[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].

[The microbiological monitoring as a basis of epidemiological control and anti-microbial therapy in conditions of multi-type hospital.]

The study was carried out to investigate features of microbiota and resistance to antibiotics of agents isolated from bio-material of patients in the conditions of multi-type hospital. The microbiological analysis was applied to 6148 samples using optimal set of corresponding techniques (classical tests, chromogenic mediums, immune serological, Maldi-Tof mass spectrometry). The resistance to antibiotics was established by using disk diffusion test (EUCAST 2016, Adagio analyzer). The leading role in etiology of pyoinflammatory processes belongs to E. coli, coagulase-negative staphylococci, enterococci, C. albicans. In the department of contaminated surgery among leaders are S. aureus, opportunistic enterobacteria, hemolytic streptococci, non-fermentative gram-negative microorganisms. In the department of traumatology and orthopedics first place was for representatives of enterobacteria family headed by E. coli, then follows S. aureus and after that other types of microorganisms. The main representatives of microorganisms, isolated from patients of the department of anesthesiology and reanimation, occurred blue pus bacillus, S.aureus, Klebsiella. In the department of therapy first place was for pneumoccocus and yeast-like fungi genus Candida. The resistance to antibiotics of main microflora differs depending on perspective of profile departments. It is extremely important to examine accurately for detection of agent of disease and to establish sensitivity to antibiotics of various groups.

[THE INFECTION INDUCED BY STREPTOCOCCUS OF SEROGROUP B IN PREGNANT WOMEN, PUERPERA AND NEWBORNS].

The streptococci of serogroup B (Streptococcus agalactiae) are one of major etiologic agents responsible for occurrence of severe perinatal infections in puerpera and newborns. The prevalence of streptococci of group B is analyzed in various categories of women (stage of preconception training, pregnancy, puerpera) and newborns transferred for particular reasons to second stage of raising. The data of microbiological monitoring during four years was involved. It is established that prevalence of carriage of streptococci of serogroup B in genital tracts of women of reproductive age on territory of Omsk consists 6-8% in different categories of female patients and has no tendency to decrease. In most cases, high or moderate level of dissemination, association with other opportunistic microorganisms. The perinatal infection of premature newborns with low body mass at birth with S. agalactiae results in clinical manifestation of generalized infectious process. The infection of healthy premature newborns most often does not result in severe infectious pathology. However; in the half of all cases development of local (significantly more rarely - generalized) pyoinflammatory induced by S. agalactiae as both isolated and in association with other opportunistic microorganisms. The relatively high rate of realization of potential of agent in newborns of risk group requires attention to the issues of diagnostic of carriage of streptococci group B in pregnant women, inclusion of this type of analysis into standards of observation for given category of female patients with purpose of timely sanitation, development and elaboration of standards of laboratory analysis on this agent.

[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.