The review of publications on alphaherpesviruses, their taxonomy, morphology and life cycle is represented. Alpha-herpesviruses are divided into three types that can cause anthroponous infections: herpes simplex virus types I and II, and varicella-zoster virus. Despite the common structure, diseases caused by these viruses differ in both pathogenesis and clinical manifestations. Because of complexity of vircella modeling the study of herpes simplex viruses more accessible for modeling is a significant need for scientific society.

Objective. In the last decade, along with tick-borne encephalitis new previously unknown infections began to occur after tick bites in all regions of ixodid ticks. In the Primorsky Krai, studies in this direction began in 2014. The aim of this study was to assess evaluation of infestation by pathogens of tick-borne infections of humans and ixodid ticks in epidemic seasons 2014-2018 on the territories of natural foci of Primorsky Krai. Methods. Assessment of the activity and prevalence of pathogens of tick-borne infections was obtained by analyzing the following three parameters: infection of ticks collected from vegetation, sucked ticks removed from people, and blood samples of individuals 2-3 days after the tick bite. Results. Using a real-time PCR, we have shown the existence in the southeast of the Primorsky Krai of the six causative agents of tick-borne infections (TBE, Lyme disease, tick-borne recurrent fever caused by Borrelia miyamotoi, granulocyte anaplasmosis, mononuclear ehrlichiosis and tick-borne rickettsiosis). Most often in ixodid ticks detected borrelia (Borrelia burgdorferi s.l., and Borrelia miyamotoi). In single cases, genetic markers of TBE virus, anaplasm and erlichia have been identified. Besides, Rickettsia heilongjiangensis DNA was detected in these areas. The interrelation between infection of ixodid ticks with tick-borne pathogens and rates of morbidity in these infections in Primorsky Krai was established. Conclusions. The data obtained concentrate attention of researchers on a variety of existing tick-borne infections, which by now represent a new, urgent problem and require further careful study not only of "old" previously known pathogens but also new newly discovered and, perhaps, not yet discovered pathogens of tick-borne natural focal infections.

Objective. In patients infected with the human immunodeficiency virus (HIV) and co-infected with the hepatitis C virus (HCV), CD4+ T-cell deficiency is more pronounced compared to HIV monoinfected subjects, due to a reduction in their naive subpopulation. This work is devoted to establishing the causes of the development of insufficiency of these cells. Methods. Two groups of HIV-infected persons were examined: HIV+HCV+ (n=21) and HIV+HCV- (n=21) receiving antiretroviral drugs for more than two years (HIV level <50 copies/ml). Anti-HCV therapy was not conducted. The control group (n=20) consisted of uninfected volunteers. The number of naive CD4+ T cells, the proportion of these included RTE (recent thymic emigrants; CD31+), the content of activated CD4+ T-lymphocytes (HLA-DR+ CD38+), the concentration in the blood of bacterial lipopolysac-charide, the activity of transaminases. Results. Immune activation negatively affected the number of naive CD4+ T cells in both groups of HIV-infected. However, only in the HIV+HCV+ group the inverse relationship between the activity of transaminases, on the one hand, and the proportion of RTE on the other hand (R_ALT-RTE =-0.590, p<0.005 and R_AST-RTE=-0.468, p<0.05), and also the level of lipopolysaccharide and the number of mature (CD31^-) naive CD4+ T-lymphocytes (R =-0.535, p<0.02). Conclusions. Thus, hepatitis activity and increased microbial translocation from the intestine in HIV/HCV co-infection may have a negative effect on the number of naive CD4+ T cells. Naive elements of varying degrees of maturity are apparently affected. Specific mechanisms for the formation of a deficit of naive CD4+ T-lymphocytes in HIV/HCV-co-infected individuals have yet to be established.

Objective. The study objective is to assess the effect of recrudescence of cytomegalovirus (CMV) infection on the content of progesterone, its receptor and metabolite 5ß-dihydroprogesterone in the early placenta in various pregnancies. Methods. The material for the study was 60 villous chorions, 30 of them were taken during the scraping of the uterine cavity in pregnant women with spontaneous abortion onset 9-11 weeks against the background of an recrudescence of CMV infection (the main group) and 30 with medical abortions on the same period and recrudescence of the infectious process (comparison group). The control group consisted of 35 villous chorions from pregnant women with CMV infection in the latent stage, taken with medical abortions for a period of 9-11 weeks. Determination of CMV DNA, verification of type specific antibodies, avidity index, progesterone receptor content, peripheral blood progesterone and villous chorion homogenate were performed with enzyme immunoassay. The activity of 5ß-dihydroprogesterone dehydrogenase was determined by a histochemical method followed by analysis with a Scion (USA) program using a digital microscope. Results. Recrudescence of CMV infection during pregnancy led to a decrease in progesterone production to 63.3±2.0 nmol/L in peripheral blood, to 21.5.1 ±2.7 nmol/L - in villous chorion, a decrease in the content of the progesterone receptor up to 14,0±0,8 nmol/L, as well as a decrease in the activity of conversion of progesterone into 5ß-dihydroprogesterone in the trophoblast at the 8-10^th week of pregnancy. In the case of spontaneous abortion against the background of an Recrudescence of CMV infection, there were more pronounced disruptions in the activity of conversion of progesterone into 5ß-dihydroprogesterone, as well as a decrease in the progesterone concentration to 44.6±2.2 nmol/L in peripheral blood, to 21.5±2.7 nmol/L - in villous chorions and receptor content in the placenta - up to 11.3±0.9 nmol/L. Conclusions. These facts, in our opinion, reveal a possible mechanism for forming a threat of premature termination of pregnancy with recrudescence of CMV infection in the first trimester of gestation.

Objerctive. Salmonella infection is the most common intestinal infection in the world. The goal of this study was to study the population structure of Salmonella Enteritidis, isolated in the Far East and Siberia from various environmental sources, using modern methods of cluster analysis. Methods. 345 S. Enteritidis strains isolated from patients and from food in 1989-2018 were studied with sporadic and flare morbidity of the population belonging to the ten major plasmid types. For the classification multidimensional analysis of the results containing genetic (composition of plasmids in the strains) and phenotypic (antibiogram) data, the cluster analysis method was used. Results. To determine the number of clusters, an independent simulation was performed with their estimated number (from 2 to 15). The data of stratification analysis revealed 9 clearly distinguishable clusters with a large number of impurities from other clusters. The detected clusters were rather clearly defined by the corresponding plasmid types of the pathogen. Conclusions. No differences were found in the strains isolated in the western and eastern regions of the Russian Federation. The effectiveness of using plasmid analysis as a method for determining pathogen populations has been confirmed.

Objective. The study of microbial status of artificial pyoinflammatory diseases of soft tissues developed after introduction of patient's own oral fluid. Methods. Comparative 7-year analysis of the microbial composition of wound discharge in artificial pyoinflammatory diseases of soft tissues and inartificial pyoinflammatory diseases of soft tissues of 2^nd to 4^th levels has been carried out in 80 patients of the Purulent surgery department of Military Clinical Hospital No. 301. Results. It has been determined that microbes revealed in artificial pyoinflammatory diseases of soft tissues showed a more pronounced diversity with the prevalence of obligate and facultative anaerobic strains compared to the 2^nd to 4^th levels of pyoinflammatory diseases of soft tissues. Maximum concentration of microbes was found in dental plaque, which distinguish features are wide diversity of microbes and high level of their virulence. Conclusions. The obtained results of the microbial status of patients with artificial pyoinflammatory diseases of soft tissues make it possible to recommend the use of the empiric treatment of such patients with antimicrobial chemotherapeutic agents affecting the anaerobic microflora.

Objective. The study objective is the morphometric characterization of acroteric villi in the infection of placenta from premature births with pathogens of prenatally significant infections. Methods. 34 placentas were studied after premature birth. A molecular genetic analysis was conducted; a histological and morphometric study was performed. The villi were counted in each field of view, their area, perimeter, horizontal and vertical dimensions, number of capillaries and their distance to syncytiotropho-blast were measured. Results. In 55.9 % placenta, genomes of intrauterine infections have been identified, including the DNA of Ureaplasma spp., Mycoplasma hominis, Mycoplasma genitalium, Streptococcus agalactiae, Cytomegalovirus, Herpes human virus type 4. In infected placentas, inflammatory processes (placenta, chorioamnionitis, deciduit, villusitis) are defined in 89.5 % of cases. Morphometric parameters of acroteric villus infected placenta were characterized by a decrease in vascular content and an increase in the distance of the vessels from syncytiotrophoblast (which indicated a decrease in gas exchange and developing hypoxia), as well as an increase in compensatory-adaptive reactions aimed at expanding the gas exchange area and improving the viability of the fetus. Conclusion. The use of morphometric characteristics of acroteric villi facilitates the discovery of mechanisms for the pathogenesis of intrauterine placenta damage and the formation of miscarriages, improving the prognosis of the newborn's condition.

Objective. Study of mediators of immune system - is one of the main immunology direction. Interferons (IFN) are the most studied group of mediators. It includes three types of IFN - I type (a, ß, ы) with marked antiviral activity, II type (y) - whose main function is immune regulation. And III type (λ₁, λ₂, λ₃, and λ₄) with antitumor and antiviral activity. The aim of work: to study condition of IFN system by evaluating the serum level of IFN's in patients with herpes zoster. Methods. 50 patients with herpes zoster were examined. Serum was taken in first 72 hours after disease manifestation. The level of IFN-ß, IFN-γ, IFN-λ₁, IFN-λ_3, IFN-λ_1/3 was determined by using specific reagents R&D Diagnostics Inc. (USA). The data were presented as a median and two quartiles (Me, Q₂₅, Q₇₅). The interrelation of indicators was estimated by the Spearman correlation coefficient. Results. The serum level of IFN-ß, IFN-λ₁, IFN-λ_3, IFN-λ_1/3 were significantly lower in patients with herpes zoster in comparison with the control group. Also, the weak positive correlation between IFN-ß and IFNλ_1/3, IFN-ß and IFN-γ; and medium positive correlation between IFN-y and IFN-λ_1/3 were established. Conclusions. The interferons deficiency was identified. Presumably the correlation between IFN-y and IFN-λ_1/3 is due to common type of producer cell - plasmacytoid dendritic cells. In addition, the direct positive effect of IFN-λ on interleukin-12 (IL-12) and on NK-cells through IL-12 cause positive effect of IFN-λ to IFN-y. Disbalance in interferons ratio - one of the potent factors of varicella zoster virus reactivation. In addition, the high serum level of IFN-γ is a factor of mild course of disease.

Objective. The study objective is to assess Th17 subpopulation of T-lymphocytes and to analyze the features of serum interleukins 17А and 17F (IL-17A, IL-17F) in children with allergic bronchial asthma. Methods. The study includes 60 children with allergic bronchial asthma and 30 healthy children. Withdrawal criteria from the study was virus-induced phenotype, severe course of asthma, administration of immunocorrecting drugs. The material for the study is venous blood. Cells were assessed with on a flow cytofluorimeter MACSQuant (Miltenyi Biotec GmbH, Germany). Immunoenzyme method was used to determine the content of IL-17A, IL-17F with eBiociens reagents (Bender Medsystems GmbH, Austria), IgE with reagents from the company Alkor Bio (St. Petersburg). Results. In the serum of children with asthma, a high level of IL-17A was detected, a moderate direct correlation of its concentration with the number of neutrophils in the peripheral blood and eosinophils in the nasal secretion was determined. Conclusions. Variability of the functional and quantitative characteristics of the interleukin-17 system was determined depending on the prevalence of allergic inflammation, the significance of imbalance in the interleukin-17 system, and the influence of Th17 lymphocytes on various aspects of inflammation and hyperreactivity of the bronchi associated with T-helpers, types 1 and 2.

Objective. Immune activation is the main predictor of the progression of infection caused by the human immunodeficiency virus (HIV). The reasons remain incomprehensible and, probably, can be multifactorial. We suggest that immune complexes are also capable of stimulating immunocompetent cells. Methods. We examined 30 HIV-infected patients who had concentrations of circulating immune complexes and the relative amount of activated T-lymphocytes. In vitro interaction of mononuclear cells of peripheral blood of uninfected donors with immune complexes containing HIV-antigens and antiviral antibodies. Results. It was found that the concentration of circulating immune complexes is directly related to the activation of T-lymphocytes. It has been shown that the interaction of mononuclear cells of healthy donors with immune complexes leads to a significant increase in the proportion of CD14+ monocytes producing interleukin-6 and to enhance the production of reactive oxygen species. Conclusions. Immune complexes containing HIV-antigens and antiviral antibodies are able to activate immunocompetent cells. Such complexes may be another factor in the activation of immunity in HIV-infection.

Objective. The objective of the study was to identify additional markers of complications of percutaneous coronary interventions in patients with acute myocardial infarction Methods. We analyzed the serum content MMP-9, TIMP-1, and MMP-9/TIMP-1 complex in 86 patients aged 41-74 with acute myocardial infarction before and after percutaneous coronary intervention. Results. The serum levels of MmP-9 and TIMP-1 in patients with acute myocardial infarction are significantly higher than in healthy individuals, while the MMP-9/TIMP-1 complex, in contrast, is lower than in the control group. The dynamics of serum concentration of MMP-9 and TIMP-1 after the intervention had a different picture: by the 7^th day, the level of MMP-9 increased, while the TIMP-1 values, on the contrary, decreased. Conclusions. Our study proved the possibility of using the serum concentration of MMP-9 (426.8-978.4 ng/ml) as a predictor of early postoperative complications in patients with acute myocardial infarction after percutaneous coronary interventions.

Objective. To determine the effect of fucoidan from Fucus evanes-cens on the dynamic processes of proliferation and apoptosis of human peripheral blood lymphocytes. Methods. Peripheral blood mononuclear cells (PBMCs) were prepared by Ficoll-Hypaque density gradient centrifugation and cultured in 96-well flat-bottom culture plates in complete were medium RPMI 1640. PBMCs were either unstimulated or stimulated in vitro with the mitogen phytohemagglutinin (final concentration 1 and 10 μg/ml), fucoidan (final concentration 1, 10, 100 μg/ml). At the end of the incubation, the number of apoptotic cells was examined by a cytofluorimetric method of measuring hypodiploid DNA stained with propidium iodide. Cell proliferation was measured PBMCs by [³H] thymidine incorporation into DNA. Results. Fucoidan from F. evanescens influenced the ability of PBMCs to blast transformation depending on the degree of proliferative cell potential: at the initially low level of spontaneous proliferation, the polysaccharide showed a stimulating effect, at the high level of spontaneous proliferation had an inhibitory effect. The direction of the effect of fucoidan also differed depending on the initial state of the cells (rest or activation) and the dose of the polysaccharide. Conclusions. The outcome of the activation of T-lymphocytes by mitogen and fucoidan can be both proliferation and apoptosis. The increase in the number of apoptotic cells upon introduction of fucoidan into the culture of lymphocytes activated by phytohemagglutinin is due to the increased sensitivity of activated cells to the induction of apoptosis at the height of proliferation and may be a reflection of the summation of mitogenic signals of fucoidan and phytohemagglutinin.

Objective. The effect of thermolabile lethal toxin (TLT) and cytotoxic necrotizing factor (CNF) Yersinia pseudotuberculosis was studied on the enzymatic activity of peritoneal macrophages. Methods. The subjects of the study were TLT and CNF proteins isolated from Y. pseudotuberculosis 2517, III serovar strain (obtained from H. Mollaret, France). The primary culture of macrophages was obtained from peritoneal exudate of guinea pigs. We studied enzymes: 5'-nucleotidase, ATPase, lactate dehydrogenase, succinate dehydrogenase, cytochrome oxidase, nonspecific esterase, NO metabolites - nitrite. Results. Under the influence of TLT and CNF toxins, peritoneal macrophages were stimulated, as evidenced by low values of ectoenzymes. At the same time, under the influence of these toxins in phagocytes, stimulation of the oxygen-forming system enzymes was detected at the initial incubation times (1-6 h), and the stimulation of NO metabolites was at the end of the observation period. Against the background of increased activity of lysosomal enzymes (nonspecific esterase) in macrophages infected with TLT, the inhibition of lysosome functions was detected under the action of CNF toxin, which indicated suppression of the digestive capacity of phagocytes. Conclusions. CNF toxin of Y. pseudotuberculosis exerts a more pronounced cytotoxic effect on macrophages than TLT, as evidenced by activity induced of oxygen and nitroxide-forming systems, and low values of lysosomal enzymes.

Objective. The content of interferon-γ (IFN-y) and interleukins (IL) 13 and 17 in the serum of women with human papillomavirus infection was examined. Methods. 38 patients with chronic cervicitis associated with human papillomavirus infection (average age 26.2 years), including 18 - with pointed anogenital warts were observed. The control group - 10 healthy female volunteers. Cytokine levels were determined using specific reagents from R&D Diagnostics Inc. (USA) by the sandwich method of enzyme-linked immunosorbent assay. Results. The levels of IFN-γ and IL-17 in the serum increased, however, no significant differences between the groups examined in various clinical variants of human papillomavirus infection were found. The level of IL-13 in women with anogenital warts was twice as high as in patients without anogenital warts. Conclusions. The increase in the content of all cytokines presented in the study in the serum testified to the activation of the immune system. The high content of IL-13 in human papillomavirus infection can serve as a marker of a persistent inflammatory reaction that accompanies the development of warts.

Objective. With the violation of mucosal immunity, the development of chronic generalized periodontitis is associated, which occupies one of the leading places in the structure of dental diseases. Of great interest are the immunological aspects of the formation of periodontal pathology in conditions of violations of carbohydrate metabolism. Methods. 65 patients were examined, including: 30 patients - 1^st group and 35 patients -2^nd group. The control group consisted of healthy volunteers (30 people). Levels of TNFα, INFγ, IL-4, IL-13 and sIgA were determined by the sandwich version of the enzyme-linked immunosorbent assay. The statistical processing of the material was carried out using the SPSS v 16 program. Results. Significant increases in TNFα, INFγ, IL-4 and IL-13 levels were registered in both groups of patients, as well as a decrease in sIgA concentrations. In patients with periodontitis without concomitant pathology, hyperproduction of TNFα and a deficiency of sIgA have been established. In the group of patients suffering from periodontitis against the background of type II diabetes, a more significant increase in IL-4 and IL-13 was revealed. Conclusions. the obtained results of the study testify to the clinically significant insolvency of both congenital and adaptive humoral immunity, characterized by a violation of the cytokine balance and hypo production of sIgA, which causes weakening of the local immune defense of the oral cavity.

Objective. Despite a large number of studies on chronic viral hepatitis, many issues related to its pathogenesis remain unsettled. First of all, it refers to pathogenic effects of the viruses themselves, the nature and patterns of the host organism's response to the pathogen, the formation of liver cirrhosis, hepatocellular carcinoma, and several other aspects. Methods. In the serum of 150 patients with chronic viral hepatitis B and C and in the serum and in the liver homogenates taken after 31 autopsies of persons who died of cirrhosis in the outcome of chronic viral hepatitis, the total antioxidant activity was studied, the content of 8-hydroxy-2-deoxyguanosine, 8-nitroguanine, reduced glutathione, malonic dialdehyde and 4-hydroxy-2,3-nonenal. Also, the degree of DNA destruction in peripheral blood lymphocytes and hepatocytes was analyzed using the comet assay. Results. It has been established that DNA destruction of hepatocytes and peripheral blood lymphocytes is one of the leading components of the formation of hepatic fibrosis in chronic viral hepatitis B and C and can be considered as its pathognomonic marker. One of the leading mechanisms of this process can be called the enhancement of oxidative and nitrosative processes. Conclusions. There is a direct link between DNA damage and the severity of sclerotic changes in the liver. Oxidative and nitrosative stress in hepatocytes and lymphocytes causes significant violations of the integrity of membrane organelles. Biochemical changes in the liver tissue during chronic viral hepatitis B and C are generally comparable to those in the serum in all respects, which makes them promising in terms of developing algorithms for diagnosing hepatic fibrosis.

Objective. The study objective is to assess the epidemiological significance of bacteria Leptotrichia in the development of purulent-septic infections of an oral cavity. Methods. We carried out a retrospective epidemiological analysis of microbiocenosis of pathological periodontal pockets in nonspecific periodontitis in 432 patients aged over 20 y.o. Results. Microbiocenosis of pathological periodontal pockets in chronic and recurrent of medium and severe periodontitis more pronounced species diversity as compared to microbiocenosis in acute low periodontitis. Bacteria Leptotrichia were detected in all observations typically in association with Staphylococcus aureus and Streptococcus pyogenes, supporting the chronic recurrent process. Conclusions. Analysis results of microbial status of periodontal pockets in patients with chronic periodontitis enable to recommend the use of empiric treatment of this pathology with antibacterial chemotherapeutic agents affecting non-spore-forming anaerobic bacteria.

Objective. The study of the mechanism of action of sulfated polysaccharide from the tang Fucus evanescens on the morphological and immunophenotypic characteristics of dendritic cells (DC) -the key effectors of innate immunity - will enable to establish a rational spectrum for its use. Methods. We investigated a partially acylated sulfated fucoidan from the tang F. evanescens. Immature DCs were obtained from bone marrow cells of BALB/c mice. Fucoidan (100 μg/ml) and commercial TNFα (20 ng/ml) were added as maturation inducers. Immunophenotypic cells were determined by flow cytometry using monoclonal antibodies. Results. Fucoidan induced the maturation of DC, as evidenced by their immunophenotypic and morphological changes. A pool of mature cells capable of presenting the antigen to naive T-lymphocytes and activating the effector mechanisms of innate immunity was formed. Conclusions. Thus, the sulfated polysaccharide from F. evanescens, which contributes to the activation of effector cells of innate immunity, can be used as a potential adjuvant to create an anti-infective defense of the body.

Objective. Interferon and its inductors are extensively used in pediatrics in combined treatment of acute upper respiratory tract viral infection due to their antiviral and immunomodulatory effect. Among national scientists and clinicians there is still no consensus on their effectiveness. The concrete problem is of interest. Methods. We conducted a retrospective analysis of 344 case records of children who treated in 2012-2017 in Outpatient Clinic No. 3 (Vladivostok). The selection was made by the prescription of interferon and its inductors. Results. Recombinant alpha-interferon ('Veferon'), inductor 'Anaferon detskiy, and combined drug 'Citovir-3' were predominantly used in the group of young children. 'Anaferon detskiy' and 'Citovir-3' were predominantly used in the group of preteen children. Interferon inductors ('Cikloferon' and 'Ergoferon') were predominantly used in the third age group. Interferon inductors were also prescribed to children as a medical prevention before and after the immunization during 3-5 days. There was no report on allergic and autoimmune reactions to these drugs during the analysis of outpatient case records. In general, interferon drugs were prescribed in 43.3 %, and interferon inductors - in 56.7 % of cases. Conclusion. Thus interferon drugs and it inductors are extensively used in pediatrics in children from young age in combined therapy of acute upper respiratory tract viral infection, and as immunomodulators for preventive purposes as well. Recombinant interferon drugs and interferon inductors are registered in Russia and some counties of CIS, and its use in pediatrics requires a further analysis both the effectiveness and the safety.

Objective. Working conditions in the concentrating mill of ore mining and processing enterprise were analyzed. Methods. We measured the levels of vibration, noise, microclimate parameters, lightness, dustiness and the level of harmful chemicals in the air of the work area in accordance with regulatory and methodological documents of Mongolia. All used equipment underwent metrological control in a timely manner. To assess the elemental status of workers, a multi-element analysis of hair samples by mass spectrometry was carried out. Results. The noise level at the main work stations exceeded the hygienic standards by 10 dBA. Technological equipment generated vibrations, the intensity of which also exceeded hygienic standards. The concentration of dust in the air of the working area exceeded the maximum allowable by 1.1-12. The concentrations of harmful chemicals (benzene, xylene, diethyl ether) were by 2-3.6 higher than normal. Conclusions. At various stages of preparation of ore for enrichment, workers of the concentrating mill are exposed to a complex influence of factors of the production environment, the level of which considerably exceeds hygienic standards. The main unfavorable factors of the working environment can be called production noise, general vibration and the impact of fibrogenic aerosols. Thus, working conditions at the ore mining and processing enterprise Erdenet can be classified as harmful. At the workplaces of persons engaged in ore processing, there are also unfavorable microclimatic conditions and the impact of infrasound, as well as low doses of ionizing radiation.

Objective. The study objective is to establish the epidemiological features of Streptococcus pneumoniae carrier of different serotypes in organized children groups during vaccinal prevention. Methods. 1574 children were examined on the nasal S. pneumoniae carriage aged 2-7 y.o., having gone to preschool institutions of St. Petersburg. Results. The percentage of S. Pneumoniae serotype strains covered by the action of 13-valent vaccine, was 36.03 %, that is lower than corresponding value (65.4 %), determined in a similar design study in St. Petersburg in 2010-2013. At the same time, it remained unclear whether this reduction could be considered the result of vaccine prevention, since the level of coverage with preventive vaccinations in the studied population was then quite low. Conclusions. The wide spread of pneumococcal serotypes, unreached by the action of the 13-valent pneumococcal vaccine, on the one hand, indicates the need for constant monitoring of the pathogen population during mass immunization programs, and on the other hand, it makes it possible to raise the question of the need to expand the antigenic repertoire of the vaccines used.

Objective. The purpose of the study - based on the analysis of the local epidemic situation to determine the key areas for improving the system of epidemiological surveillance of measles infection in specific conditions of time and place. Methods. As materials of the research were used data from the official registration of the incidence of measles the population of Ekaterinburg for 1988-2017, medical documentation of cases of measles in 2016, the results of serological screening for measles IgG employees of medical organizations in the period of outbreaks of measles and materials routine serological monitoring of measles immunity in the "indicator" populations for 2014-2016 used in epidemiological, clinical, serological and statistical research methods. Results. It is established that in modern conditions the epidemic process of measles in the metropolis has become intermittent, which does not exclude the occurrence of a local outbreak, with primary involvement in the epidemic process of previously unvaccinated children and adults, with the most active spread of infection in medical organizations. Serological studies of immunity to measles, conducted among employees of medical organizations, showed that up to 80 % of the surveyed in the IFA had a protective level of prtivokorevyh antibodies, with the largest number of such persons in the age group over 50 years. Among seronegative to 40 % of employees had an interval from the last vaccination for more than 10 years. When analyzing the results of planned serological monitoring of anticorruption immunity in the "indicator" groups, it was found that the excess of the permissible number of seronegative persons (more than 7 %) in the "indicator" groups occurred both in the short and long terms after vaccination and revaccination. The most unfavourable indicators of seroprotection were obtained among adolescents aged 16-17 and adults. Conclusions. To control the epidemic situation of measles, it is necessary to maintain vaccination coverage of children in the age groups (12 months) in the national vaccination calendar (6 years) at least 95-98 %, as well as to decide on the planned revaccination of the population under 50 years of age with an interval between vaccinations at 10 years.

Objective. Micobacteria resitant to antituberculosis drugs endanger the fight against tuberculosis worldwide. Methods. A retrospective epidemiological study was conducted, based on the observation of the epidemic process of tuberculosis infection in 2006-2017 in Omsk region. We used the data of federal statistical surveillance forms, and also bacteriograms of tuberculosis patients. Results. Against the background of a decrease in the incidence of tuberculosis to 62.2 per 100 thousand of the population, the age structure of newly diagnosed patients was changed: an increase in the proportion of people aged 35-44 from 19.2 to 31.9 %, while reducing the proportion of 18-24 y.o. from 13.8 to 6.1 % and 45-54 y.o. from 21.8 to 13.5 %. The number of patients co-infected with the human immunodeficiency virus (from 1.4 to 22 %) has increased. The incidence of bacterial excretion increased from 39.8 to 56 %. 51.8 % of mycobacterial isolates were characterized by different types of drug resistance. Among newly-detected bacterial invaders, the proportion of patients with multidrug-resistant mycobacteria increased from 24.1 to 30.5 %. The incidence of tuberculosis with extensively drug-resistant tuberculosis was 1.6, and prevalence was 13.6 per 100,000 of population and was characterized by a pronounced upward trend. Conclusions. Under the circumstances, the regional system of epidemiological surveillance will require new approaches to optimization, taking into account changes in the parameters of the epidemic process.