Background. Respiratory syncytial virus (RSV) and parainfluenza virus together account for up to 40% of the pathogens causing acute respiratory infections in children and adults. RSV infection does not result in the development of stable immunity, which necessitates the search for effective methods of its drug-based prevention. The aim of the work was to study of the virucidal activity of the drug Thymogen®, a dosed nasal spray, against human respiratory viruses (parainfluenza virus and respiratory syncytial virus) in vitro. Material and methods. The virucidal effect of the drug Thymogen®, a dosed nasal spray, was studied in vitro on the Vero (ATCC CCL-81) cell culture in comparison with the drugs Hexoral® and Lizobact COMPLETE® against the parainfluenza virus and respiratory syncytial virus. The work was carried out in two stages: a study of the cytotoxicity of Thymogen® followed by a study of the virucidal effect at working range of drug concentrations of the drug. Results and discussion. The cytotoxicity assessment of the drug Thymogen®, a dosed nasal spray, allowed the use of a working range of drug concentrations of 0–63%. The virucidal activity of the drug Thymogen®, a dosed nasal spray, was revealed against the respiratory syncytial virus in vitro, starting with a drug concentration of 1.2%; and the parainfluenza virus, starting with a drug concentration of 0.4%. Conclusion. The obtained data may serve as a basis for conducting appropriate clinical studies on the use of the drug Thymogen®, a dosed nasal spray, in patients with acute respiratory viral infections, including respiratory syncytial virus and/or human parainfluenza virus as infectious agents.

Antimicrobial photodynamic inactivation is of particular interest in the context of the global spread of antimicrobial resistance. Aim. Evaluation of the effect of porphyrins on planktonic and biofilm forms of wound infection pathogens during photodynamic inactivation in vitro. Methods. Objects: asymmetric water-soluble porphyrins containing heterocyclic fragments on the periphery of the porphyrin cycle: residues of benzoxazole (O-por), N-methyl benzimidazole (N-por) and benzothiazole (S-por). Microorganisms: planktonic forms (N=91): clinical isolates from wound discharge with a predominance of gram-positive microorganisms; biofilms (N=20). Irradiation parameters: light source — LED lamp (white light) 20 W, maximum luminous flux 1500–1800 Lm; exposure time: 10, 15, 30, 60 minutes. The bactericidal effect of porphyrins on planktonic forms was studied using the «sterile» stain method. The destructive activity of porphyrins to biofilms was assessed by changes in optical density. Results. Antibiotic resistance was determined in 84.9% of the strains (95% CI 65.3–97.5). Three porphyrin compounds provided a high level of lysis of 94.5% of antibiotic-resistant and antibiotic-sensitive strains (N=86; 95% CI 86.7–102.3) after 10 minutes of irradiation. Porphyrins did not have a bactericidal effect on 5.5% of the strains (N=5; 95% CI 14.9–25.9); 80% (N=4) of these strains were gram-negative microorganisms. The activity of S-por and N-por porphyrins ranged from weak biofilm destruction to no effect, and the absence of destructive activity was determined for O-por. Conclusions. Porphyrins have a pronounced bactericidal potential against planktonic forms of gram-positive pathogens of infectious diseases, including those with antibiotic resistance. Some types of molecules (N-por, S-por) led to weak biofilm degradation.

Background. The World Health Organization has included Pseudomonas aeruginosa in the list of multidrug-resistant bacteria which urgently requires the development of new antibiotics and regulation of the use of existing ones. The aim of the study was to identify and evaluate the correlation of phenotypic and genetic resistance of clinical isolates of P. aeruginosa isolated from patients in the Republic of Tatarstan. Methods. 40 clinical isolates of P. aeruginosa from patients in the Republic of Tatarstan were studied. Susceptibility to antimicrobial drugs was assessed using the disk diffusion method. The presence of resistance genes was tested using polymerase chain reaction. Results. Phenotypic resistance to beta-lactam antibiotics was detected in 85–100% of clinical isolates of P. aeruginosa out of 40 studied. Moreover, 38% of isolates carried the mexB gene for resistance to beta-lactam antibiotics. Resistance to fluoroquinolones was shown by 80% of isolates, and resistance to aminoglycosides was detected in 45–55%. The mexD gene associated with resistance to fluoroquinolones was identified in 20% of isolates. The aminoglycoside resistance genes (mexY, aac(3)-IIa, aphA1, rpsL) were detected in 3–50% of P. aeruginosa isolates, respectively. Conclusion. The presented results indicate a discrepancy between the phenotypic manifestation of resistance and the presence of antibiotic resistance genes. This indicates the presence of many mechanisms of resistance to the same groups of antibiotics, which should be taken into account when developing complex drugs to overcome bacterial resistance to the drug. At the same time, isolates with a low level of expression of genetic resistance determinants are susceptible to the antibiotic and pose a threat of spreading resistance genes.

Urinary tract infection (UTI) is a common infection seen in both community and hospital settings. Antibiotic treatment is essential for achieving a favorable outcome of UTI. However, the increasing prevalence of antibiotic-resistant bacteria in urine has made it difficult to select appropriate antibacterial therapy. The aim of the study was the analysis of antibiotic susceptibility of Escherichia coli in UTIs. Material and methods. The study was conducted using biological material (urine) collected from patients in different hospital departments, which was received in the bacteriological laboratory of the Republican Scientific and Practical Medical Center of Urology (P6), for the period from January 2020 to December 2022. Nutrient media and discs with antimicrobial drugs manufactured by Himedia (India) were used. Results. Analyzing the data of positive results of bacteriological studies, it was revealed that the dominant pathogen is Escherichia coli, which accounted for 70% of all isolated pathogens; Klebsiella pneumoniae was isolated in 9% of cases, and Pseudomonas aeruginosa — in 6%. The conducted analysis of the resistance of E. coli strains isolated from patients in the hospital showed a high level of resistance to antimicrobial drugs. The highest resistance rates were observed toward ampicillin, ceftazidime, cefepime, norfloxacin, ciprofloxacin, levofloxacin, and moxifloxacin. The studyrevealed that uropathogenic E. coli strains had high resistance to beta-lactam antimicrobial drugs, including inhibitor-protected ones, and the range of resistance varied from 23.1 to 77.8%, depending on the type of antimicrobial drug and the year of isolation of E. coli strains.

Wound infection has a negative impact on the course of the wound healing process, slowing down tissue reparation, reducing the patient's quality of life, and increasing economic costs. Ineffective eradication of the pathogen can lead to chronic inflammation and expansion of the tissue damage area, therefore early detection and treatment of wound infection promotes faster healing, reducing the incidence of adverse effects. Aim. To evaluate the possibility of using the original polymer antimicrobial gel as part of a dressing and its effect on the healing of staphylococcal-infected wounds in vivo. Materials and methods. A polymer composition based on polyvinylpyrrolidone containing dioxidine and gentamicin (RU2822155C1) was applied to medical material. The obtained samples were lyophilized, sterilized, and their antibacterial activity against S. aureus ATCC 29213 was determined. The in vivo study was carried out on 12 rats, to which an infected skin defect was applied. The animals were taken out on the 3rd, 7th, and 10th days of the experiment; wound contamination was monitored, and tissue blocks were removed for histological examination. Results. The dressing with the original gel was characterized by the presence of significant antibacterial properties against S. aureus ATCC 29213, while the activity of the samples was preserved after lyophilization, sterilization, and storage for 1.5 years. During the in vivo experiment, the growth of S. aureus was not recorded in animals of the experimental group as soon as on the third day from the start of the experiment, while in animals of the control group, S. aureus was isolated at all observation periods. Morphological examination showed acceleration of wound cleansing, relief of purulent inflammation, as well as an earlier onset of reparation processes in the wounds of animals of the experimental group. Conclusion. The effectiveness of the developed antimicrobial wound dressings in stopping the acute staphylococcal infectious process, taking into account the traumatization of the wound surface and good biocompatibility, allow us to consider promising further studies of the possibilities of using the studied materials in the treatment of acute infectious process, as well as in the treatment of chronic wounds.

The aim of the study was to analyze the effectiveness of microbiological studies and the use of parenteral and enteral forms of antibacterial drugs in sepsis of patients with brain damage of various etiologies. Material and methods. The study included 40 patients (23 men, 17 women, average age 50.43±2.84). In patients who survived and died from sepsis, the type, duration, as well as the total amount of parenteral and enteral antibiotics, were assessed. The prognostic value of microbiological parameters of urine, tracheobronchial aspirate, venous blood, cerebrospinal fluid, and intravenous fragment of the central venous catheter was studied, with the absolute and relative number of cases of positive and negative microbiological culture determined. Results. In all 40 examined patients, 22 microbiological cultures were isolated from urine and the tracheobronchial tree, venous blood, cerebrospinal fluid, and the intravenous segment of the central venous catheter, of which 17 species were found in tracheobronchial aspirate, 10 in urine, 10 in venous blood, 8 in cerebrospinal fluid, and 10 in the intravenous segment of the central venous catheter. Of the 22 microorganisms, 9 (40.9%) isolates were representatives of enterobacteria. The patients were given 23 types of parenteral antibiotics and 10 types of enteral and inhalation antibacterial drugs. Conclusion. Detection of Providencia stuartiiin bronchial aspirate and Acinetobacter baumanii, Escherichia coli in urine was reliably associated with the group of deceased patients, which can be considered an unfavorable prognostic factor. Administration of amikacin sulfate intravenously with long-term use, as well as fosfomycin and ciprofloxacin with enteral administration, increase the survival of patients with sepsis.

The increase in the proportion of comorbid forms of socially significant infections, in particular the combination of tuberculosis with HIV infection and chronic viral hepatitis, is a pressing problem, including of a therapeutic nature: on the one hand, the combined use of anti-tuberculosis and antiretroviral therapy creates an additional burden on the liver; on the other hand, the situation is aggravated by specific disorders of its function associated with the presence of a chronic viral infection, most often hepatitis C and B. In this regard, the inclusion of drugs with hepatoprotective properties in the treatment regimens for this pathology is advisable. The article presents a clinical observation of the effectiveness of remaxol inclusion in the treatment regimen of a patient with disseminated pulmonary tuberculosis, comorbid with HIV infection and chronic hepatitis C with signs of a hepatotoxic reaction to the etiotropic therapy (the main course of treatment). The drug was administered according to the scheme: 400.0 ml intravenously by drip every other day No. 5, then 400.0 intravenously by drip once a week No. 4. The treatment with remaxol contributed to the relief of clinical and laboratory signs of drug-induced liver damage, which in turn made it possible not to interrupt the course of etiotropic therapy, while the improvement of the general condition of the patient increased his adherence to the treatment. The obtained results allow us to continue research in this direction.

Urolithiasis occupies a leading position in the structure of diseases of the urinary system. The morbidity rates of urolithiasis directly related to the quality of drinking water are analyzed. The excess of silicon compounds in drinking water is considered a risk factor for the development of urolithiasis in the population. A new comprehensive approach is proposed for studying the influence of the mineral composition of drinking water, in particular, the content of silicon compounds in water sources, on the frequency of urolithiasis.

The regional features of the frequency of thromboembolic complications and the structure of risk factors in outpatient practice were investigated. Gender and age analysis showed the prevalence of males aged 80 years and older. Cardiac arrhythmias and chronic heart failure had the greatest share in the risk factors for PE.

Viral infections occupy a leading place in various human pathologies and are one of the main causes of death among people, both in developed and developing countries with a weak health care system. The huge diversity of viruses and their unique variability pose a serious challenge to the developers of antiviral agents. The purpose of this review is to analyze the current state of development of emergency prevention and treatment agents, as well as promising areas for the development of chemotherapy for viral infections. The main direction in the development of effective means for the treatment of viral infections is the creation of medications based on abnormal nucleosides and their precursors, small interfering RNA, releaseactive compounds, and the search for targets among viral proteins. The review considers the most significant results in the field of creating agents for the treatment of viral infections.

Diseases caused by microscopic fungi (mycoses) have become an important clinical problem in recent decades. The importance of mycoses in rheumatology has increased significantly due to the active introduction of genetically engineered biological drugs into clinical practice, primarily tumor necrosis factor-α inhibitors and interleukin-17 inhibitors. In addition, a number of questions arise when establishing timely and correct diagnosis, as well as prescribing rational therapy in patients with mycotic septic arthritis, a disease that is quite difficult to treat. The most common etiological agents of fungal arthritis (FA) include Candida spp., Aspergillus fumigatus, Sporothrix schenckii, Coccidioides immitis, Blastomyces dermatitis, Cryptococcus neoformans, and Histoplasma capsulatum. This review examines the problems of diagnosis and treatment of FA associated with these pathogens.

Standard chemotherapy suppresses angiogenesis and reduces vascularization of cervical cancer (CC). A more pronounced response to treatment was detected in more vascularized and oxygenated tumors, but it follows that suppression of angiogenesis during initial courses of chemotherapy may lead to a decrease in the response after subsequent treatment. Preservation of the numerical vessel density during therapy can serve as a prognostic factor for an insufficiently good response to treatment. Methods of molecular targeted therapy of CC are aimed primarily at inhibiting angiogenesis and restoring the normal functioning of the immune system fighting the tumor. The addition of targeted antiangiogenic therapy drugs to standard cytostaticagents for the treatment of patients with persistent, recurrent, or metastatic CC increases progression-free survival and overall life expectancy, but the side effects of such therapy are often severe and sometimes fatal. The main complications recorded are neutropenia, central and peripheral arterial and venous thrombosis, the formation of intestinal and vaginal fistulas. Resistance to targeted drugs develops very quickly, followed by restoration and even an increase in vascularization due to the progression of tumor cell hypoxia and the inclusion of angiogenesis pathways without the VEGF participation. It should be noted that suppression of angiogenesis during any method of treating cervical cancer increases hypoxia of the remaining tumor, which contributes to increased production and release of proangiogenic cytokines, such as VEGF, and the progression of angiogenesis.