretory immunity of intestinal epithelial cells. Further monitoring of genotypes will allow determining the distribution of norovirus recombinants with the polymerase GII.P16 in Russia.

Clinical and laboratory characterictic of acute HIV-infection in adult residents of Novosibirsk region

Purpose of the study. To study the characteristics of acute HIV infection in adults in the Novosibirsk region in 2017– 2018.

Materials and methods. 200 patients with acute HIV infection, residents of the Novosibirsk region, aged 15 to 74 years, hospitalized in 2017–2018, 104 men and 96 women were examined. The diagnosis was verified by detecting antibodies to HIV in ELISA with a negative or doubtful result of the immunoblot, as well as by determining the quantitative content of HIV RNA in the blood by PCR. The hemogram, the content of CD4 + lymphocytes in the blood were determined. In addition, HIV-1 was studied in 71 patients for belonging to a genetic group.

Results. Patients of 20–40 years old prevailed – 70.5%. The sexual way was dominant in women (69.0%), injecting psychoactive substances was more often in men (32.2%). Frequent symptoms were fever (99%), exanthema (65.5%), polylimfoadenopathy (54.0%). Less common were diarrhea (36.0%), pharyngotonsillitis (23.0%), aphthous stomatitis (6.5%), hepatomegaly or hepatosplenomegaly (8.5%). Secondary diseases were revealed in 26.5% of patients. Leukopenia was recorded in 63.0%, thrombocytopenia in 62.5%, lymphocytosis and atypical cells of the lymphoid series in 14.0%. All patients had a high “viral load” – from 23,000 to 10,000,000 or more copies / ml, a decrease in the number of CD4 + less than 350 cells – in 38.0%. From among 71 patients, 19.7% had HIV-1 subtype A, and 76.0% had recombinant HIV-1 CRF63_02A. In the latter, “viral load” of more than 10,000,000 copies / ml was more often recorded (67.8% vs. 33.4%, p = 0.004).

Conclusion. A significant number of cases of acute HIV infection were reported in the Novosibirsk region in 2017– 2018. Its detection is possible by examination of all febrile patients who apply to medical institutions. Early initiation of antiretroviral therapy with the appointment of well-tolerated regimens contributes to the formation of a high commitment to therapy.

CLINICAL AND LABORATORY FEATURES OF ACUTE VIRAL GASTROENTERITIS IN ADULTS, RESIDENTS OF NOVOSIBIRSK

The aim of this study was to determine the frequency and the clinical and laboratory features of acute viral gastroenteritis in adult patients the residents of Novosibirsk.

MATERIALS AND METHODS

A total of 363 patients aged 16 to 82 years hospitalized with a diagnosis of"acure gastroenteriris" in the winter-spring season 2016 and with no evidence of immunosuppression were examined. In addition to generally accepted diagnostic techniques faeces were investigated using polymerase chain reaction for the detection and differentiation group A and C rotaviruses (HRVA and HRVC), I norovirus genogroup II (HNoV Gil) and astroviruses (HAstV) with applying the original set of specific primers.

RESULTS

Viral etiology has been set at 19,6% of patients with acute gastroenteritis. Noroviruses were predominant (10,2%), the proportion of rotavirus was 7,7%, astroviruses - 1,7%. The proportion of viral gastroenteritis was higher in the winter months and decreased in spring months. The moderate form of the disease dominated (99.4%). No significant differences in clinical symptoms, blood count and coprogram parameters were revealed in patients with different etiology of viral gastroenteritis, except the higher frequency of lymphocytosis in norovirus infection (p < 0,05).

CONCLUSION

Set frequency of viral gastroenteritis in adults, no significant differences in the clinical picture of viral gastroenteritis of various etiologies determine the necessity of elaboration and introduction into clinical practice of universal test systems for the detection of common viral pathogens.

[Chemiluminescent reaction of leukocytes stimulated with different agents in patients with erysipelas]

Forty-three patients with erysipelas and 10 donors were examined using chemiluminescent analysis in the presence of latex and staphylococcal reagent containing protein A. Staphylococcal protein A proved to be a more potent activator of oxygen metabolites than latex. Heterogeneity of chemiluminescent response of leukocytes stimulated by different agents makes it possible to assess the functional reserve of neutrophils and differentiate between the hyper-, normo-, and hyporeactive forms of erysipelas.

[Recurrent forms of opisthorchiasis]

The paper deals with follow-ups of 4 patients with chronic opisthorchiasis, two of whom were treated with chloxylum and two with bilthricide. Eight-thirty six months after discontinuation of anthelmintics, there were recurrent or enhanced complaints, repeated finding of Opisthorchis eggs and antigens in the feces. These changes were accompanied by elevated blood eosinophil counts. It is suggested that Opisthorchis metacercariae can be long preserved in latency in the definitive host and recurrent opisthorchiasis forms may develop.

[Dynamics of activity of creatine kinase and its isoenzymes in the serum of patients with alcoholism]

Activity of creatine kinase (CK) and its isoenzymes was studied in blood serum of 32 patients with alcohol abstinent syndrome of various severity as well as in persons with long-term remission (from 1 to 14 years) as compared with the enzymatic activity in healthy volunteers. The severity of alcohol abstinent syndrome correlated with an increase in the total enzyme activity in blood, where content of the all three CK isoenzymes (MM, MB and BB), especially of BB-CK, was elevated. Content of MB and BB isozymes was increased in blood of patients with long-term remission, while activity of each of the isozyme constituted up to 20-30% of total CK activity, which was by one decimal order higher as compared with control values. Importance of the alterations observed in activity of creatine kinase and its isoenzymes for diagnosis of alcoholism, especially under conditions of alcohol abuse and long-term alcohol abstinence, is discussed.

[Change in the activity of creatine kinase and its MB isoenzyme as affected by partial and complete occlusion of the coronary artery in rats]

A model of different degree left coronary artery (LCA) occlusion in rats has been developed. The activity of creatine kinase and its cardiospecific MB isoenzyme was determined both in the cardiac muscle and blood plasma of 62 animals at different time after complete or partial LCA occlusion. A direct dependence of the decrease in the enzyme activity in the heart and hyperfermentemia on the degree of LCA occlusion has been established. It is concluded that the model of LCA occlusion in rats could be useful for the study of different forms and stages of myocardial ischemia.

[Decurarization using the cation-anion molecular interaction of a myorelaxant and its antagonist]

In experiments on the cat neuromuscular preparation the authors investigated the anticurare action of the new compound IEM-931 having sulphonate-anionic groups 20 A apart. The new compound administered in a dose of 184 mkM/kg prevents and removes the curare effect of rythetronium which is its structural analogue. Regarding tubocurarine the antagonism is displayed, however, only from the dose of 384 mkM/kg. This indicates that efficacy of the anticurare action of IEM-931 is directly related to complimentarity of the interacting molecule structure. The experiment with regional relaxation of the cat muscles shows that the anticurare action of IEM-931 is realized both in the blood and on the cholinoreceptor. Moreover, as a result of molecular interaction the inactive complex is formed.

[Pharmacological characteristics of a new curariform compound from a series of naphthalene-peri-tetracarboxylic acid derivatives]

Experiments staged with rabbits, cats, frogs and chicken have proved tetracarboxylic acid dibenzosulphoethylate-bis (para-piperidinophenol)-diimidonaphthalene-1, 4, 5, (see article) to be capable of totally blocking the neuro-muscular conduction in a dose of 0.5 mg/kg and to block 20 per cent of it in a dose of 0.3 mg/kg. The action of the compound on the arterial pressure is half as great as that of d-tubocurarine. A pharmacological analysis conducted on the musculus rectus abdominus of the frog and chicken points to an antidepolarizing type of action. The durarolike effect of (see article) can be averted or abolished by introduction of nivalin (galanthamine), proserine and pimadine. The author deems it expedient to make clinical trials of the drug.