Цель. Сравнить морфологию, минеральный и органический профиль магний-фосфатных бионов (МФБ) и кальций-фосфатных бионов (КФБ) для оценки пригодности МФБ как группы сравнения с целью тестирования специфичности эндотелиотоксического действия КФБ. Материалы и методы. МФБ и КФБ были искусственно синтезированы посредством перенасыщения имитирующей состав крови среды солями магния и кальция соответственно. Морфологические свойства МФБ и КФБ были изучены при помощи электронной и атомно-силовой микроскопии, элементный состав-посредством энергодисперсионной рентгеновской спектроскопии, атомно-эмиссионной спектроскопии и CHNSO-анализа, функциональные группы-инфракрасной спектроскопией с преобразованием Фурье и спектроскопией комбинационного рас-сеяния света, формула входящих в состав бионов химических соединений-рентгеновской порошковой дифрактометрией. Белковый профиль МФБ и КФБ был исследован методом электрофореза в полиакриламидном геле с последующим окрашиванием нитратом серебра. Результаты. Как МФБ, так и КФБ представляли собой сферические частицы губчатой структуры диаметром 80-200 нм и средним диаметром около 120 нм, склонные к формированию кластеров из нескольких частиц. И МФБ, и КФБ состояли из углерода, кислорода, азота, водорода и фосфора, однако МФБ содержали магний и характеризовались минимальным содержанием кальция. МФБ и КФБ содержали фосфатные, карбонатные и гидроксильные группы, при этом МФБ состояли из магния фосфат гидрата и хантита, а КФБиз гидроксиапатита и карбонат-гидроксиапатита. Белковый профиль МФБ и КФБ был схожим.

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We compared peculiarities of the production process of the older and modern(created 80 years after) sorts of winter rye. It is determined that the specific coenotic productivity of a modern sort is 60.6% higher.This increase is due to higher number of productive sprouts per unit area and higher sprout weight. The coenosis of modern sorts is highly resistant to lodging. The modern sort has a 33.5% higher leaf surface index and a 17.7% higher share of the leaves in the upper tier, differing in their erectile orientation in space. As for the content of total chlorophyll in the dry matter of leaves and vagina, the modern sort is inferior to the older by 30.2%during theearing period, and by 17.5%during the milky-wax ripeness period.As for the content of total chlorophyll in the sowing area, the compared sorts were practically the same, but the ratio between chlorophyll a and c was noticeably different. As for the chlorophyll content in stems, in dry matter and in the area of ​​sowing, the modern sort is inferior by1.5 times and more to the older in both observation terms. The sorts differed in the biomass accumulation and its distribution between the parts during the vegetation period. To establish the ear productivity, the older sort used only the current photosynthesis products.In conditions of an unfavorable growth year, the modern sort used previously accumulated by leaves and re-utilized assimilates. The actual and potential productivity of an ear in a modern sort is higher by 77.4 and 68.0%, respectively, but the degree of its vegetative mass supply is lower by 48.6%.Only due to the higher, by 77.4%, utilization of the mass of the sprout, the modern sort binds a greater number of grains in the ear with a higherseparate mass.Since the sharp increase in the ear productivity potential was not accompanied by the same growth of the sprout vegetative mass, the modern sort, in unfavorable conditions for growth, has tensions in the relation system between the sprout vegetative mass and pouring grain. This may be the reason of the unstable achievedyield level.

Relevance. Klebsiella pneumoniae is a major cause of severe healthcare-associated infections in children, representing one of the six most widespread multidrug-resistant microorganisms worldwide and requiring the implementation of population-wide treatment strategies.Aim. To study the risk factors for Klebsiella spread in pediatric healthcare settings.Materials and Methods. Here we performed a descriptive retrospective epidemiological study of Klebsiella spp. cases in pediatric units across the entire Kemerovo region (2012–2019). In total, we documented 27,852 treatment outcomes. We further selected 52 confirmed cases and assessed their risk profiles in comparison with 738 condition-matched control children.Results. Average incidence of Klebsiella spp. detection in pediatric healthcare settings was 78.52 per 1,000 patients (95% CI = 75.42–81.74). We revealed a declining incidence of Klebsiella pneumoniae infection in the region, with notable 4-year cyclicity. The proportion of Klebsiella pneumoniae-infected patients increased 2-fold after 5 days of antibiotic therapy. Among the risk factors of Klebsiella pneumonia infection were artificial feeding (OR = 9,21, 95% = 3,31–35,45, р = 0,0001), assisted ventilation (OR = 7,36, 95% CI = 3,92–14,0], р = 0,0001), use of nebulizers (OR = 5,34, 95% CI =2,49 – 10,9], р=0,0001), airway management (OR = 4,62, 95% CI =2,49–8,56, р = 0,0001), preterm birth (OR = 2,55, 95% CI =1,38 – 4,69, р=0,001), low body weight (OR = 2,48, 95% CI = 1,34–4,56, р = 0,002), enema administration (OR = 1,80, 95% CI = 0,78–3,81, р = 0,088), and nasogastric intubation (OR = 1,79, 95% CI = 0,85–3,54, р = 0,065).Conclusions. The incidence of Klebsiella pneumoniae infections is currently lowering and has 4-year cyclicity. Antimicrobial treatment is associated with 2-fold increased risk if administered for ≥ 5 days. A number of healthcare-associated risk factors of Klebsiella pneumoniae infections have been found.

Relevance. The bacteria of the genus Klebsiella are among the leading pathogens of health care-related infections (HAI). Newborn children are a special risk group for HAI and Klebsiella etiology. It is necessary to look for new approaches to the prevention of HAI of Klebsiella etiology. Purpose. To identify medical technologies that have a high risk of nosocomial infection in children, to develop a risk-oriented methodology for the prevention of Klebsiella infections. Materials and methods. In order to identify possible risk factors, an analytical epidemiological study of the "case-control" type was performed. The observation group consisted of 52 people, the comparison group - 744 people. Results and discussion. Out of 18 studied risk factors for 9 (catheterization of peripheral and central veins, intravenous infusion, catheterization of the bladder, lumbar puncture, oxygen inhalation, hygienic treatment of the oral cavity, drinking regimen and the use of drugs by mouth), the effect on the frequency of infection of patients was not established. Effective 3 preventive measures are not possible without risk identification. To solve this problem, the Ishikawa diagram was applied. The medical technologies that determine the risk in this group of patients are the technologies of respiratory support and nutrition of the newborn baby. To a large extent, the risk of Klebsiella spp. depends on how widely antibiotics of the carbapenem group are used, which determine the colonization of the intestine of a newborn child by carbapenemase-producing Klebsiella. Conclusions. The chances of infection in children with Klebsiella pneumoniae are 3.07 times higher with antibiotics and depends on the group. 9 risk factors influencing the infection of children were identified. The risk-oriented approach to the prevention of HAI is based on identifying risk factors that contribute to infection and monitoring the properties of the hospital population of Klebsiella spp

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доктор медицинских наук, профессор, заведующая кафедрой эпидемиологии, 1 Федеральное государственное бюджетное образовательное учреждение высшего образования «Кемеровский государственный медицинский университет» Министерства здравоохранения Российской Федерации, г. Кемерово, Россия Введение. Особое внимание к Klebsiella pneumoniae обусловлено их эффективным гидролизом широкого спектра β-лактамных антибиотиков и глобальным распространением антибиотикоустойчивых штаммов вследствие горизонтального переноса генов и клональной экспансии [2,3]. Klebsiella pneumoniae, устойчивые к карбапенемам и продуцирующие бета-лактамазы расширенного спектра (БЛРС), классифицируются как один из шести наиболее опасных патогенов с множественной лекарственной устойчивостью в больницах по всему миру [4]. Доля этих микроорганизмов в структуре возбудителей ИСМП, составляет не менее 20% [1]. Цель исследования. Изучить резистентность штаммов Klebsiella pneumoniae, выделенных из клинического материала детей, получающих лечение в детском многопрофильном стационаре г. Кемерово. Материалы и методы. Для анализа распространенности резистентных штаммов Klebsiella spp. изучены результаты эпидемиологического мониторинга (2018г.) на 18 административных территориях Кемеровской области, проведено их ранжирование по степени риска методом перцентилей.