[Clinical and laboratory diagnosis of tick-borne rickettsioses in areas of low risk of infection Rickettsia sibirica.]

For the first time, a comparative description of clinical and laboratory parameters in patients with clinical signs of tick-borne rickettsiosis in a natural focus with a low risk of infection with R. sibirica and circulation of R. raoultii is given, depending on the results of serological verification of the diagnosis. Established almost complete coincidence of clinical and laboratory parameters in patients with tick-borne rickettsiosis, regardless of the presence of antibodies to R. sibirica and / or R. raoultii. It was shown that even the complex use of complement fixation test, indirect immunofluorescent test and ELISA for the detection of antibodies to R. sibirica does not allow verification of the diagnosis in a third part of patients with pathognomonic signs of tickborne rickettsiosis. In seropostive patients, antibodies to R. sibirica prevailed, which makes it impossible to differentiate cases of tick-borne rickettsiosis of different species etiology. The possible reasons of the phenomenon of «seronegativeness¼ of patients with tick-borne rickettsiosis and approaches to its study are discussed. It is concluded that with the existing diversity and insufficient knowledge of rickettsiae circulating in natural foci, and the current state of laboratory diagnostics, the basis for the diagnosis of «Tick-borne rickettsiosis¼ should be the clinical and epidemiological signs of this infectious disease, which must be recorded in the established order even no serological verification. For such cases, ICD-10 has two encoding options: A 79.9 - Rickettsiosis, unspecified (infection caused by rickettsia, no other indication) and A 77.9 - Spotted fever, unspecified (tick-borne fever, no other indication) [mkb-10.com].

[Evaluation of the effectiveness of the serological methods for the identification of antibodies in patients with tissue ricketsiosis on the territories of a different risk of Rickettsia sibirica infection.]

Cases of tick-borne rickettsiosis in Siberia and the Far East are associated with R. sibirica, the causative agent of Siberian tick typhus (STT). In connection with a sharp reduction in the nomenclature of diagnostic products and an increase in the spectrum of species of founding rickettsiae on the territory of Russia, new approaches to the laboratory verification of diagnoses are needed. We present an evaluation of the effectiveness of serological research methods (complement fixation test, indirect immunofluorescence, and ELISA) in patients with tick-borne rickettsioses in areas of different risk of infection with R. sibirica. Patients were diagnosed with STT from the highly endemic territory of the Altai Republic and from the Naziayevsky district of the Omsk region, where natural foci of rickettsioses of the spotted fever group was detected with the circulation of two species of pathogenic rickettsia, R. sibirica and R. raoultii. As a control group, samples of sera from epidemic seasons from clinically healthy people in Omsk were used. To verify the diagnosis of Siberian tick typhus, the use of serological methods is most appropriate, of which the most sensitive is ELISA, which allows detecting antibodies at an earlier time. In the ELISA for confirmation of the diagnosis, the first serum can be examined only on IgM. Investigation of the 2nd serum should be performed in ELISA for the presence of IgM and IgG antibodies with R. sibirica antigen. Reaction of indirect immunofluorescence (RNIF) for the study of paired sera should be conducted with specific antigens of rickettsia circulating in this focus. In laboratories not equipped for setting ELISA, it was recommended to use CFT. When the titer increases in two or more times and IgM and IgG are detected in the second serum, taking into account clinical manifestations, the diagnosis of "Siberian tick typhus" can be considered confirmed.

[The molecular biological methods of express-detection of pathogens in ticks taken way from patients as a basis of preventive therapy of tick transmissible infections.]

The complex molecular biologic study of ticks, took off from people in the Omskii oblast during Spring-Summer periods in 2014-2016 established their infection with agents of tick's transmissive infections and testifies a significant risk of infection of population. The analysis of ticks I. persulcatus established that rate of detection of DNA of borrelia made up to 59,5%, rickettsia - 30.6%, anaplasmae and erlichiae - 5.9%. The analysis of ticks D. reticulatus by polymerase chain reaction detected DNA of rickettsia in 20.5%, borrelia - in 6.6%, RNA of tick-borne encephalitis virus - in 3.6%. No DNA of anaplasmae and erlichiae was detected. During sequencing of tests positive to rickettsia the most often Rickettsia raoultii was identified. The approaches to expressdiagnostic and preventive therapy of tick-born transmissive infections were substantiated with consideration for mixt-infection of agents and pathogenic characteristics of developing nosologies. The algorithms of laboratory analysis regulated by the Sanitary Regulations 3.1.33-10-15 "Prevention of infections transmitted by ticks" require a broader implementation.

[Ureaplasma urealyticum and Ureaplasma parvum in etiology of urogenital mixt-infections].

The complex study of 104 vaginal samples from patients with urogenital uroplasmosis was carried out. U. parvum were detected in 67.3% patients, U. urealyticum--in 12.5% and in 20.1% cases--two species were registered at the same time. Isolation of clinical significant concentration of both ureaplasma (> 10(4) CFU/ ml) was detected in about 50% of cases. Expression of inflammation of vaginal mucus depended on the level of concentration of infection agents. U. parvum were associated with bacterial vaginosis, while in urogenital candidosis U. parvum was detected rarer than U. urealyticum. The dominant numbers of clinical ureaplasma were high sensitive to "new" macrolides and chinolons, however the high percent of isolates were resistant to erytromicin and doxiciclin.

[A new drug for serodiagnosis of listeriosis]. / Novyi preparat dlia serodiagnostiki listerioza.

Development and introduction into practical public health of new rapid methods for laboratory diagnosis of listeriosis, that will be characterized by a high sensitivity and specificity, is still a pressing problem. Listeriosis erythrocytic diagnosticum developed at the Omsk Research Institute for Natural Focal Infections permits the detection of species-specific antibodies in patients' sera and convalescents after this infection and is characterized by a sufficiently high diagnostic efficacy. Use of this agent appears to hold good promise in the diagnosis of listeriosis in the acute period of the disease, in retrospective diagnosis, and in screening of risk groups.