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The study of the length of the amplification products of the coagulase gene with the subsequent restriction analysis (the method of PCR--restrictive fragment length polymorphism, or RFLP) was used for typing 90 S. aureus strains. Among the strains under study, 78 were methicillin-resistant S. aureus (MRSA) strains, including 74 obtained in 1986 - 2002 in hospitals of different cities of the Russia and Belarus, as well as epidemic strains EMRSA-1, -2, -3, -12, obtained from the National Laboratory of Health, London (UK). The use of this method made it possible to type all the strains under study, which were differentiated into 9 groups by means of endonuclease Sfo1 and 7 groups by means of Alu1. Majority of clinical MRSA strains, belonged, according to the type of restriction, to groups 4 and 5. The study of the coagulase gene by the method of PCR - RFLP made it possible: to analyze the epidemic situation in hospitals for a period of several years; to compare the properties of strains isolated in different hospitals; to establish the genetic relationship of strains, isolated in 1998 - 2002, with strains, isolated in 1986 - 1990. The results of the study suggest that at least two epidemic MRSA strains, genetically similar to international strains, circulate in hospitals of Russia.

A total of 292 patients with pneumonia confirmed by clinical, roentgenological and laboratory methods, admitted to the hospital from closed communities during the one year period, were examined. The sputa of patients with pneumonia in the acute stage were studied in the polymerase chain reaction (PCR). The predominence of M. pneumoniae and C. pneumoniae causualties in autumn and winter period was established. The monitoring of atypical infective agents with the use of the PCR techniques gives evidence for conclusion on their ever growing role in the etiological structure of community acquired pneumonia in groups of closely interacting young people.

Infection is the main cause of severe complications and death in oncologic patients. The paper presents the results of a 3-year (2002-2004) local (regional) microbiological monitoring of hospital infections that complicated the main disease in patients of a regional oncologic hospital (Moscow region). The 3-year monitoring revealed the leading microorganisms being the etiological agents of the hospital infections. The dynamics of the resistance of the main hospital microflora to the antibiotics used in the hospital within the above mentioned period was studied. The results served as the basis for recommendations on optimization of the antibacterial therapy of oncologic patients with infectious complications under conditions of a regional oncologic hospital.

In September-December 1998 the epidemic rise of outhospital pneumonia (EP) among children was observed in St. Petersburg, which led to a twofold increase in morbidity rate this year. The study of the etiology of EP during the period of 1998-2001 confirmed the prime role of Streptococcus pneumoniae (74.5%) and, for the first time in Russia, revealed the epidemic outbreak of acute chlamydiosis (Chlamydia pneumoniae), diagnosed in 67.3% of children, the maximum occurrence (87.5%) in 1998 with only 19% of the patients having the disease in the form of monoinfection. The prevalence of S. pneumoniae and C. pneumoniae in the etiology of EP and more severe course of mixed infection suggested that these infective agents played a leading role in the epidemic outbreak of acute respiratory infections in St. Petersburg.

A total of 67 patients with blood system diseases and infectious complications were examined. During the period of the examination 139 microorganisms were isolated. Of these gram negative microorganisms constituted 51%, gram positive microorganisms--34.8% and fungal flora--14.2%. Most frequently the following gram negative microorganisms were isolated from the patients: Pseudomonas sp. (including P. aeruginosa), Klebsiella pneumoniae, Escherichia coli, Haemophilus influenzae. All isolated microorganisms retained sensitivity to imipenem, with the exception of individual strains of Pseudomonas sp.; the latter exhibited sensitivity to amicacin and ceftazidim. Cefotaxime was active with respect to 75% of K. pneumoniae strains and all E. coli strains, ciprofloxacin was active with respect to 43% of E. coli strains, 80% of K. pneumoniae strains and 83.4% of Pseudomonas sp. strains, cefepim was active with respect to 85.7% of Pseudomonas sp. strains and all E. coli strains, ceftazidim was active with respect to all Pseudomonas sp. and E. coli strains. 75% of K. pneumoniae strains, 77.8% of Pseudomonas sp. strains and 86% of E. coli strains retained sensitivity to amicacin. 25% of K. pneumoniae strains required testing for ESBL production.

The detection frequency of antibodies to Hepatitis E Virus (HEV) was studied in residents of the South and of the Middle European Part of the Russia Federation as well as of Siberia. Antibodies to HEV were most often found both in patients with hepatic pathologies and in subjects with diseases unrelated with a primary hepatic lesion, in particular, in patients with skin and venereal diseases and with HEV. A higher concentration of antibodies to HEV was noted also in blood donors, medical personnel and isolated communities, like prisons or psychiatric clinics. A correlation was established between the rate antibodies to HEV are registered and such risk factor as contacting with blood or a gross violation of the hygienic rules.

Aim: To assess feasibility of implementation of Guidelines of Russian Society of Cardiology (RSC) on the management of non ST elevation acute coronary syndrome (adaptation of Guidelines of the European Society of Cardiology) in an ordinary noninvasive community hospital., Methods: Retrospective analysis of inhospital management of 266 consecutive patients with acute coronary syndromes without persistent ST elevation admitted to coronary unit of a community hospital in January-July, 2001., Material and Results: Main characteristics of the group: mean age 69 years (34% >75 years), men - 56%, history of myocardial infarction - 38%, hypertension - 67%, diabetes - 23%, pain at rest as an index event - 98%, symptoms duration exceeding 20 min - 61%, ECG changes - 87% (42% ST deviation), signs of left ventricular failure - 14%. Myocardial infarction as index event was diagnosed in 32% of pts by serial measurement of total CK activity. There were no angiographies or revascularizations during hospital stay (20-/+6 days) because of absence of catheterization facilities. Medical treatment: antiplatelet agents - 99% (98% - aspirin) of patients; proportion of patients treated with heparins - 83% (low molecular weight heparins - 18,5%). Most of the patients received b-blockers (79%) and nitrates (78%). Use of calcium channel blockers was relatively low (15%). Few patients (20%) received statins. Inhospital rate of death and nonfatal myocardial infarction was 3,5% i 3%, respectively. Rate of chest pain recurrence was high (38% overall, 26% with ischemic ST-T ECG changes) and at least partially could be explained by the lack of invasive interventions., Conclusion: Management of patients with non ST elevation ACS in coronary unit of a community hospital during the period surveyed in this study was in line with corresponding RSC guidelines (as related to noninvasive treatment) except duration of hospitalization. This was associated with acceptable rate of death or/and myocardial infarction (6,5%) in a group of relatively high risk pts. High rate of angina recurrences during rather long hospital stay reflected absence of invasive treatment.