One of the leading problems of modern public health is healthcare-associated infections (HAIs), which lead to significant social and economic damage, and affect the quality of medical care. The proportion of HAIs in obstetric institutions among all the Ministry of Defense of the Russian Federation for 9 years decreased by 1.7 times. The number of puerperas of HAIs decreased by 1.4 times, and HAIs of newborns decreased by 1.6 times. The proportion of puerperal sepsis in the structure of purulent-septic infections of puerperas is 1.7 ± 0.5 %, and sepsis of newborns is 4.4 ± 1.5 %. The average incidence of puerperas of IUPS was 2.0 ± 2.1 per 1,000 births. The incidence of HAIs in newborns was 2.0 ± 1.8 per 1,000 newborns. The ratio of HAIs of newborns to intrauterine infections on average was 1: 9, and in some regions 1:2–1:150. The obtained data on the incidence of HAIs in puerperas and newborns indicates the insufficiency of a systematic approach to recording, analyzing and predicting the incidence of HAIs, which requires a detailed development of standard epidemiological definitions of the case HAIs of puerperas and newborns, intrauterine infections of newborns, as well as a detailed analysis of risk factors for the development of HAIs in obstetric facilities.

Objective. To characterize the profiles and genetic determinants of antibiotic resistance in pathogens of community-acquired urinary tract infections (UTI) in women of reproductive age in St. Petersburg (Russia).
Materials and methods. The study included strains of microorganisms obtained from 145 women of reproductive age with diagnosed with a UTI. Antibiotic susceptibility was evaluated by disk diffusion method; the interpretation of the results was carried out in accordance with the EUCAST criteria. Strains of uropathogenic enterobacteria were tested by PCR for the presence of beta-lactamase genes: beta-lactamase genes encoding enzymes of the AmpC group (MOX, CMY, LAT, BIL, DHA, ACC, MIR, ACT, FOX), TEM, SHV, OXA‑1, ESBL genes of the CTX–M group, genes of carbapenemases (KPC, OXA‑48) and metal-beta-lactamases (VIM, IMP, NDM).
Results. Most cases (81 %) of UTIs in women in St. Petersburg were due to enterobacteria, with Escherichia coli highly prevailing (66 %). Fosfomycin, meropenem and nitrofurantoin had the highest in vitro activity against uropathogenic Enterobacteriaceae. High rates of resistance to betalactam antibiotics were found (from 16 % to cefotaxime to 28 % to amoxicillin/clavulanic acid). The genes of TEM-beta-lactamases were found in 31 isolates (26.7 %), SHV – in 17 (14.6 %), CTX–M type – in 15 (12.9 %), DHA – in 2 (1.7 %). The other beta-lactam resistance genes (MOX, CMY, LAT, BIL, ACC, MIR, ACT, FOX, KPC group, OXA-like group, VIM, IMP, NDM) were not detected.
Conclusion. Microbiological and molecular analysis of the structure of beta-lactam resistance is important for the effective of epidemiological control of antimicrobial resistance in pathogens causing urinary tract infections.

Detection of carbapenem resistance genes is a critical issue for hospitals due to possible recommendations for infection control and targeted therapy. The Cepheid Xpert instrument, a Carba-R test for the detection and differentiation of five common carbapenemase genes, was tested from September 2020 to February 2021. As part of the approbation, 20 tests were provided. This review presents the results of the approbation of a relatively regular sensitivity study on Siemens WalkAway‑96 plus. Cepheid Xpert Carba-R analysis has been shown to be an accurate and fast tool for detecting colonization by carbapenem-resistant gram-negative bacteria, which can help limit the spread of these organisms in hospitals.

Current COVID-19 pandemic demands improvements in antiviral prophylaxis. Tyloron, as biological interferon activator, has been synthesized in the 70th of previous century. We used Tyloron in 60 patients – relatives and partners living together with solid organ transplant recipients – in autumn 2020, during second wave of the SARS-CoV‑2 pandemic. Results were compared with 60 patients used other means of antiviral prophylaxis. In patients taking Tyloron the number of febrile episodes was significantly lower (р < 0.02).

The data on the prevalence of tuberculosis in the Russian Federation are presented. A decrease in the prevalence of tuberculosis over the past 49 years, from 1970 to 2019, and a decrease in the number of patients with tuberculosis are shown. The factors influencing the prevalence of tuberculosis infection in the Russian Federation are considered: timely detection, quality of diagnosis and treatment of tuberculosis patients, MBT drug resistance, HIV infection in tuberculosis patients. The reliability of indicators characterizing the prevalence of tuberculosis has been studied.

Situation on tuberculosis (TB) in the world according to World Health Organization and in the Russian Federation. Factors, having impact on TB burden level. The specific prevention of TB in all age and social groups is a priority and cost-effective way to actually reduce the burden of TB at the present stage in the presence of a vaccine that has shown its effectiveness in organizing anti-epidemic measures between 1961 and 1992. Recovery of the National calendar of preventive inoculations and the Calendar of inoculations according to epidemic indications on TB is an important step in ensuring national security and improvement of a demographic situation in the country.

Due to the incidence increase of tuberculosis, there is increasing need for epidemiological surveillance of concomitant pathologies among HIV-infected people. The main goal of the authors is to develop information technologies for collecting and processing material on the incidence of HIV infection and tuberculosis in assessing the risks of contamination of contacts in the foci and the effectiveness of epidemiological response. There are descriptive and evaluative epidemiological research methods, the results of clinical studies at the work. There are also presented the features of clinical aspects of concomitant pathology that affect the risk of developing tuberculosis in contact persons. The work presents optimization of use of databases and standard computer programs, which will make it possible to carry out a comprehensive epidemiological assessment of the risks of contamination of contacts in foci of HIV infection and tuberculosis, to determine belonging of the outbreak to groups of high risk of developing tuberculosis in contact, to determine a wider range of contacts and the boundaries of the outbreak.

Staphylococcal meningitis (SM) ranks fourth in the etiological structure of purulent bacterial meningitis in the Russian Federation. The most common cause of staphylococcal meningitis is Staphylococcus aureus, which accounts for 68 % of all cases. This meningitis is characterized by a higher mortality rate (30 %) than staphylococcal meningitis of other types of Staphylococcus (13 %) and mainly affects people over 25 years of age. With increasing age, the probability of death increases, and among people over 65 years of age, the mortality rate reaches 44 %.

The article presents a clinical example of the treatment of persistent intestinal dysfunction in a patient with a relapse and in the period of COVID-19 convalescence. Differential approaches to the clinical and laboratory diagnosis of gastrointestinal disorders in patients with COVID-19 or SARS-CoV-2 infection and with a high risk of pseudomembranous colitis are considered. The role of bacteriophages in restoring the normal function of the gastrointestinal tract is considered. The total duration of treatment of a patient with a gastrointestinal disorder on the background of relapse and subsequent convalescence of COVID-19 from the moment of treatment was 8 weeks with the active use of anti-inflammatory, sorbing, anticoagulant, antiviral and antibacterial therapy. A significant contribution to the process of clinical improvement was made by the use of intestinal bacteriophage, reducing the risk of pseudomembranous colitis.
Conclusions. COVID-19 is a disease characterized by a multisystem lesion and long-term consequences for immunocompetent organs, including the gastrointestinal tract. This fact forces us to reconsider some aspects of traditional therapy for intestinal dysfunction and provides opportunities for new, less aggressive treatments.

Ichthyosis is an extensive group of hereditary skin diseases characterized by keratinization disorders of the type of hyperkeratosis, which leads to the formation of scales on the skin resembling fish scales. Of all hereditary diseases of keratinization, ichthyosis is the most common disease. In many countries, there are various support groups for patients with ichthyosis, in particular, the All-Russian Charity Foundation for Helping Children with Ichthyosis, the Children- Butterflies Foundation, the Public Organization Support for People with Ichthyosis (Russia), the Foundation for Ichthyosis and Related Skin Types (USA), etc.
Objective. To assess the dynamics of the incidence of congenital ichthyosis in the city of Moscow among the population of all age groups for 2015–2020, according to the data of the Moscow Scientific and Practical Centre for Dermatovenerology and Cosmetology (Russia).
Materials and methods. Using federal statistical observation form No. 12 ‘Information on the number of diseases registered in patients living in the service area of a medical organization’, approved by the order of Rosstat No. 679 dated November 22, 2019, we analyzed the incidence of congenital ichthyosis in Moscow for 2015–2020.
Results. Analysis of data on the incidence of congenital ichthyosis in the context of age groups of the population of the city of Moscow for 2015–2020 showed a trend towards an increase in the incidence of congenital ichthyosis. The increase in the incidence of ichthyosis was detected in almost all age groups of the city's population and was most pronounced in 2018 and 2019 in comparison with the previous time interval.
Conclusions. The revealed increase in the incidence of congenital ichthyosis in Moscow may be due to both the true number of cases and the improvement in the quality and availability of primary specialized health care. An important trend is towards wider implementation in medical practice methods, which make it possible to identify a specific genetic defect, to carry out prenatal diagnostics during pregnancy, an intravital histological (pathological-anatomical) study of a skin biopsy, if necessary, differential diagnosis and verification of the diagnosis, as well as genetic counseling of parents, including to assess the birth of children with ichthyosis during pregnancy.