Микробиологические и эпидемиологические особенности микобактериозов Резюме Актуальность. Группа нетуберкулезных микобактерий включает более 200 видов, из которых порядка 50 являются возбудителями микобактериальных инфекций, или микобактериозов, которые клинически и рентгенологически схожи с туберкулезом. Микобактериозы представляют собой мультидисциплинарную, недостаточно изученную проблему. Цель-обобщить современные представления о данных заболеваниях. Заключение. В обзоре представлена информация по основным аспектам рассмотренной проблемы: определены особенности экологии и диагностики нетуберкулезных микобактерий, описана эпидемиология данных заболеваний, установлена возможность вариативности клинических проявлений микобактериозов, в т. ч. среди иммунокомпрометированных лиц и на примере инфекций, связанных с оказанием медицинской помощи. Особое внимание уделено возрастающей необходимости разработки нормативно-правовых документов, касающихся профилактики, диагностики и лечения инфекций, вызываемых нетуберкулезными микобактериями.

The review presents data on proven clinical manifestations of the disease caused by non-tuberculosis mycobacteria. It was determined that pulmonary mycobacteriosis is one of the most common clinical forms of this mycobacterial infection, which is characterized by intoxication and respiratory syndromes. Dust in the air of the working area, as a professional factor, contributes to the emergence of pneumoconiosis and silicosis associated with mycobacteria. It is proved that M. avium has the ability to damage the intestinal mucosa, causing bacteremia and secondary damage to the bone marrow and spleen. The researchers point to the fact that non-tuberculosis mycobacteria can cause lymphadenopathy with lesions of the intraabdominal and cervical lymph nodes. Also, there is the possibility of mycobacteriosis of the skin. It is proved that mycobacterial infection contributes to the development of calcification of mitral, aortic valves and coronary arteries. It was determined that in the etiology of acute pancreatitis mycobacteriosis also plays definite role. Keywords: Mycobacteriosis, non-tuberculosis mycobacteria, clinical presentations, epidemiology.

According to the results of a 1-year prospective study found that new cases of pain was observed more frequently in the lumbar region - 20,7% (95% CI from 15,2 27,2%), in the neck and 11.7% (95% CI of 7.5% to 17.2%) and upper back was 7.4% (95% CI 4,1-12,2%), the most common new cases of pains in the limbs was at the knees of 6.9% (95% CI of 3.7 to 11.5%).

Aim. To study the prevalence and incidence of new cases, and the role of risk factors such as PARK2 gene polymorphism and mechanical loads in non-specific low back pain development in workers of a large petrochemical enterprise.Methods. On a cross-sectional study by continuous sampling method (all factory workers - 580 people, the participation rate 87.6%) the prevalence of problems with the musculoskeletal system, including low-back pain was studied. Russian version of the Nordic questionnaire and the analysis of medical records were used. 228 people without any musculoskeletal system problems (the participation rate 82.4%) were selected for the 6-month prospective study. PARK2 gene rs926849 A/G polymorphism has been identified in 177 workers; epithelial cells of the oral cavity served as material for genetic analysis. The severity of the work process was evaluated in all workplaces. Multivariate statistical analysis was conducted by logistic regression method.Results. The prevalence of low back pain reached 38.7%; the incidence of new cases at 6 months was 13.3%. In case of genotype AA of PARK2 gene rs926849 polymorphism (compared with protective genotypes AG and GG) the low back pain was more common (OR=1.68, p=0.047). Another risk factor was age (OR=1.06, p=0.005). The presence of the «work severity» variable in the model increased the level of statistical significance of the «genotype» variable from p=0.055 to p=0.047, i.e. the association with the risk of low back pain increased.Conclusion. Hereditary predisposition and age play a significant role in the development of non-specific low back pain among workers; mechanical loads may increase the effect of a genetic predisposition, but do not have an independent etiologic importance.

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