В обзоре представлены данные литературы о формировании иммунного ответа при туберкулезе, об особенностях клеточного и гуморального звена в зависимости от выделения лекарственно-чувствительных и лекарственно-устойчивых штаммов M. tuberculosis. Показана роль цитокинов, генетических факторов при нарушениях иммунных реакций, влияющих на патоморфоз и клинические проявления туберкулеза.
Corynebacterium spp. - representatives of the normal microflora of the human body, but their role in the development of diseases in both immunocompromised and immunocompetent patients is known. Corynebacterim spp. (C. pseudodiphtheriticum, C. striatum, C. amycolatum, C. accolens, C. argentoratense, etc.) is associated with diseases of the respiratory tract: tracheitis, pharyngitis, rhinosinusitis, bronchitis, etc. They can be transmitted by airborne droplets, household contact, and possibly by hematogenic pathways. Corynebacterim spp. toxins do not produce, but are capable of adhesion and invasion, biofilm formation, production of neuraminidase, hyaluronidase, and hemolysin. It is necessary to take into account not so much the species, but the strain affiliation of isolates of Corynebacterium spp., since among the representatives of one species of non-diphtheria corynebacteria (for example, C. pseudodiphtheriticum), colonizing the respiratory tract, there may be strains that can exhibit not only pathogenic properties, but also probiotic activity. Microbiological diagnostics is based on their quantitative determination in biological material, phenotypic (culture study, test systems for biochemical identification, Vitek 2 automated systems) and genotypic (16SpRNA gene sequencing and rpoB) methods. It is possible to use mass spectrometric analysis (MALDI-ToF-MS). The greatest activity against Corynebacterium spp. in vitro studies preserve vancomycin, teicoplanin, and linezolid. Successful therapy with at least two of the following antimicrobial agents (AMP) has been reported: vancomycin, rifampicin, linezolid, and daptomycin. The sensitivity of isolates of Corynebacterium spp. to AMP is not related to the species, but is due to strain differences, and therefore it is necessary to test each isolated strain. Continuous monitoring of the sensitivity of Corynebacterium spp. strains to AMP is necessary due to the observed variability of these traits. Of particular importance is the identification of multidrug-resistant isolates that are currently considered highly pathogenic. When compiling the review, the databases Scopus, Web of Science, The Cochrane Library, CyberLeninka, RSCI were used.
Relevance. Currently, the incidence of COVID-19 is growing in many countries of the world, including Russia. There are suggestions about a likely protective role against the new coronavirus infection of widely used traditional vaccines against respiratory infections (influenza, tuberculosis, pneumococcal infection). Those vaccinated with these vaccines are less likely to report deaths and severe forms of COVID-19 diseases in vulnerable populations.The aim is to determine the frequency of detection of positive markers of a new coronavirus infection in individuals with different vaccination histories.Materials and methods. We examined 313 employees of an educational institution with various vaccination histories at the age of 20–54 years from May to September 2020. The determination of SARS-CoV-2 RNA and specific IgM and IgG antibodies to the virus nucleocapsid was carried out.Results. Positive markers for SARS-CoV-2 (PCR and / or ELISA) were found in 51 (16.3%) people. All examined patients had no signs of acute respiratory viral infections. Among people with positive markers of coronavirus infection (PCR and / or ELISA), the number of people vaccinated against diphtheria, tetanus, measles and hepatitis B (HBV) was 13.7–17.6% of those examined. Among those with negative PCR results, the number of people vaccinated against these infections was higher (p ≤ 0.05) and amounted to 51.0–56.6%. Similar results were found in the determination of specific IgM and IgG.Conclusion. Positive markers of a new coronavirus infection were found much less frequently in persons who had a history of vaccination with ADS-M-toxoid, measles and hepatitis B vaccines.
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