COVID-19 pandemic has posed a severe healthcare challenge calling for an integrated approach in determining the clues for early non-invasive diagnostics of the potentially severe cases and efficient patient stratification. Here we analyze the clinical, laboratory and CT scan characteristics associated with high risk of COVID-19-related death outcome in the cohort of severely-ill patients in Russia. The data obtained reveal that elevated dead lymphocyte counts, decreased early apoptotic lymphocytes, decreased CD14+/HLA-Dr+ monocytes, increased expression of JNK in PBMCs, elevated IL-17 and decreased PAI-1 serum levels are associated with a high risk of COVID-19-related mortality thus suggesting them to be new prognostic factors. This set of determinants could be used as early predictors of potentially severe course of COVID-19 for trials of prevention or timely treatment.
Strains of microorganisms characterized by resistance to antimicrobial drugs used in medical organizations continue to spread In most regions of the world including Russia. It is clear that it affects both the effectiveness of antimicrobial therapy and tactics and strategy of its use not only in adults patients but also in children. The pandemic of coronavirus infection, in addition, highlighted the growing problems in treatment of invasive mycoses, the dose adjustment of antibiotics during sorption and dialysis therapy methods. These circumstances made it necessary to make adjustments to Guidelines on Diagnostics and Antimicrobial Therapy of Infections Caused by Multiresistant Strains of Microorganisms, which were prepared by a group of leading Russian experts in 2020 [1]. The submitted version of the recommendations was approved on 25.03.2022 at a joint meeting of the working group with representatives of public organizations: Association of Anesthesiologists-Intensivists, the Interregional Non-Governmental Organization Alliance of Clinical Chemotherapists and Microbiologists, the Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC), and NGO Russian Sepsis Forum. These recommendations reflect an interdisciplinary consensus opinion on approaches to the diagnosis and antimicrobial therapy of infections caused by multiresistant microorganisms. They are based on data from publications obtained from randomized trials as well as based on international clinical guidelines with a high degree of evidence.It is rational to use the Guidelines for determining the tactics of empirical and etiotropic therapy of the most severe infections.
НИИ хирургии детского возраста ФГБОУ ВПО «РНИМУ им. Н. И. Пирогова» МЗ РФ, Москва, Россия 2 ФГБОУ ВО «Башкирский государственный медицинский университет» МЗ РФ, г. Уфа, Россия 3 ФГБОУ ВО «Уральский государственный медицинский университет» МЗ РФ, г. Екатеринбург, Россия 4 ФГБУ «Национальный медицинский исследовательский центр хирургии им. А. В. Вишневского» МЗ РФ, Москва, Россия Обзор литературы посвящен одной из актуальных проблем современной интенсивной терапии-диагностике сепсиса у детей� В обзоре освещены современное определение понятия «сепсис» и критический анализ публикаций по педиатрическому сепсису за последние годы� Рассмотрены преимущества и недостатки подхода рекомендаций «Сепсис-3» в педиатрической интенсивной терапии� Особое внимание уделено возможностям методам раннего выявления и оценки тяжести органной дисфункции у детей с инфекцией посредством специальных шкал pSOFA или PELOD-2�
Introduction. Strains of microorganisms resistant to antimicrobial agents are commonly found in medical units throughout most regions of the world, including Russia. This leads to lower antimicrobial therapy efficacy when treating nosocomial infections. In this regard, the timely implementation of adequate antibiotic therapy is of great importance.The objective of the guidelines: To provide summarized information on contemporary approaches to microbiological diagnostics and the assessment of results, as well as the principles of rational use of antimicrobial and antifungal agents, including treatment of infections caused by multiple drug-resistant strains of microorganisms.Subjects and methods. These guidelines are based on published data obtained in the course of randomized trials, as well as information presented in the provisions of international guidelines supported by high-level evidence. The guidelines were prepared by a working group of Russian experts with extensive experience in research and practical work in this area. On October 11, 2019, the final version of the guidelines was reviewed and approved at a joint meeting of the working group and representatives of the public organizations which initiated the development of these guidelines (Association of Anesthesiologists-Intensivists, the Interregional Non-Governmental Organization Alliance of Clinical Chemotherapists and Microbiologists, the Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC), NGO Russian Sepsis Forum).Conclusion. The guidelines reflect an interdisciplinary consensus of approaches to the diagnostics and antibiotic therapy of infections caused by multiresistant microorganisms. The provisions set forth should be used to decide on the strategy of empirical and etiotropic therapy of the most severe infections.
Любое клинически значимое инфекционное заболевание, развившееся у человека в результате его пребывания в условиях лечебного учреждения независимо от степени оказанной ему медицинской помощи, принято называть инфекциями, связанными с оказанием медицинской помощи (ИСМП). В настоящее время данной патологии принадлежит одно из ведущих мест в структуре смертности в стационаре, она определяет значительное увеличение сроков пребывания пациента в лечебном учреждении и повышает стоимость его лечения. Возникшая в результате ИСМП потеря трудоспособности человека наносит весомый экономический ущерб государству, больному и его семье [1].
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.