The relevance of the work is due to the increase in the number of hospital infections associated with antibiotic-resistant gram-negative pathogens on a global scale. For medical institutions, both from a clinical and economic point of view, the catastrophic situation is that the multidrug-resistant pathogens increasing leads to limited possible treatment options. Analysis of published scientific articles shows that today the strict epidemiological surveillance and the study of the pathogen resistance profile in each medical facility is an effective tool for controlling the growth of multidrug-resistant microorganisms, thus reducing morbidity and mortality.

Patients with hemoblastosis, especially recipients of hematopoietic stem cells, are the most immunocompromised group of patients, especially during prolonged episodes of drug-associated granulocytopenia. The aim of the study. To characterize catheter-associated bloodstream infections in patients with hematological profile. Materials and methods. During June to October 2017, catheter-associated bloodstream infections were detected in six patients in the oncogematology department. Results and discussion. All patients came from different regions of the Russian Federation. The diagnosis of infectious complication: catheter-associated bloodstream infection was established only in 33.3 %. When determining laboratory markers of sepsis, high numbers of procalcitonin were observed in 50.0 % of patients, presepsin in 100.0 The growth of the bacterium Burholderia cepacia was observed in both central venous catheters (CVCs) and blood taken from CVCs. Phentotypically, all isolated cultures of Burholderia cepacia can be divided into three types: pan-resistant; polyresistant; polyresistant, but keeping sensitivity to co-trimoxazole. Multilocus sequencing of their DNA was carried out. The same sequence type was found in four patients. Given that the patients came from different regions, had not previously been in the same medical organization, care for CVC in the department of oncogematology was carried out by the same medical staff it can be assumed that four cases were caused by the same hospital strain Burkholderia cepacia.

Objectives. Assessment of the probability of simultaneous infection with two or more pathogens of clinical substrates of transplant patients. Materials and methods. The retrospective analysis of bacteriological studies of clinical isolates among transplant patients operated from January to July 2020 is performed. This study included 93 patients. Results and discussion. Тhe risk of bacterial complications in the postoperative period is associated with representatives of the gram-negative pathogens Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. All the studied strains were resistant to antibiotics. A significant number of coinfections with two or three pathogens cases were recorded in the current period – 20.4 %. For the two and more pathogens’ colonization the highest mortality rate is shown, 42.1 %. Conclusions. Modern epidemiological feature is the Acinetobacter baumannii predominance among the microflora of transplant patients. It has been shown that the incidence of co-colonization by ≥ 2 different gram-negative pathogens is significant and increases the mortality rate.

The results of numerous studies indicate the high importance of infectious agents in the formation of pathology of the cardiovascular system. Timely and correct management of patients with these disorders is important to prevent adverse outcomes. Purpose of research. To evaluate the clinical significance of detected cardiovascular disorders in influenza and other acute respiratory viral infections (ARVI) of various etiologies. Materials and methods. The study included 60 male and female patients aged 18 to 65 years who sought emergency care for shortness of breath, chest pain, palpitations, heart failure, and hypertension. The main group included 30 patients with confirmed ARVI (influenza, RS-infection, parainfluenza, adenovirus infection) at the time of examination. The comparison group consisted of 30 patients without ARVI, including the last three months. Assessed the medical history, the value of oxygen saturation, blood pressure, electrocardiogram data. Criteria not included: the duration of ARVI more than 7 days at the time of examination, the presence of severe chronic diseases: rheumatological and oncological pathology, HIV infection, as well as injuries that explain the analyzed complaints. Results. Against the background of influenza and ARVI, complaints of shortness of breath and a feeling of insufficiency of the inhaled volume were noted in 80 % of patients, obsessive painful cough was noted in 73 %. Less often (43 %) there was pain, discomfort or tightness in the chest. The average oxygen saturation index in patients with ARVI and influenza was significantly lower: 95.400 ± 0.935 %, and in the comparison group – 97.400 ± 0.935 %, p < 0.0001. ST-segment depression (53 %) and decreased R-wave voltage (27 %) were significantly more common in patients with acute respiratory viral infections and influenza. Conclusions. Patients with ARVI and influenza often present complaints that require differential diagnosis between the natural manifestations of the infectious and inflammatory process and developing complications associated with lesions of the bronchopulmonary and cardiovascular systems. Complaints of shortness of breath and chest discomfort are often accompanied by a decrease in oxygen saturation and significant changes in the ECG, which requires mandatory examinations to determine the risk of adverse course due to hypoxic and ischemic changes and determine the patient’s further management tactics in patients with ARVI and influenza.

The legionellosis infection associated with medical care is usually registered for patients with reduced immunity, including those receiving immunosuppressive therapy. Prevention of nosocomial legionellosis in patients is essential due to high mortality. The aim. Analyze of the potential risks of legionellosis infection in patients of surgical departments. Materials and methods. Isolation of Legionella pneumophila from water supply systems in Moscow hospitals and serotyping of the isolated microorganism was performed using bacteriological, molecular genetic and enzyme immunoassay methods. Results and discussion. The study showed that there are potential risks of disease in surgical departments of hospitals that provide medical care, including immunocompromised patients. The content of Legionella pneumophila in water reached 10 5 CFU/l. The share of Legionella pneumophila SG 1, which causes up to 80 % of cases of legionellosis in the world, is 13 % in the water of the surveyed hospitals. The only action prevention of legionellosis is the biological safety of water. Conclusion. Due to the presence of potential risks, prevention of legionellosis is a necessary component of ensuring the safety of the treatment process for patients with immunosuppression.

Aim. To study the features of the clinical manifestations of pneumonia that developed in children with COVID-19. Materials and methods. The data of the case histories of 36 children aged from 8 months to 17 years, who were hospitalized in the children’s infectious diseases department of the Mytishchi City Clinical Hospital, were analyzed for confirmed pneumonia with the release of the SARS-CoV-2 virus. On the first day of hospitalization, all children underwent examination: clinical examination, pulse oximetry, general clinical blood and urine tests; X-ray examination or computed tomography of the chest organs, biochemical blood test; coagulogram; analysis of a swab from the nasopharynx and pharynx for SARS-CoV-2 virus RNA by polymerase chain reaction. Repeated laboratory and instrumental studies were carried out after 5–7 days or more often if necessary. All patients received therapy in accordance with the current interim guidelines for the prevention, diagnosis and treatment of new coronavirus infection COVID-19. Results. Most (97 %) patients had moderate severity, 3 % were mild. The main clinical symptoms were severe intoxication, a rare dry cough, an increase in body temperature to subfebrile numbers, and harsh breathing. In 36 % of the patient, shortness of breath was revealed with anxiety or physical exertion. Dry rales were also heard in 36 %, more often in the lower sections. By localization, right-sided (78 %) upper lobe (58 %) pneumonia prevailed. In 64 % of children there were dysfunctions of the gastrointestinal tract of various origins, in 17 % was exanthema. Conclusions. In children with pneumonia caused by SARS-CoV-2, as a rule, intoxication syndrome predominates, typical auscultatory symptoms are absent, diarrhea is often noted, sometimes exanthema, enanthema, rhinopharyngitis. According to laboratory studies, lymphopenia with a normal level of leukocytes, an increase in C-reactive protein are more often detected; indicators of biochemical blood analysis and general urine analysis remain unchanged.

Goal. To assess the frequency of skin manifestations in children, the need and effectiveness of pathogenetic therapy for skin rash associated with COVID-19 in children. Materials and methods. The data of the case histories of 55 children aged 8 months to 18 years with confirmed infection caused by the SARS-CoV-2 virus were analyzed. Of these, 36 were hospitalized with a diagnosis of community-acquired pneumonia of coronavirus etiology (SARS-CoV-2 virus identified) in the children’s infectious diseases department of the Mytishchi City Clinical Hospital. Another 19 children received treatment on an outpatient basis for rhinopharyngitis and/or bronchitis or tracheobronchitis against the background of laboratory-confirmed COVID-19. In most cases, there was a moderate course (64 % or 35 children) and a mild form (36 % or 20 patients). The SARS-CoV-2 virus was identified in pharyngeal and nasal swabs using the standard polymerase chain reaction method. All patients received therapy in accordance with the current temporary guidelines, and if indicated, other drugs. Results. In 7 (13 %) children in the acute period of coronavirus infection, urticarial rashes were found, in 3 (5 %) – maculopapular. Itching was mild in most cases. According to children and (or) their parents, elements of exanthema appeared in the period from 1st to 8th days from the time the first symptoms of COVID-19 developed. The rash persisted for 1 to 7 days. In 2 children who had a pronounced widespread exanthema against the background of rhinopharyngitis in the absence of pulmonary lesions, a prolonged period of significant astheno-vegetative disorders was noted. In one of the observed children on day 1, exanthema was the only manifestation of coronavirus infection. When prescribing additional antihistamines, there was no significant result. When using enterosorbents (Zosterin Ultra 30 or 60), the appearance of new elements stopped, the rash regressed within 2–5 days. Conclusions. 18 % of children treated for mild to moderate COVID-19 developed skin rashes. Exanthema with coronavirus infection in children should be considered one of the symptoms of the disease. Despite the more frequent detection of urticaria-type rash, no direct relationship with allergic history has been identified. The use of enterosorbents contributes to the relief of exanthema.

The provision of anti-tuberculosis care to the population of the Russian Federation has a largely preventive direction. Dispensary observation of population groups with an increased risk of tuberculosis is one of the most important sections of providing anti-tuberculosis care to the population. The materials on the organization and results of dispensary observation of patients with an increased risk of tuberculosis are presented: indicators of tuberculosis incidence and mortality and data on the reliability of some indicators. The factors influencing the results of dispensary observation of patients with an increased risk of tuberculosis in different groups of dispensary observation and the quality of preventive measures are considered. The data on the use of Diaskintest for the timely detection and diagnosis of active tuberculosis in children and the identification of children in the early period of tuberculosis infection are presented.

Introduction. The coronavirus infection (COVID-19) pandemic has created a unique opportunity to establish patterns in Internet user activity in connection with a new disease. Objective of the study. To assess the relationship between the interest of Internet users in issues related to COVID-19 in the countries of Central Asia: Kazakhstan, Kyrgyzstan, Uzbekistan and Tajikistan and the dynamics of the epidemic process of this infection according to search queries in Google Trends. Materials and methods. The analysis of queries on the topic “COVID-19” received from Google Trends from 09.01 to 04.10.20 was carried out. Results. An analysis of search activity for queries in Kazakhstan that may be associated with symptoms of COVID-19 showed that only queries containing the keyword “smell”, “loss of smell”, “shortness of breath”, “temperature” have a correlation with the confirmed number of coronavirus infection (r = 0.65 for the query “smell”, r = 0.53 for the queries “loss of smell” and “dyspnea”, r = 0.60 for the query “temperature”). In Kyrgyzstan, when analyzing queries that may be associated with coronavirus infection, correlations were found only for those that contained the keyword “smell” (r = 0.62) and “temperature” (r = 0.53) from 09.01 to 04.10.2020. Correlations (r > 0.65) were found between the dynamics of queries containing the keywords “coronavirus”, “infection” among Internet users in Kazakhstan, Kyrgyzstan and Uzbekistan. When analyzing inquiries related to the diagnosis of COVID-19 in Kazakhstan and Kyrgyzstan, an increased interest of the Internet public in the computed tomography method was revealed, and the peak of interest coincided with the maximum number of confirmed cases of COVID-19 (the correlation coefficient was 0.714). Conclusion. The relationship between Internet inquiries, media reports, and actual incidence rates is multifactorial and requires further study. Nevertheless, the main trends in Internet search queries during a pandemic can serve as an additional component of epidemiological surveillance.

Relevance. The emergence of a new coronavirus infection COVID-19 in the world has set for medical workers, including those of a prophylactic profile, tasks related to the prevention, diagnosis and provision of medical care to patients. Currently, information on the epidemiology, clinical features, prevention and treatment of this disease is somewhat limited and is under study. At the same time, timely implementation in full of a complex of sanitary and anti-epidemic (preventive) measures in medical organizations aimed at preventing the occurrence of infections associated with the provision of medical care is of great importance in the prevention of COVID-19. The aim. Determination of the features of the organization of sanitary and anti-epidemic (preventive) measures in a pediatric emergency hospital during the period of the spread of COVID-19. Summary. Strict adherence to sanitary and anti-epidemic (preventive) measures in emergency pediatric medical organizations aimed at preventing new coronavirus infection plays an important role in the prevention of infections associated with the provision of medical care. For their implementation, a number of administrative, organizational and anti-epidemic measures are required in a medical organization.

Relevance. The emergence of a new coronavirus infection COVID-19 in the world has posed new challenges for medical workers, including laboratory specialists, related to the rapid and timely diagnosis of this infection. Timely diagnosis of it allows you to start taking preventive and curative measures in time to provide medical care. The aim. Determination of the level of immunoglobulins M and G to the SARS-CoV-2 coronavirus in employees of a medical emergency pediatric organization with the aim of conducting a study of collective (population) immunity. Summary. The main diagnostic method for determining SARS-CoV-2 is the polymerase chain reaction. To detect immunoglobulins M and G to the SARS-CoV-2 coronavirus, enzyme-linked immunosorbent assay, immunochemiluminescent and immunochromatographic methods are used. A study conducted at the Research Institute of Emergency Pediatric Surgery and Traumatology showed that employees began to develop immunity to COVID-19.

The work is devoted to the necessity of conducting a screening study of thyroid function in women in the pre-gravidar period and during gestation. Pathological conditions of the thyroid gland are one of the most common diseases of the endocrine system, second only to diabetes mellitus in prevalence. At the same time, in recent years, there has been an increase in thyroid insufficiency. Clinical and subclinical hypothyroidism are the most common hormonal dysfunctions during pregnancy, which have a negative impact on the course of gestation and fetal development. At the same time, subclinical hypothyroidism is an easily treatable disease that reduces the pregnancy related morbidity of the mother and fetus. Screening only at-risk patients probably skips most cases. Therefore, guidelines should be established for universal screening of thyroid dysfunction in the pre-gravidar period and during pregnancy with their own ranges for thyroid stimulating hormone during gestation, calculated taking into account regional, ethnic and population characteristics. Levothyroxine replacement therapy in a woman with subclinical hypothyroidism in the pre-gravidar period and during pregnancy should begin immediately after the diagnosis of this condition and be adequate in terms of timing and dose.

The main medico-social and economic features of the organization of public health systems in leading foreign countries and Russia are considered. The priority directions of further exploratory scientific and practical research, including in urology, have been determined.