Introduction: Lack of comparative studies on efficiency of a broad range of COVID19 vaccines leads to lower levels of adoption and subsequent lower total immunity in several regions, including Republic of Belarus. This clinical study captures and transparently demonstrates varying immunogenic responses to Sputnik V and Sinopharm vaccines. Aim of this study was: to compare the immunogenicity and reactogenicity of Sputnik V (Gam-COVID-Vac), RF and Sinopharm (BBIBP-CorV), PRC vaccines in vaccinated individuals. Materials and Methods: A total of 60 adults participated the study. The immune response after vaccination was assessed using enzyme immunoassay. IgG levels measured in all participants at three time points: before the vaccination, 42 days after the first vaccine dose, and 6 months after the first vaccine dose. The results of the SARS-CoV-2 antibody test is quantified according to the WHO First International Standard (NIBSC code:20/136) and expressed in international units (BAU/ml). Results: The study participants were divided into two groups, where 30 people (50%) were vaccinated with Sputnik V (Gam-COVID-Vac), and 30 people were vaccinated with Sinopharm (BBIBP-CorV), with no gender differences in the groups. The IgG levels at 42 days after the first vaccine dose were: Sputnik V (Gam-COVID-Vac)(42 days): Me=650.4 (642.2-669.4); Sinopharm (BBIBP-CorV)(42 days): Me=376.5 (290.9-526.4); p<0,001). The IgG levels at 6 months after the first vaccine dose were: Sputnik V (Gam-COVID-Vac)(6 months) Me=608.7 (574.6-647.1); Sinopharm (BBIBP-CorV)(6 months): Me=106.3 (78.21-332.4); p<0,001). Reactions after vaccination appeared in 27 vaccinated individuals (45%). Conclusion: The study showed that Sputnik V (Gam-COVID-Vac) vaccine was more immunogenic than Sinopharm (BBIBP-CorV) vaccine. IgG levels in vaccinated individuals who previously recovered from SARS-CoV-2 infection ("hybrid immunity") were higher than in SARS-CoV-2 naive individuals. Reactions after vaccines administration were mild to moderate.

Частота бактериальных коинфекций среди пациентов с COVID-19 невелика, поэтому избыточное назначение антибиотиков может способствовать селекции резистентных штаммов энтеробактерий и грамотрицательных неферментирующих бактерий.Цель исследования -оценка локальных особенностей и генетических механизмов антибиотикорезистентности K. pneumoniae на фоне пандемии инфекции COVID-19.Материал и методы. Отобрано 37 устойчивых к карбапенемам штаммов K. pneumoniae, выделенных в 2016, 2017 и 2020 гг. от госпитализированных пациентов, в том числе 15 штаммов, выделенных от пациентов с COVID-19. Методом микроразведений в бульоне определены минимальные подавляющие концентрации (МПК) меропенема и колистина. Определение МПК эравациклина, цефидерокола, цефтазидима/авибактама, меропенема/ваборбактама, имипенема/релебактама выполнено с использованием диагностической системы Sensititre на планшетах EUMDROXF. Чувствительность к 11 комбинациям из 2 разных антибиотиков определена модифицированным методом тестирования бактерицидности различных комбинаций. Для 4 штаммов K. pneumoniae выполнено высокопроизводительное секвенирование с последующим поиском детерминант антибиотикорезистентности и вирулентности, а также с оценкой плазмидных профилей.Результаты. Все штаммы были устойчивы к меропенему (МПК 50 32 мг/л, МПК 90 128 мг/л) и продуцировали карбапенемазы KPC и OXA-48. Штаммы, выделенные в 2016-2017 гг., были чувствительны к колистину (МПК 2 мг/л), в 2020 г. сохраняли чувствительность только 26,7% штаммов (МПК 50 64 мг/л, МПК 90 256 мг/л). Чувствительность к комбинациям из 2 антибиотиков с включением колистина сократилась с 84,6-100% в 2016-2017 гг. до 26,7-66,7% в 2020 г. Выделенные в 2020 г. штаммы сохраняли чувствительность к цефтазидиму/авибактаму (МПК 1 мг/л). Выявлено 5 штаммов, устойчивых к цефидероколу c МПК 8 мг/л. Штаммы 2564 и 3125, выделенные в 2020 г. из мокроты пациентов с инфекцией COVID-19, относились к различным сиквенс-типам (ST512 и ST23) и содержали ген карбапенемазы bla OXA-48, штамм 2564 дополнительно содержал ген карбапенемазы bla KPC-27. Устойчивость к колистину была вызвана инактивацией генов mgrB за счет инсерций IS1-и IS5-подобных транспозонов.Заключение. Выполненные генетические исследования демонстрируют многообразие механизмов антибиотикорезистентности у K. pneumoniae, приводящих к формированию устойчивости в том числе к антибиотикам, до настоящего времени не использовавшимся в Республике Беларусь.

Aim. Within the microbiological monitoring program, to study the prevalence of carbapenemase-producing K. pneumoniae in the healthcare organizations of the Gomel region and assess their level of resistance to antibacterial drugs. Materials and methods. For 91 clinical isolates of Klebsiella pneumoniae with multiple antibiotic resistance, isolated in Gomel and Gomel region, carbapenemase genes were detected by real-time PCR and sensitivity to antibacterial drugs was determined. Results. 68 carbapenemase producers were revealed: KPC — 1 isolate, OXA-48 — 47 isolates, NDM — 20 isolates. Carbapenemase producers were found in 11 Gomel health organizations and 8 central district hospitals of the regional centers of the Gomel region. All of them had an associated resistance to most antibiotics and retained sensitivity to colistin (91.2% sensitive isolates) and tigecycline (98.5%). Conclusion. The spread of carbapenemase-producing K. pneumoniae isolates in healthcare organizations makes it very difficult to conduct effective antibiotic therapy for patients and requires the introduction of appropriate infection control measures aimed at limiting their circulation in the hospital environment.

Combined antibiotic therapy is widely used for infections caused by carbapenem-resistant K. pneumoniae. The objective of this work was to identify the synergistic activity of combinations of two carbapenems against multidrug- and extensively drug-resistant K. pneumoniae strains producing various types of carbapenemases. For 60 antibiotic-resistant K. pneumoniae strains isolated in 8 cities of Belarus, the minimum inhibitory concentrations (MIC) of colistin and carbapenems were determined by subsequent broth microdilution method, and the genes of carbapenemases and phosphoethanolamine transferases were detected. The checkerboard method was used to determine the sensitivity to the combination of ertapenem and doripenem. High MIC values of carbapenems were revealed for NDM carbapenemase-producing strains (MIC50 of meropenem 64 mg/L, MIC50 of doripenem 64 mg/L). Doripenem was more active; MIC of doripenem ≤ 16 mg/L (low level of resistance) was determined in 28 (46.7%) strains, MIC of meropenem ≤ 16 mg/L - in 8 (13.3% of strains). The effect of potentiating the activity of doripenem with ertapenem at a fixed pharmacokinetic / pharmacodynamic concentration was observed for 20.0% of the strains producing KPC carbapenemase and 29.0% of the strains producing OXA-48 carbapenemase. The potentiating effect was independent of the presence of colistin resistance. Thus, the ability of ertapenem to potentiate the antimicrobial activity of doripenem and meropenem against some of the strains producing serine carbapenemases (KPC and OXA-48) was confirmed. The necessity of routine determination of the true MIC values of carbapenems was shown to optimize their dosage regimens and select the combination antibiotic therapy regimens.

Objective: to study the level of interleukin-6 in the blood of patients with liver cirrhosis and to identify the diagnostic significance of this parameter. Material and methods. We have done the research among patients with chronic liver diseases (cirrhosis, chronic hepatitis, non-alcoholic fatty liver disease) and have determined the IL-6 level in the blood plasma in the patients and in healthy people of the control group. Conclusion. We have revealed a statistically significant increase of the interleukin-6 level in the blood plasma of the patients with liver cirrhosis compared to the similar parameter in the healthy people of the comparison group. The degree of the increased IL-6 level was directly proportional to the severity of the pathological process. The value of the concentration of interleukin-6 in the blood can be used as an additional criterion for evaluation of severity of liver cirrhosis and portal hypertension.