The epidemic situation with tuberculosis in the Russian Federation is improving, but remains tense. From 2008 to 2018, the tuberculosis incidence rate of the population of the Russian Federation decreased by 1.9 times. The factors affecting the course of the epidemic process of tuberculosis infection are considered: the reliability of indicators, the standard of living of the population, the timely identification of patients with tuberculosis, HIV infection in patients with tuberculosis and the resistance of mycobacterium tuberculosis (MBT) to medicinal anti-TB drugs. The incidence of tuberculosis in some cases underestimated due to deliberate misregistration and registration of newly diagnosed patients with tuberculosis. The use of Diaskintest during mass examinations of children and adolescents does not allow for the timely diagnosis of active tuberculosis in 60 % of children and in 12 % of adolescents identified from the Mantoux test. Primary infection of MBT in children 0–17 years of age with the use of Diaskintest, compared with the use of the Mantoux test (virage), is detected on average only in 6.9 % (from 3.1 to 26.3 %) of children with primary infection (virage) diagnosed by Mantoux test.

Parameters in which it is necessary to estimate efficiency of the held anti-epidemic events in the territory directed to decrease in a burden of TB at the present stage.

Antiseptics are an effective method of fighting infections associated with the provision of medical care, are widely used for the treatment and prevention of a number of diseases. The antimicrobial activity of antiseptics used in a multi-field hospital has been studied.

Background. Nosocomial infections remain an urgent problem of modern medicine. Along with bacterial infection of the bloodstream a special danger is posed by ventilation-dependent lung infection (VDLI), the main source which are still at the intensive care unit (ICU).

Objectives. Assessment of the spread of bacterial infections in ICU over a five-year period. Analysis of the severity of postoperative complications depending on the infection location.

Methods. A retrospective analysis of the frequency and form of blood flow and ventilation-dependent lung infection in patients, operated under cardiopulmonary bypass in the years 2013–2017.

Results. The rate of blood contamination in the departments ranged from 8.0 to 9.8 %; against the ICU — from 17 to 24 % (p < 0,01). Gram-negative associated mortality was significantly higher than gram-positive (p < 0.001). Acinetobacter spp. and Klebsiella spp. are the most common agents. Analysis of the primary detection of the pathogen showed that in 73.6 % of cases, the trachea is the area of the initial localization of combined-form infection.

Conclusions. The risk of bacterial complications in the early postoperative period is associated with gram-negative pathogen s (Acinetobacter spp. and Klebsiella spp.). Constant bacteriological monitoring in ICU is an effective prognostic tool of blood flow and ventilation-dependent lung infection. 

The etiology of community-acquired pneumoniae (CAP) was evaluated according to the results of molecular-genetic and bacteriological researches of nasopharyngeal aspirate from 405 patients. According to molecular genetic studies, S. pneumoniae and M. pneumoniae are most frequently isolated from patients with CAP, and more often in children than in adults. Associations of microorganisms have been identified, among which S. pneumoniae occupies a leading position. According to bacteriological studies, S. pneumoniae is frequently isolated from patients with CAP, although the bacteriological method is not very effective.

Through rapid ATP tests, it was found that additional automatic cleaning of endoscopes after manual handling reduces the number of cases of inadequate final cleaning of the surface of the endoscope and its channels by 4.0–4.5 times as compared to using manual treatment alone. Performing of an automatic final cleaning of endoscopes enables to increase the degree of epidemiological safety of non-sterile endoscopic interventions.

The article presents an assessment of the effectiveness of the effect of specific prevention measures on the incidence of tick-borne viral encephalitis in the population of the regions of the Siberian Federal District. The data on the incidence of Rospotrebnadzor of the Russian Federation and the regions of the Siberian Federal District for 2000–2017 years were used, the reporting of regional health services, the conditions and cause-effect relationships of the incidence of tick-borne encephalitis were assessed in the analysis of epidemiological survey maps of outbreaks. The study found that the analysis of the potential risk of contact with the foci of this infection in the regions of the Siberian Federal District, based on the ranking of regions by the level of population’s appeal for tick bites, can be considered as a prognostic criterion in planning the volume of preventive measures. Vaccination, having a significant impact on reducing morbidity (r = –0.89; p < 0.001) and mortality (r = –0.86; p < 0.001) from this infection, together with seroprophylaxis, can be one of the leading factors in epidemiological forecasting the incidence of tick-borne viral encephalitis in endemic areas.

Purpose. To evaluate the significance of IgG detection to glycoprotein E of varicella-zoster virus (VZV) for the infection stage diagnosis.

Materials and methods. Integration of literature data.

Results. Analysis of literature data allows to make quite reasonable conclusion that the dynamics of IgG antibodies to glycoprotein E of VZV is subject to the general laws of the antibody productions in the course of infectious processes, although the final completion of this discussion the essential results of direct detection of the dynamics of these antibodies in various stages and forms of the indicated infection.

The problem of assessing and improving the quality of medical care in a medical organization is considered. Analyzed the management of medical organization processes. A scheme for managing these processes, a list of regulatory documents, types and methods for monitoring the effectiveness of their implementation are presented. Formed groups of criteria used to assess the quality of the medical organization. It is argued that the introduction of a quality management system for the provision of medical care in a medical organization increases the efficiency of its activities.

Clinical observation of a young patient without an organic pathology of the heart, who repeatedly sought medical help in connection with complaints of episodes of dizziness, lability of blood pressure and pulse numbers, is presented. The medical survey revealed a link between clinical symptoms and progressive retardation of AV conduction (from first-degree AV block to second-degree Mobitz II), and therefore the patient was recommended to be implanted with permanent artificial cardiac pacemaker. To clarify the nature of the conduction disorders, an invasive electrophysiology study was performed, which revealed a proximal AV block due to vagal influences. As the most likely cause of stimulation n. vagus was considered identified in a patient gastroesophageal reflux disease associated with hiatal hernia. Surgical treatment (laparoscopic fundoplication) led to a regression of the clinical and electrocardiographic picture, avoiding the implantation of permanent artificial cardiac pacemaker. The tactic chosen is consistent with the algorithm for managing patients with AV conduction abnormalities (2018 ACC / AHA / HRS Guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay), which involves eliminating potentially reversible causes of bradyarrhythmia before deciding whether to install permanent artificial cardiac pacemaker.