[Etiology of the epidemic outbreak of community-acquired pneumonia in children in St. Petersburg]. / Etiologiia épidemicheskoi vspyshki vnebol'nichnoi pnevmonii u detei Sankt-Peterburga.

In September-December 1998 the epidemic rise of outhospital pneumonia (EP) among children was observed in St. Petersburg, which led to a twofold increase in morbidity rate this year. The study of the etiology of EP during the period of 1998-2001 confirmed the prime role of Streptococcus pneumoniae (74.5%) and, for the first time in Russia, revealed the epidemic outbreak of acute chlamydiosis (Chlamydia pneumoniae), diagnosed in 67.3% of children, the maximum occurrence (87.5%) in 1998 with only 19% of the patients having the disease in the form of monoinfection. The prevalence of S. pneumoniae and C. pneumoniae in the etiology of EP and more severe course of mixed infection suggested that these infective agents played a leading role in the epidemic outbreak of acute respiratory infections in St. Petersburg.

[Immunoserodiagnosis of acute Streptococcus pneumoniae and Chlamydia pneumoniae infections in the period of epidemic rise of non-hospital pneumonia in children in St. Petersburg, 1998-2001]. / Immunoserodiagnostika ostroi pnevmokokkovoi i khlamidiinoi infektsii pri épidemitseskom pod"eme vnebol'nichnoi pnevmonii u detei v Sankt-Peterburge v 1998-2001 gg.

The dynamics of the antibody formation to S. pneumoniae and C. pneumoniae in children during the epidemic outbreak of non-hospital pneumonia in St. Petersburg in 1998-2001 was studied. For the first time the inhibiting influence of acute C. pneumoniae infection on the synthesis of antibodies to S. pneumoniae in acute mixed infection was established. The prolonged (up to days 29-39 of the disease) circulation of IgM and IgG antibodies in acute chlamydial infection, as well as the prevalence of the primary infectious process, were detected.

[The role of intrauterine infection of the central nervous system with herpes simplex viruses in development of encephalopathies in infants]. / Znachenie vnutriutrobnogo infitsirovaniia tsentral'noi nervnoi systemy virusami prostogo gerpesa v razvitii éntsefalopatii u detei rannego vozrasta.

Intrauterine infections often affect the infant brain and cause meningoencephalitis and long-term encephalopathy. In this study we have analysed morphological changes in different parts of CNS of 22 deceased infants who had suffered from encephalopathy of different degree due to persistence of herpes simplex viruses. Morphological, immunofluorescent, serological methods were used. Antigens of herpes simplex viruses I and/or II were detected in the CNS of most examinees. Relevant antibodies were detected in the serum and cerebrospinal fluid. Intrauterine infection was confirmed by the presence of specific for herpes simplex viruses morphological changes in the placentas. Hydrocephaly, secondary microencephaly, false cysts, microgyria were found macroscopically. There were herpes simplex viruses specific histological changes such as nuclear hyperchromatosis, intranuclear basophilic and acidophilic inclusions and nonspecific changes (gliosis, productive vasculitis). The data demonstrate that intrauterine herpes simplex viruses persistence in the CNS is an important cause of infantile encephalopathy, specific and nonspecific changes indicate a chronic course of the infection and depend on the degree of clinical symptoms.

[Frequency of acute cytomegalovirus infections among people of differing age groups]. / Chastota ostroi tsitomegalovirusnoi infektsii sredi lits raznykh vozrastnykh grupp.

The incidence of cytomegalovirus (CMV) infection was assessed from the presence of anti-CMV IgM in the sera of 1312 children of different age and 250 adults by the Labsystems enzyme immunoassay kit. CMV-specific IgM are rare in newborns (1.3%), but their incidence increases to 5% during the first year of life. These antibodies occur in 5-6% preschool and schoolchildren. The incidence of acute CMV infection is the highest in adults: 15%.

[Status of the fetus and placental function in women with viral and Mycoplasma infections]. / Sostoianie ploda i funktsiia platsenty u zhenshchin s virusno- mikoplazmennoi infektsiei.

Females with viral and Mycoplasma infection were studied for the fetal and placental status. There was fetal growth retardation; disorders in fetal cardiac performance; placental dysfunction appeared as decreased levels of placental lactogen, chorionic gonadotropin, appeared signs of placental aging, decreased blood flow.

[Involvement of the afterbirth in influenza]. / O porazhenii posleda pri grippe.

Light- and fluorescence-microscopy examinations of 186 placentas were carried out, with concurrent determination of placental interferon, isolation of influenza virus, and serologic tests of maternal and fetal blood, and amniotic fluid. In 32 of the cases, placentitis caused by serotype A or B of influenza virus was present, characterized by hyperplasia and subsequent destruction of amniotic cells, trophoblast, decidual cells, and vascular endothelium, by the presence of influenza antigens, fuchsinophilic cytoplasmic inclusions in the affected cells, and lymphoid infiltrates, and/or by circulatory disturbances. In addition, an interferon possessing properties of viral, immune, and placental interferon was detected in a number of placentas. A or B influenza virus was isolated from 3 placentas. Diagnostic titers of anti-influenza antibody occurred in fetal blood and amniotic fluid samples. The present results indicate that influenza virus may persist and replicate in placental cells.

[Viral appendicitis]. / Vurusnye porazheniia cherveobraznogo otrostka.

In order to study the appendix involvement with respiratory viruses in appendicitis, 44 cases of this disease in patients varying in ages from 14 to 71 years were investigated at random. Light microscopy and immunofluorescent examinations of the appendix were performed. The results were compared with those of serological blood tests done in the time course. In 20 patients the role of respiratory viruses and sometimes Mycoplasma pneumoniae proved to be doubtless by a significant rise in antibody titres (4-32-fold), as a rule, without any marked manifestations on the part of the respiratory organs. This was combined with detection of the antigen of the agent in enterocytes and with structural changes of the organ typical of these infections according to the results of previous examinations of the intestinal tract in generalized acute viral respiratory infections and mycoplasmosis. In 14 patients the role of respiratory viruses seemed to be likely. They showed positive results of immunofluorescent and light microscopy examinations without a significant rise in antibody titres, however. In 7 patients the role of respiratory viruses did not seem convincing: they had positive results of either immunofluorescence or serological tests alone. Three patients had no evidence of lesions caused by respiratory viruses or mycoplasma.

[Incidence of intrauterine infections caused by respiratory viruses and Myc. pneumoniae and the role of serological studies in their diagnosis]. / O chastote vnutriutrobnykh infektsii, vyzvannykh respiratornymi virusam i Myc. pneumoniae, i roli serologicheskogo issledovaniia v ikh diagnostike.

Examinations involved 40 stillborns and infants of up to 3 days of age using light and immunofluorescent (IF) microscopy, and the results obtained were compared with the data of clinical observations and serological examinations of the blood of infants and their mothers. The diagnostic titer of antibody determined by complement fixation and hemagglutination-inhibition tests was higher to respiratory viruses (1--4 in each baby) in 72.5% of babies and to M. pneumoniae in 17.5%. At a high antibody titer indicating a considerable duration of the disease, the results of IF studies were usually negative and the structural changes typical for individual infections of this group were insignificant or absent. This agrees with the results of previous studies of postnatally developing viral infections. At low antibody titres, in a number of cases the results of IF studies were positive and there were structural changes indicating a recent development of the disease. The possibility of antibody formation in fetuses was confirmed by selective studies of globulins in influenza A which proved to be M-globulins.