The antibacterial resistance and virulence genotypes and phenotypes of 148 non-duplicate Klebsiella pneumoniae strains collected from 112 patients in Moscow hospitals in 2012-2016 including isolates from the respiratory system (57%), urine (30%), wounds (5%), cerebrospinal fluid (4%), blood (3%), and rectal swab (1%) were determined. The majority (98%) were multidrug resistant (MDR) strains carrying bla (91%), bla (74%), bla (51%), bla (38%), and bla (1%) beta-lactamase genes, class 1 integrons (38%), and the porin protein gene ompK36 (96%). The beta-lactamase genes bla, bla, bla, bla, bla, bla, bla, bla, bla, bla, and bla were detected; class 1 integron gene cassette arrays (aadA1), (dfrA7), (dfrA1-orfC), (aadB-aadA1), (dfrA17-aadA5), and (dfrA12-orfF-aadA2) were identified. Twenty-two (15%) of clinical K. pneumoniae strains had hypermucoviscous (HV) phenotype defined as string test positive. The rmpA gene associated with HV phenotype was detected in 24% of strains. The intrapersonal mutation of rmpA gene (deletion of one nucleotide at the polyG tract) was a reason for negative hypermucoviscosity phenotype and low virulence of rmpA-positive K. pneumoniae strain KPB584. Eighteen virulent for mice strains with LD ≤ 10 CFU were attributed to sequence types ST23, ST86, ST218, ST65, ST2174, and ST2280 and to capsular types K1, K2, and K57. This study is the first report about hypervirulent K. pneumoniae strain KPB2580-14 of ST23 harboring extended-spectrum beta-lactamase CTX-M-15 and carbapenemase OXA-48 genes located on pCTX-M-15-like and pOXA-48-like plasmids correspondingly.

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We report here the genome sequences of 10 Klebsiella pneumoniae strains of capsular type K2 isolated in Russia from patients in an infectious clinical hospital and neurosurgical intensive care unit. The draft genome sizes range from 5.34 to 5.87 Mb and include 5,448 to 6,137 protein-coding sequences.

Irradiation of the  tumor through the  ridge  filters  in order  to reduce  the  damage of the  normal tissues while maintaining the same damage to the neoplastic tissue  as with uniform field is used for many decades. In recent years, a positive effect has been demonstrated using synchrotron radiation and beams of accelerated protons with radiation fields diminished to 25-100 micrometers with the same distances between them.  Less skin  damage achieved while  maintaining the  required level of large  neoplasms eradication in the  case  of X-ray and gamma  irradiation through ridge  filters  can be partially explained by the features of the physical distribution of the dose over the depth of the irradiated tissue,  namely, the “merging” of fields at depth. But the  good  results from  the  use of the  ‘hills and  valleys’ in radiation fields  created by the  modern radiation sources  have attracted attention to radiobiological issues for explaining the principal differences in reaction to  spatial fractionation of the  absorbed dose  between tumor and  normal tissues. We  are  talking about the  role  of the  so-called ‘communal effect/bystander effect’, the  effect  of radiation on the  immunological processes, the  differences in damage and  restoration of the  microvasculature in normal and  tumor tissue, etc. Although there  is the lot of publications concerning experimental studies of the effectiveness of ‘spatial dose fractionation’, as well as those  considering radiobiological mechanisms of the  observed expansion of the ‘therapeutic interval’, there  is still no clarity in this issue. The purpose of this review is to systematize the available data on the clinical  and experimental confirmation of the effectiveness of ‘spatial fractionation’ and the  various  explanations of its  advantages over conventional, uniform dose  distribution. Special  attention is paid  to the  issues  of combination of spatial fractionation with  superhigh dose rate  irradiation (FLASH-radiotherapy) on the  new  radiation facilities, including proton accelerators, which  are  now  in use in this country.

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