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Aim: Study manifestations of epidemic process during acute intestinal infections to establish reasons of low effectiveness of the prophylactic measures carried out and evaluation of the role of rotavirus infection in general disease structure of intestinal infections of unknown etiology., Materials and Methods: Data on morbidity of acute intestinal infections of population of Moscow were analyzed. Hospitalized patients with acute intestinal infections were examined using real-time PCR method test-systems of laboratory of molecular virology of Mechnikov RIVS with subsequent typing., Results: Evaluation of multi-year manifestations of epidemic process of morbidity of acute intestinal infections in Moscow has shown, that the cumulative morbidity does not have a tendency of reduction, because the proportion of infections with undeciphered etiological factors is almost 80% of the total aggregate morbidity. The proportion of rotavirus infection in total morbidity of AII of established etiology increased from 53.2 in 2004 to 82.6% in 2014. Morbidity in childrenwith rotavirus infection is 6 times higher than morbidity in adults., Conclusion: The results obtained give evidence on the necessity of carrying out specific prophylaxis against viral intestine infection, mostly of rotavirus and norovirus infections. The highest effect should have been expected from use of a bi-vaccine, development of which seems quite an actual problem.

Aim: Characterize spectrum of antibiotics resistance of Acinetobacter baumannii strains, isolated from patients of 8 surgical and reanimation departments of 3 medical institution of Moscow, and determine molecular-genetic mechanisms of stability of their carbapenem-resistant forms., Materials and Methods: 95 strains of A. baumannii, isolated from patients of reanimation and surgical departments of Moscow in 2012-2014, were studied. Sensitivity of strains to antibiotics was tested phenotypically according to recommendations of EUCAST. The presence of VIM, IMP, OXA-23, OXA-40, OXA-48, OXA-58 and NDM genes in the studied strains was determined by polymerase chain reaction in real time., Results: 86.3% of strains turnedout to be non-sensitive to carbapenems, sensitive--13.7%. 80.0% of strains were non-sensitive to gentamicin, 80.0% of strains--to netilmicin, 94.7% of strains--to ciprofloxacin 2.1%--to colistin. 91.6% of isolates have shown non-sensitivity to members of 2 and more classes of antibiotics, 78.9% of strains--to members of 3 classes. 2 strains were panresistant, 4.2% (4/95) of the isolates were sensitive to all the classes of antibiotics. Metallo-β-lactamases were not detected. Genes of carbapenemases (OXA-23 and/or OXA-40) were detected in 85.3% (81/95) of strains, characterized phenotypically as non-sensitive to carbapenems., Conclusion: The results obtained shown an increase of resistance to carbapenems and multiple resistance in clinically significant strains of A. baumannii. Resistance to carbapenems is associated with OXA-23 and OXA-40 genes. The conclusions allow to justify perspectives of introduction of technologies of molecular-genetic testing of antibiotics resistance.

Aim: Evaluation of the role of contemporary methods in epidemic control of brucellosis outbreaks among employees of auxiliary facilities in Moscow zoo nursery., Materials and Methods: During 2003-2013, biannually, sera from more than 200 employees of the nursery, that work during periods of epizootics of small and large cattle in nursery auxiliary facilities, were studied. A complex of laboratory methods for brucellosis was used: variations of traditional serologic agglutination method in tubes--Wright's reaction (WR), on glass--Huddleston's reaction, Coombs' anti-globulin reaction; enzyme immunoassay with immune-dominant S-LPS; realtime polymerase chain reaction with primers based on genus target of BCSP31 protein gene., Results: After eradication of sheep brucellosis in 2003, the percentage of nursery facility employees, that react positively to brucellosis, has decreased from 42.7% to 15.9-17.2% in 2005-2006. RT-PCR detected human infection during epizootics 5.8 times more effectively compared with EIA. The repetition of the brucellosis epizootics in 2007 and 2009 among large cattle and a 2-year yak had initiated a rise in infection rate among employees, that had not previously (2003-2006) reacted to brucellosis. Acute clinical forms of brucellosis were not detected in 2012-2013 and antibody titers in EIA in previously infected employees have decreased in the absence ofbrucellosis epizootics in the nursery. 30 employees, infected with brucellosis causative agent, were detected for the entire period of examination, among those 10 individuals had developed clinical forms of brucellosis (6--acute, 4--chronic)., Conclusion: Epidemic control for 11 years, based on a complex of laboratory methods, allowed to register infection and outbreaks of brucellosis in the nursery employees during epizootics of 2003, 2007 and 2009. RT-PCR--effective method of detection of infection in humans during brucellosis periods in the nursery. EIA--sensitive method during chronic forms of brucellosis in the periods between and after epizootics compared with RT-PCR. A variation of a traditional serologic method of diagnostics has shown a lower sensitivity, informativity with a larger duration of analysis compared with RT-PCR and EIA.

Aim: Study phylogenetic interconnections of HIV-1 subtype A and B variants circulating in Novosibirsk region (NSR)., Materials and Methods: 268 HIV-1 variants isolated in 2007 - 2010 from blood samples of HIV infected patients in NSR, Samara, Congo and Moscow. HIV-1 variant genotyping was performed by analysis of 1.3 kb long pol gene nucleotide sequences. Phylogenetic analysis of nucleotide sequences was carried out by program Mega version 4.1 by constructing phylogenetic trees by nearest neighbor method. Nucleotide distances were calculated by Kimura method., Results: The studied HIV-1 subtype B variants form separate phylogenetic groups with a low HIV-1 nucleotide sequence homology level combined based on territorial principle and/or time of HIV infection in a territory but not possessing interconnection with a specific population risk group. Subtype A HIV-1 is a fairly homogenous monophyletic group. Phylogenetic differences during studies of HIV-1 isolated from risk group patients - injection drugs users and individuals infected through sexual contacts were not detected. HIV variants isolated from patients infected in Moscow and Samara generally grouped with HIV variants circulating in the European part of Russia., Conclusion: An independent circulation of genetically separate HIV-1 subtype B groups is observed on the territory of siberian region which is a result of multiple independent introductions of distant variants of the virus. The confirmed limited spread of this HIV-1 genetic variant with a subsequent territorial separateness creates a possibility of formation of genetically different virus populations. The studies of subtype A viruses performed confirm the high level of homogeneity detected earlier in other Russia territories of HIV-1 belonging to this genetic variant. Monophyly of subtype A HIV variants is explained by imposition of 2 factors - territorial mobility of the population inside the country and lack of specific transmission routes for HIV-1 subtype A.

Aim: Study of taxonomical structure ofwound infection agents, prevalence of mixes, and detection of character of their possible connection with the results of various microorganisms population interaction in septic wounds., Materials and Methods: A microbiological study of material from patients with wound infection (WI), 582 of those were cured in reanimation and intensive therapy departments (RITD; group 1) and 1455 - in surgical departments (SD; group 2), was performed. Taxonomic membership and ability to coexist was determined in 4129 microorganisms strains. Etiological role of the agents was evaluated by using values of consistency rate (CR). Species that were present in more than 50% of samples were considered consistent, in 25 to 50%--additional, and in less than 25%--random. Frequency rates (FR) were also determined, that is the fraction of a certain species (genus) of the microorganism (in %) from all the isolated cultures that correspond to 100%. For the determination of the significance of individual species of the agent in the structure of mixed microorganism populations, FR - their fraction (%) in mixed population from the number of strains of this species that correspond to 100% - was calculated., Results: A significant part of the microorganisms strains, more frequently in reanimation department (65.5%), caused wound suppuration in populations mixed with other species of the agents. In reanimation and surgical departments consistent species of wound infection agents were not detected. A leading etiological role of Staphylococcus aureus (FR 19.2% and 23.9%) was determined, and FR of S. aureus strains in mixes was 64.6% in RITD and 46.8% in SD. The parameters ofotheragents of WI in the comparison groups were similar. However FR among mixes in RITD were significantly higher for streptococci that do not belong to S. pyogenes species (72,5%), and also nonfermentative microorganisms (67,2%), and in SD - in Klebsiella pneumoniae mixes. For agents of wound infection especially in RITD, low species diversity was characteristic and the number of mixes variants is significantly higher. In RITD mixed infections develop more frequently, and the ecological community of microorganisms reaches higher values than in SD., Conclusion: During the analysis of microbiologi-cal data in RITD and SD general patterns and specific features of taxonomical structure, prevalence of mixed populations and character of their ecological community in wound infection was determined.

Aim: Studies of hepatitis C virus (HCV) genotype and subtype structure in patients with chronic hepatitis C in 3 regions of the Central federal district of Russia., Materials and Methods: Hepatitis C virus genotype and subtype structure was determined in patients with chronic HCV infection in Moscow (1993 - 1995 and 2005), Moscow region (2008) and Vladimir region (1993 -1995, 2005-2007). HCV genotype was determined by using A. Widell et al. (1994) technique, PCR (AmpliSens diagnostic kits), Genotype C test system., Results: In all studied regions and during all the time periods the first position in rating belonged to HCV 1b subtype. In 1993 - 1995 and 2005 - 2007 period changes in HCV genotype and subtype structure were registered that consisted of relative weight of 1b subtype decrease and 3a subtype increase. Subtype 1b in females with chronic hepatitis C was registered more often than in males. In Vladimir region 3a subtype in males was detected more often than in females. In males older than 30 years the first rating position belongs to 1b subtype and in males younger than 30 years--subtype 3a. In females older than 30 years in Moscow region and Vladimir region, as well as in females younger than 30 years in Vladimir region subtype 1b was detected more often, while in Moscow region HCV subtypes 1b and 3a were detected with the same rate of 47.6%., Conclusion: Currently there is an urgent need to include mandatory monitoring of hepatitis C virus genetic variants into the system of hepatitis C epidemiologic control in Russia. This approach will allow for a significant increase in quality of hepatitis C serological diagnostics, and can be used in the prognosis of evolution of the epidemic process of this disease.

Aim: Analysis of clinical cases of tick-borne spotted fever (TSF) group rickettsiosis in 2005 - 2010., Materials and Methods: General clinical, biochemical and serological parameters were determined in 10 tick-borne spotted fever group rickettsiosis patients who had visited various geographical regions of the World., Results: TSF group rickettsiosis diagnostic criteria, optimal serological diagnostics timing were determined. Possible diagnostic errors, features of serological diagnostics and antibacterial therapy of this nosologic form are discussed., Conclusion: Indication for TSF examination are primarily epidemiologic including tick attachment indication and clinical data. Serological studies are positive only in 3 - 4 weeks after the onset of the infection and thus can not be used for early diagnostics.

Aim: Genetic and antigenic characterization of Neisseria meningitidis strains isolated during meningococcal infection outbreaks from individuals in contact with patients with generalized form of meningococcal infection., Materials and Methods: Strains obtained in 2007 - 2009 in Moscow during examination of individuals that were in contact with patients during meningococcal infection outbreaks were analyzed. Multilocus sequence typing, genetic subtyping and typing of VR fragment (FetA) techniques were used., Results: Data regarding investigated strains were submitted to the database at http://pubmlst.org/neisseria/. Previously undescribed sequence types were found in 12 strains, sequence-type could not be determined in 2 strains, 2 strains lacked VR fragment (FetA). Serogroup A meningococci had "P1.5-2,10: F3-5" antigenic profile and belonged to ST-75 and ST-3349 sequence-type, these data does not support the emergence of epidemically significant strains in the territory under surveillance. All typed serogroup C strains and 1 serogroup B strain are of "ST-41/44 complex/Lineage 3" clonal complex. Subtypes of serogroup C meningococci strains match subtypes of strains that cause generalized forms of infection, while serogroup B strains isolated from the carriers and strains isolated from the patients had different antigenic profiles. Ungrouppable strains had notably higher level of genetic and antigenic diversity: only 6 of 16 strains (37.5%) could be sequence-typed using earlier data, all these strains are of clonal complex "ST-53 complex" that consists mostly of strains isolated from the carriers. CONCLUSION. Ratio of meningococci population circulating in Moscow and subpopulation capable of causing generalized form of meningococcal infection (GFMI) is different for meningococci of various serogroups. Ungrouppable strains isolated from the carriers are highly different from strains causing GFMI.

Aim: To assess rate and level of contamination by Legionella pneumophila of cooling water systems in industrial facilities as well as hot water supply systems of administrative buildings in Moscow region., Materials and Methods: Cooling water systems of 8 industrial facilities and hot water supply systems of 12 administrative buildings or complexes located in Moscow or Moscow region were examined. Samples of water, washes and biofilms were studied by bacteriologic methods and RT-PCR. Results. Significant level of contamination of water systems by L. pneumophila was revealed in examined objects. Rate of contamination of cooling water systems in industrial facilities was 70%. The agent was detected in stagnant, end-capped, and rarely used segments of all hot water supply systems during decrease of water temperature to 36-52 degrees C. Visual detection of natural biofilms on the object correlated with high concentration of L. pneumophila in water samples. In some cases, associations of L. pneumophila with Pseudomonas aeruginosa were detected, including water samples from supply systems of 2 healthcare facilities., Conclusion: Obtained results confirm the importance of implementation of modem concept of legionellosis prevention in our country, based on regular quantitative monitoring for Legionella in potentially dangerous water objects and conduction of preventative measures if contamination exceeds acceptable level.

Aim: Comparative analysis of structure of tcfA gene coding tracheal colonization factor of Bordetella pertussis strans isolated in Moscow from patients with pertussis., Materials and Methods: Ninety-seven strains of B. pertussis isolated in different periods of pertussis infection epidemic process (1948 - 1989--from collection of Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology; 1990 - 2007--isolated in Moscow from patients with pertussis) were studied. Primers for amplification of tcfA gene region with size 945 n.p. were used. Amplicons obtained in PCR were used for sequencing. Nucleotide sequences of tcfA gene types of B. pertussis strains were matched to EMBL/GenBank database., Results: Sequencing of tcfA gene fragments revealed two sequence variants. Ninety-six of 97 studied B. pertussis strains had the same sequence variant--variant 1. The one strain was characterized by other nucleotide sequence--variant 2, which differed from variant 1 by presence of insertion g in position 396 that led to reading frame shift., Conclusion: The structure of tcfA gene circulating population of B. pertussis strains is homogenous and is characterized by presence of "vaccine" allele dominating in majority of countries in the world.

Aim: Genetic characterization of 37 strains and CSF samples containing DNA of Haemophilus influenzae type b isolated in Moscow during 2007-2009., Materials and Methods: Multilocus sequence-typing method was used and also variant of method for capsule type determination was approbated., Results: Ten sequence types, of which 7 were described in previous studies and 3 were revealed for the first time during this work, were detected in studied sample. ST-6 and ST-92 were the most frequently detected--9 strains (24%) of Hib belonging to each sequence type were revealed. All detected sequence types, except one, belong to clonal complex "ST-6" ("A1/A2"). Obtained data were compared with results of typing of Hib strains isolated in Moscow in 1999-2001. Genetic changes in studied population of Hib are characterized by decreased proportion of Hib belonging to ST-6 (from 54% to 24%) and increased number of sequence types belonging to clonal complex "ST-6" differing from ST-6 on more than one locus of allelic profile (from 2 types [2 strains, 5.4%] to 5 types [9 strains, 24%])., Conclusion: In 2007-2009, number of Hib strains with sequence type ST-95 (7 strains, 19%), which is typical for strains circulating in Russia, is markedly increased. Capsule type I was detected in 32 (86.5%) of studied strains, whereas capsule type II--in 5 (13.5%) of studied strains. Capsule type II was detected only in Hib strains with ST-80 sequence type.

Aim: Analysis of influenza morbidity and mortality including delayed mortality as well as study of the association between increased mortality in elderly and influenza incidence., Materials and Methods: Epidemiologic methods of research as well as reporting forms No. 2 and C51 for Moscow for the period 1999-2005 were used. Analysis was performed for 28,801,565 cases of influenza illness as well as for 41,310 fatal cases, of which 6048 cases due to cardiovascular and respiratory diseases were extracted. Retrospective epidemiologic analysis of perennial and within-year incidence of influenza and mortality due to mentioned diseases in Moscow was performed. Correlation analysis was done using Spearman rank correlation coefficient and Pearson correlation coefficient., Results: Delayed mortality concept was introduced. Existence of delayed mortality after influenza illness in persons >60 year old with ischemic heart disease, acute myocardial infarction and cerebrovascular disease was proved. It was established that vaccination against influenza in persons aged >60 years with underlying cardiovascular diseases during epidemic season could prevent 246 deaths each year., Conclusion: Delayed mortality was detected only in patients with cardiovascular diseases, whereas in patients with respiratory diseases direct complications due to influenza developed. Influenza immunization of elderly persons could yield marked economic effect as cost of treatment of one case of acute myocardial infarction or attack of cerebrovascular disease is significantly higher than cost of vaccination.

Aim: To study pathogenic characteristics of B. pertussis strains isolated from patients during different periods of pertussis infection epidemic process., Materials and Methods: Strains of B. pertussis isolated in Moscow during 1967 - 1971, 1980 - 1985, and 2001 - 2005 were studied. Nutrient media: Bordet-Gengou blood agar, casein-charcoal agar., Animals: mice - F1 hybrids (CBA x C57BL6). Pathogenic characteristics of strains were studied by assessment of virulence (LD50), leukocytosis-stimulating (LS units) and histamine-sensitizing (HSD50) activities of cultures. Genotyping was performed using standard equipment and reagents for DNA isolation, amplification, sequencing and detection of results., Results: On the sample of 164 strains, pathogenic and genotypic characteristics of B. pertussis populations circulated during 1967 - 1971, 1980 - 1985, and 2001 - 2005. Majority of B. pertussis strains isolated in 1967 - 1971 and strains circulated during current phase of epidemic process were virulent (80.75% and 81.8% respectively) and had significant leukocytosis-stimulating and histamine-sensitizing activity, whereas strains isolated from patients with pertussis in 1980 - 1985 characterized by lower virulence and toxicity. Genotyping showed strains carrying "non-vaccine" allele ptxA1, which emerged in the middle of 1970s, totally displaced strains with "vaccine" alleles ptxA2 and ptxA4., Conclusion: Adaptive changes of B. pertussis driven by increased vaccination coverage involve both ptxA gene and pathogenic characteristics of infectious agent in the range of genotypically homogenous population with domination of strains, which have high levels of virulence and toxicity.

Aim: To study etiologic role of microorganisms during wound infection and elucidation of their populations interaction in patientswith burns., Materials and Methods: 2137 patients with wound infection treated in burn center were studied. 3179 samples of wound exudates and 6501 strains of microorganisms were studied. Assessment of microorganism's etiologic role was carried out using results of calculation of various statistic indexes, including indexes of ecological similarities of microorganisms in the wound (indexes of contamination, prevalence or persistence, incidence). Ecological similarity of wounds' microflora was determined by calculation of the coefficient Kj., Results: It was established that Staphylococcus aureus is the most common cause of mono- and mixed wound infections. It was determined that Kj value for common agents points to antagonism or associative interaction. During particular time periods of the study values of Kj significantly differed and depended from species. Specifically, for Pseudomonas aeruginosa the values of Kj were equal or exceeded 30% during several years. It was the first time when correlation between persistence and ecological similarity indexes was studied in agents of wound infections., Conclusion: In order to reveal factors influencing on microbial etiology of mixed wound infections it is reasonable to consider the nature of interspecies interactions of causative agents.

Aim: To study genetic diversity of Pseudomonas aeruginosa strains circulating in intensive care unit (ICU), to determine the source of these strains and duration of circulation of epidemically-significant clone in the hospital., Materials and Methods: Genotyping of 106 P. aeruginosa strains isolated from patients, clinical specimens and fomites was performed by random amplified polymorphic DNA analysis with oligonucleotide primer Sh1 of 10 bp long., Results: Out of 106 P. aeruginosa isolates, 72.6% belonged to the same genotype, which was dominated in ICU during whole study period. It was established that 58.3% of examined patients were colonized by identical strains belonged to prevalent genotype that indicates the intrahospital transmission of epidemic strain., Conclusion: Obtained data show that during the period of observation (15 months) one clone of P. aeruginosa dominated in ICU, which was characterized by multiple resistance to antibiotics and caused nosocomial infection in 58.3% of patients. This confirms the need of continuous molecular-microbiological monitoring of hospital microflora in order to early detect potentially dangerous epidemic hospital strains, which are able to cause nosocomial infections.

Aim: To study the rate of infection of ticks captured one of the Moscow park terrains with bacteria (agents of tick borreliosis and anaplasmosis)., Materials and Methods: Rates of infection of dried ticks with agents of main tick-borne bacterial infections (tick borreliosis and anaplasmosis) were determined by nested PCR., Results: In May-June 2006, 76 ticks (40 adult females, 36 adult, males) belonged to Ixodes ricinus species were captured by the method "on flag". Number of ticks on the chosen terrain was 1.77 ticks per km2. 22.4% of ticks (12 females and 5 males) were positive for the agent of tick borreliosis--spirochete Borrelia burgdorferi sensu lato which is pathogenic for humans. The main detected pathogen was Euro-Asian genovariant of B. garinii--7 female and 5 male ticks (70.6% from total number of infected ticks) were infected with it. Five female ticks were infected with genovariant of B. afzelii. One female tick (1.2%) was infected with B. valaisiana., Conclusion: Anaplasma A. phagocytophilum causing human granulocytic anaplasmosis was not detected in captured adult ticks.

Aim: The objective of this study was to assess dynamics of prevalence of hemotransmissive viral infections (HTVI) markers as mono- or mixed infections in patients admitted to Sklifosovsky Research Institute of Emergency Medicine., Materials and Methods: Two hundred thirty-five thousands and seventy patients admitted to the Institute during 1998 - 2007 were screened for the presence of laboratory markers of HTVI (antibodies to HIV, HBsAg, and anti-HCV)., Results: The long-term screening revealed 27,942 (11.9%) persons positive for laboratory markers, of which 3,099 (11.1%) were positive for >1 marker. It was established that HIV infection as well as viral hepatitis B and C have different level of similarity and ability to coexist. HIV infection was more frequently detected in association with other infections, whereas hepatitis B and C--as monoinfections., Conclusion: Attempt to consider the mutual influence of HTVI on their prevalence from the view of modern concept of microorganisms' ecology was made. Computation of Jaccard similarity coefficient showed that HIV and HCV have the greatest abilities for coexistence, whereas HIV and HBV--the smallest.

Aim: To perform advanced antigenic characterization of meningococci belonging to serogroups A and B and circulating in Moscow according to modern nomenclature of Neisseria meningitidis strains., Materials and Methods: Method of typing of "VR" fragment of FetA protein together with methods of genetic subtyping and multilocus sequence typing was used., Results: Detailed information about studied strains was inputed in Internet database--http://pubmlst.org/neisseria/. Typing of serogroup B strains did not allow to define dominating variant of "VR, fragment of FetA protein which is in accordance with subtyping data obtained previously. Serogroup A strains were notable for less variability of "VR" fragment variants: 6 variants were detected. For the majority of serogroup A strains, it was possible to trace connection between belonging of the strain to particular genetic subgroup and its revealed antigenic profile. For strains from genetic subgroup VI, antigenic profile P1.5-2, 10; F1-5 detected in 14(18%) strains was typical, whereas antigenic profile P1.5-2, 10; F3-5 was typical for genetic subgroup X and was detected in 50 (63%) strains. Antigenic profile P1.5-2, 10-67; F3-5 was detected in 5 (6%) strains, and other 10 antigenic profiles were revealed in one strain each., Conclusion: Prevalence of strains with antigenic profile P1.5-2, 10; F3-5 is explained by change of predominant genetic subgroup from subgroup VI to subgroup X in Moscow population serogroup A meningococci observed after 2003.

Testing of immunocompromised patients for markers of beta-herpesviruses--human herpesvirus type 6 (HHV-6) and cytomegalovirus (CMV), as well as gamma-herpesvirus--Epstein-Barr virus (EBV), revealed that all mentioned infections are frequently detected, mainlyas mixed infections. Chronic HHV-6 infection was diagnosed in more than half of the patients, whereas markers of acute phase of CMV and EBV infections were detected in 25% and 15% of patients respectively.

Human herpes virus type 6 (H HV-6) and cytomegalovirus (CMV) seroprevalence among HIV-infected and healthy women of childbearing age from Chelyabinsk and Moscow was measured with ELI - SA test-system for detection of antibodies to respective viruses. Seropositivity to HHV-6 was detected in 93.5% of HIV-infected women, that is 1.2 times more often than in healthy woman of child-bearing age. Seropositivity to CMV was detected in 87% of HIV-infected women, that is 1.05 times more often than in healthy woman of childbearing age. Low titers to HHV-6 and CMV were detected in seropositive healthywomen more frequently (in 44.1 and 48.4% respectively) whereas intermediate and high titers prevailed in HIV-infected women (in 73.9% for HHV-6 and 31.4% for CMV).

Influenza and acute respiratory viral infections (ARVI) continue to be one of the most actual medical and social-economic problem. But problem of high incidence of ARVI often regarded as problem of influenza only. Information about methods of prognosis of massive spreading of ARVI complex and universal system of their prophylaxis including influenza is presented in the article.

Pulse electrophoresis of group A streptococci (GAS) isolated in 1998 - 2004 in Moscow from patients during outbreaks of tonsillitis in child institutions, military unit and also from sporadic cases in children and adults was performed. During analysis of 48 strains 16 pulse electrotypes were recognized. These data allow to consider that in different child institutions (and other groups) accumulation and spreading of most adapted to such environment variants of GAS are take place and population structure of GAS in such institutions is unique on molecular and other characteristics. This study showed that complex typing of GAS (use of pulse electrophoresis and PCR for detection of erythrogenic toxins A and C) will help to improve molecular-epidemiologic surveillance for streptococcal group A infection, development of recommendations on reduction of morbidity from this infection and also to decrease risk of its severe forms, complications and mortality.

A total of 167 children with bronchial asthma (BA) have been examined for the mycoplasma infection rate. Among investigated patients 62,8% were infected with one or more mycoplasma species. The prolonged persistence in patient body as well as biological properties of mycoplasmas give grounds to consider these agents as a risk factor in the development of the allergy-infection-borne BA and its relapses.

The analysis of meningococcal strains of different serogroups, isolated from the liquor of patients in Moscow, which was carried out with the method of multilocus sequencing-typing (MLST), was presented. At the periods of epidemic morbidity rises in Moscow the prevalence of group A meningococcal strains, belonging to subgroups III with sequence-types 5 (in the 1970s) and 7 (in 1996), was noted, and at a period between epidemics strains of genetic subgroups VI and X were isolated. Meningococcal strains, groups B and C, isolated in 1995 - 2002, had, as a rule, unique sequence-types, differing both one from another and from N. meningitidis sequence-types detected in other countries. Among group B meningococci the prevalence of strains belonging to clonal complex ST-18 was noted, while for group C meningococcci strains belonging to clonal complex ST-41/44 were most typical. Such genetic variability of circulating meningococci was regarded as characteristic of the period between epidemics, observed in Moscow since the end of the 1980s.

The article deals with the results of the 10-year study of the synanthropic urban foci of leptospirosis on the territory of Moscow. Information on the manifestation of the activity of the foci under study, rodents serving as the reservoir of infection in these foci, the etiological structure of the leptospires among these rodents, the state of leptospirosis morbidity among humans is presented.

The characterization of the pulse-electrotypes of L. monocytogenes, isolated in 2003-2004 in Moscow from different sources, is presented. Among the cultures, isolated from humans, one outbreak pulse electrotype was detected and from different objects in buildings where a wide variety of food products was produced several probably related and unrelated pulse-electrotypes were obtained. The conclusion was made that several independent L. monocytogenes clones existed on the territory of Moscow, and many products supplied to retail trade and public catering enterprises were contaminated with these clones. Pulse electrophoresis was shown to be the most effective method for intraspecific typing and the study of the molecular epidemiology of listeriosis. Grounds for the necessity to improve the microbiological diagnostics of L. monocytogenes infection are given.

A salmonellosis outbreak, caused by S. typhimurium, was investigated with the use of some microbiological and molecular-biological methods of typing. This investigation revealed that the outbreak was caused by the "outbreak" electrotype of the multi-resistant variant of the infective agent, found to have several plasmidovars. The possibilities and limitations of typing by sensitivity to antibiotics and plasmid DNA profile were shown. These methods of intraspecific typing were regarded as methods making it possible to establish the heterogeneity of S. typhimurium with the use of intraclonal markers.

Medical personnel is one of the main risk groups with respect to hospital infections for which hepatitis B and C are professional pathology. The degree of the risk of contamination of the personnel greatly depends on the character, urgency and duration of professional activity, accuracy in following the rules of personal safety while working with infected material, the proportion of patients contaminated with viruses of hepatitis B and C in specialized departments, the epidemiological danger of therapeutic and diagnostic methods, the possibility of reliable disinfection and sterilization of the equipment. In the system of measures aimed at preventing the infection of the medical personnel a special role belongs to the specific immunoprophylaxis of hepatitis B. Prolonged experience in the immunization of the medical personnel of a big hospital demonstrates a high immunological and epidemiological efficiency of the use of vaccine against hepatitis B, produced by the Research and Manufacturing Complex "Combiotech", Russia.

The article deals with the results of the epidemiological analysis of the spread of salmonellosis in Moscow. During the last 15 years the proportion of Salmonella enteritidis was about 80% and more. After salmonellosis morbidity decreased to 19.9 per 100,000 of the population (the minimum level) in 1985 its sharp rise was noted. Morbidity rate increased from 31.7 in 1987 to 55.1 per 100,000 in 1988, then to 93.9 per 100,000 of the population in 1989 (the maximum level). In the subsequent years up to 1996 a decrease in morbidity rate was observed, but in 1997-2002 morbidity rate stabilized within 29.8-35.7 per 100,000 of the population without a perceptible tendency towards decrease. The sharp increase of the etiological role of S. enteritidis which led to a wide spread of Salmonella infections was caused by the "chicken-egg" factor of their transmission. High morbidity rate among children and adults, registered all the year round, is the consequence of the constant epidemic activity of this factor.

HIV positive patients needing urgent treatment have become reality in the clinical practice of the multiprofile hospital of the Sklifosovsky Research Institute of Emergency Aid. 243,030 patients and 55,163 donors were examined at the Laboratory of Clinical Immunology and AIDS Diagnostics during the period of 1989-2001, and among the examinees 814 patients and 13 donors were found to be HIV-infected. The highest detection rate of HIV-infected patients was registered in the poisoning center, the somatic-psychiatric and endotoxicosis departments. After the period of a sharp rise in the number of HIV-positive patients (1997-2000) a decrease in their proportion among hospitalized patients was registered in 2001.

During the period of 1953-2001 scarlet fever morbidity level fluctuated from 670.3 to 65.9 per 100,000 of the population in Moscow and from 531.9 to 35.0 per 100,000 of the population of the Russian Federation. In recent years an increased morbidity was more pronounced in Moscow than in the Russian Federation as a whole. Children formed the greater part of scarlet fever patients, the cases of scarlet fever among children in Moscow occurring more often than, on the average, in Russia. As before, annual morbidity among children attending children's institutions was higher 3- to 4-fold than among children brought up at home. This difference was most sharply pronounced among young children during the first two years of their life. In contrast to morbidity observed during previous 20-30 years, a drop in morbidity among children during the first two years of their life was registered, while morbidity level among children aged 3-6 years and 7-14 years increased. Scarlet fever morbidity had a pronounced seasonal (autumn-winter) pattern. In a group of children aged 3-5 years who attended organized groups, on the average, 78.6% of scarlet fever cases fell on seasonal morbidity, the most prolonged one.

The distribution of morbidity and mortality in newborns, as well as morbidity of parturient women, in maternity hospitals of Moscow official have been analyzed according to statistical data for 1996-1999. The methods of cluster analysis (k-medium and tree classification by the method of the next door neighbours) were used. The evaluation of the stability of the distribution of morbidity and mortality in maternity hospitals was made with the use of chi 2 criterion. The specific features of the distribution of morbidity and mortality of newborns, as well as morbidity of parturient women, in the hospitals under study were detected. The methodological approach to the evaluation of epidemiological safety in maternity hospitals was proposed.

During the period of 1995-2001 bacteriological examination of 13,842 patients with purulent septic diseases (PSD) was carried out. The statistical processing of data revealed that equalization of the dynamic rows of intensive and extensive values characterizing the number of patients with PSD caused by etiologically important infective agents made it possible to evaluate the reliability of information. A trend to increased etiological importance of the genera Pseudomonas, Escherichia and Klebsiella was established. The number of diseases caused by Staphylococcus, Streptococcus, Enterococcus and Proteus decreased.

Retrospective analysis of the epidemic of HIV infection in Moscow allowed to mark out two periods: the first--from 1987 to 1993 and the second one--from 1994 to 2000. The characteristic feature of the first period of the epidemic was the sexual transmission of the agent mainly among homosexuals; the most affected group were persons aged 20-39 years and the number of AIDS patient decreased with a simultaneous growth in lethality. During the second stage of the HIV infection epidemic changes in the prevailing transmission routes of the agent occurred: injection drug addicts took the leading role. Changes in the ratio of HIV-infected men and women took place along with active involvement of persons aged 13-18 years into the epidemic process. The established changes in the epidemiological situation require corrections in the strategy and tactics of epidemic control and prophylactic measures.

During the period preceding the year 1998 when the peak values of the rabies incidence were registered in the Moscow region, a noticeable increase in fox frequency and the density of their population occurred, especially in 3 endemic areas of the north-western zone. Considering the fact that this zone was endemic for rabies, an increased density of the fox population was, most probably, the critical factor of the epizootological risk and the main cause of the emergency situation in rabies in 1998. The data obtained in this investigation may serve as a real basis for the prediction of the epizootic situation.

The fecal microflora of patients with acute enteric infections (AEI) has been examined on the territory of the Moscow region. The pathogens of high, moderate and low priority levels have been detected. As revealed in this study, shigellae, salmonellae, enteropathogenic and enteroinvasive Escherichia are the etiological agents of bacterial diarrheas on the territory of the Moscow region. The dynamics of the etiological agents of AEI in the region has been established.

The role of influenza and parainfluenza viruses, respiratory syncytial viruses and adenoviruses in the etiological structure of morbidity in acute respiratory virus infections (ARVI) in children hospitalized during the 19 year period is analyzed. As the result of examination of 56,287 patients by direct immunofluorescent test, respiratory viruses were detected in 21% of cases. The seasonal character, periodicity and level of ARVI morbidity were established. According to medical records, in the 1990s ARVI took a more severe course in children than that observed in the 1980s. In addition, the data on morbidity among children regarding rotavirus infection and ARVI were found to be similar.

Statistical data obtained during prolonged investigations on the structure of infective agents isolated from patients with acute respiratory diseases (ARD) in Moscow in 1989-1999 were analyzed. The study revealed that fluctuations of ARD morbidity rates were linked with the prevailing circulation of one or another type of the virus. The absence of the dominating role of influenza viruses was confirmed. The conclusion was made on the necessity of using, in addition to influenza vaccinal prophylaxis, chemoprophylactic interventions to maintain ARD morbidity on the acceptable level.