Background Efficacy of Helicobacter pylori eradication therapy depends on the chance of having a resistant H. pylori strain, which is ultimately related to the local antimicrobial resistance epidemiology. Aim To assess H. pylori resistance to clarithromycin, amoxicillin, metronidazole, levofloxacin, and tetracycline in adult patients in the Smolensk region of Russian Federation over a 9‐year period. Materials and methods Biopsy samples were taken from the gastric antrum and body of 573 and 210 patients with dyspepsia symptoms and positive rapid urease test during esophagogastroduodenoscopy in 2015‐2017 and 2009‐2010, respectively. Antimicrobial susceptibility testing was performed for clarithromycin, amoxicillin, metronidazole, levofloxacin, and tetracycline by the agar dilution method. Results A total of 143 strains of H. pylori isolated during 2015‐2017 and 133 strains isolated during 2009‐2010 were tested. Culture success rates were 30% vs 64% for the two periods. Over the 2015‐2017, the prevalence of resistance to clarithromycin was 6.3%, to amoxicillin 1.4%, to metronidazole 23.8%, to levofloxacin 24.5%, and to tetracycline 0.7%. Over the 2009‐2010, the corresponding resistance rates were 5.3%, 4.5%, 3.8%, 8.3%, and 0%, respectively. There were no significant increases in resistance to clarithromycin, amoxicillin, and tetracycline (P > 0.05) over the 9 years period. Significant increase in resistance to levofloxacin (8.3% in 2009‐2010% vs 24.5% in 2015‐2017, P < 0.01) and metronidazole (3.8% in 2009‐2010% vs 23.8% in 2015‐2017, P < 0.01) was observed. Conclusions H. pylori resistance to clarithromycin remained low in the Smolensk region of Russian Federation between 2009 and 2017. Resistance to levofloxacin and metronidazole increased between 2009 and 2017.

The expansion and standardization of clinical trials, as well as the use of sensitive and specific molecular diagnostics methods, provide new information on the age-specific roles of influenza and other respiratory viruses in development of severe acute respiratory infections (SARI). Here, we present the results of the multicenter hospital-based study aimed to detect age-specific impact of influenza and other respiratory viruses (ORV). The 2018–2019 influenza season in Russia was characterized by co-circulation of influenza A(H1N1)pdm09 and A(H3N2) virus subtypes which were detected among hospitalized patients with SARI in 19.3% and 16.4%, respectively. RSV dominated among ORV (15.1% of total cases and 26.8% in infants aged ≤ 2 years). The most significant SARI agents in intensive care units were RSV and influenza A(H1N1)pdm09 virus, (37.3% and 25.4%, respectively, of PCR-positive cases). Hyperthermia was the most frequently registered symptom for influenza cases. In contrast, hypoxia, decreased blood O2 concentration, and dyspnea were registered more often in RSV, rhinovirus, and metapneumovirus infection in young children. Influenza vaccine effectiveness (IVE) against hospitalization of patients with PCR-confirmed influenza was evaluated using test-negative case–control design. IVE for children and adults was estimated to be 57.0% and 62.0%, respectively. Subtype specific IVE was higher against influenza A(H1N1)pdm09, compared to influenza A(H3N2) (60.3% and 45.8%, respectively). This correlates with delayed antigenic drift of the influenza A(H1N1)pdm09 virus and genetic heterogeneity of the influenza A(H3N2) population. These studies demonstrate the need to improve seasonal influenza prevention and control in all countries as states by the WHO Global Influenza Strategy for 2019–2030 initiative.

Here we present the data on foreign research publications describing healthcare-associated enteroviral (nonpolio) infections (HAI) sought in the Worldwide Database for Nosocomial Outbreaks (Institut für Hygiene und Umweltmedizin, Universitȁtmedizincomplex “Charite”, Germany) as well as PubMed search engine (The United States National Library), covering 1936–2017 timeframe. The publications retrieved contained the data on 28 nosocomial outbreaks caused by Enterovirus A (EV-A71), В (Echoviruses 11, 17, 18, 30, 31, 33, Coxsackie viruses А9, В2, В5) and D (EV-D68). It was discovered that the majority of the nosocomial enteroviral (non-polio) outbreaks occurred in obstetric hospitals and neonatal units so that children were mainly maternally infected. In addition, a case associated with intrauterine infection was described. It was shown that outbreaks might be started by an infected child at the incubation period. Single publications reported nosocomial outbreaks in geriatric hospitals. Generally, nosocomial enteroviral (non-polio) outbreaks were characterized by polymorphic clinical picture caused by any certain pathogen serotype and within a single site of the infection. Few lethal outcomes were recorded. Enterovirus B species dominated among identified etiological agents. Violated hospital hygiene and infection control contributing to spread of infection were among those found in neonatal units: putting used diapers out on baby bed prior disposal, sharing bathtub, toys and household objects as well as poor hand hygiene in medical workers. One of the measures recommended to improve diagnostics of enteroviral (non-polio) infections was virology screening of children with suspected sepsis in case of unidentified etiology. It was established that etiological decoding of nosocomial outbreaks was impossible without applying pathogen-specific diagnostic tools, mainly nested RT-PCR and direct sequencing of followed by subsequent phylogenetic analysis.

Background. The issue of outbreaks of infectious diseases in healthcare facilities is not often discussed in the scientific community. Several years ago, the primary etiological agents of outbreaks in hospitals were bacteria, whereas in most cases under modern conditions, outbreak incidence is caused by viruses. Aim. Based on the analysis of research materials on outbreaks of infectious diseases in healthcare facilities of Ural and Siberian Federal Districts, this work aimed to characterize infectious diseases under contemporary conditions and identify problematic issues of the preanalytical stage of epidemiological diagnostics and the organization of preventive and anti-epidemic measures. Methods. The data of federal statistical monitoring form No. 23 Information on outbreaks of infectious diseases (18 units of information) and the copy of the Acts of an epidemiological investigation of foci of infectious (parasitic) diseases with the establishment of a causal relationship (14 units of information) were analyzed. The work used epidemiological and statistical methods of information processing. The significance of differences between the indices of independent samples was evaluated using Fishers exact test. Results. In 2018, 14 outbreaks of infectious diseases were recorded in healthcare facilities in 7 out of 18 subjects in Ural and Siberian Federal Districts. The total number of victims was 183 people (97 (53.0%) children and 86 (47.0%) adults). Most of the outbreaks (12 of 14; 85.7%) were of viral etiology. One outbreak was of bacterial, and one was of fungal origin. Discussion. Viruses played a key role in the formation of foci with multiple diseases in the healthcare facilities of Ural and Siberian Federal Districts in 2018. Most of the foci of infection with an aerogenic transmission mechanism were caused by varicella-zoster virus, and those with fecaloral transmission mechanism were etiologically associated with Norwalk virus. Children were the most vulnerable contingents in outbreaks in the healthcare facilities. In all the situations analyzed, the prerequisites for an outbreak include the untimely isolation of the source of infection, hospital overload, and inadequate financial and logistical support. Anti-epidemic measures were conducted to the fullest extent during outbreaks of acute intestinal infections in comparison with outbreaks of a different etiology. Conclusion. Most outbreaks registered in the hospitals could be prevented by vaccination of the related population.

Objective. To study the antimicrobial resistance of H. pylori to clarithromycin, amoxicillin, metronidazole, levofloxacin, tetracycline in adult patients in the Smolensk region. Materials and Methods. Overall, 573 adult patients were included in 2015-2017 and 210 – in 20092010 with positive rapid urease test at the time of gastroscopy for dyspeptic complaints. Antimicrobial susceptibility testing of H. pylori isolates to clarithromycin, amoxicillin, metronidazole, levofloxacin and tetracycline was performed by the agar dilution method. Results. 143 and 133 strains of H. pylori isolated in 2015-2017 and in 2009-2010 were tested. The rates of resistance of H. pylori strains in 2015-2017 were 6.3% for clarithromycin, 1.4% – for amoxicillin, 23.8% – for metronidazole, 24.5% – for levofloxacin, 0.7% – for tetracycline. In 2009-2010 the corresponding numbers were: 5.3% – for clarithromycin, 4.5% – for amoxicillin, 3.8% – for metronidazole, 8.3% – for levofloxacin, 0% – for tetracycline. When assessing the dynamics of antimicrobial resistance of H. pylori in the Smolensk region over the past 9 years, there has been no noticeable increase in the resistance to clarithromycin, amoxicillin and tetracycline (p>0.05), with a significant increase in H. pylori resistance to metronidazole and levofloxacin (p<0,01). The resistance of H. pylori to metronidazole did not exceed the critical value of 40%. Conclusions. The prevalence of H. pylori resistance to clarithromycin and metronidazole in the Smolensk region was low throughout the study period, therefore standard triple therapy is recommended as a first line empirical therapy for H. pylori infection in adults. Preference in choosing a second-line empirical therapy between quadruple therapy with bismuth and triple therapy with levofloxacin should be stated in favor of quadruple therapy with bismuth because of the high rates of H. pylori resistance to levofloxacin.