jofinЖурнал инфектологииJournal Infectology2072-6732IPO “АIDSSPbR"10.22625/2072-6732-2014-6-3-5-14jofin-334Research ArticleДискуссионные статьиDiscussion ArticlesКлючевые аспекты проблемы врожденных инфекцийKey aspects congenital infectionЛобзинЮ. В.LobzinYu. V.

директор Научно-исследовательского института детских инфекций, заведующий кафедрой инфекционных болезней Северо-Западного государственного медицинского университета им. И.И. Мечникова, д.м.н., заслуженный деятель науки РФ, академик РАН, профессор; тел.: 8(812)234-60-04, факс 8(812)234-96-91

niidi@niidi.ruВасильевВ. В.VasilevV. V.

руководитель отдела врожденной инфекционной патологии, ведущий научный сотрудник Научно-исследовательского института детских инфекций, профессор кафедры инфекционных болезней болезней Северо-Западного государственного медицинского университета им. И.И. Мечникова, д.м.н., профессор; тел.: +7-921-940-93-84

vcubed@yandex.ruНаучно-исследовательский институт детских инфекций, Санкт-Петербург, Россия Северо-Западный государственный медицинский университет им. И.И. Мечникова, Санкт-Петербург, РоссияРоссияScienсе Research Institution of Children’s Infections, Saint-Petersburg, Russia Noth-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, RussiaRussian Federation20142010201463514Copyright © Лобзин Ю.В., Васильев В.В., 20142014Лобзин Ю.В., Васильев В.В.Lobzin Y.V., Vasilev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.niidi.ru/jofin/article/view/334

Ключевыми вопросами решения проблемы врожденных инфекций в РФ являются: использование в отечественной клинической практике общепринятой терминологии, адаптированной к рекомендациям Всемирной организации здравоохранения; отражение в классификации врожденных инфекций современных представлений об инфекционном процессе; научная разработка и внедрение в практическую деятельность врачей «стандартных определений случаев заболеваний» применительно к различным врожденным инфекциям; оптимизация протоколов и клинических рекомендаций по диагностике, лечению и профилактике врожденных инфекций; повышение качества знаний по инфекционной патологии специалистов, занимающихся оценкой риска врожденных инфекций, ведением беременных и детей. Основываясь на собственном опыте и анализе публикаций, авторы предлагают возможные пути решения.

The key questions to solve the problem of congenital infection in the Russian Federation are: using in national practice over world accepted terminology adapted to the recommendations of the World Health Organization; representation of the modern concepts of an infectious process in the classification of congenital infections; scientific development and introducing in clinical practice the «standard case definitions», applied to different congenital infections; optimization of protocols and clinical guidelines for diagnosis, treatment and prevention of congenital infections; improvement a knowledge in the infectious disease for all  pecialists involved in the risk assessment of congenital infections, manage pregnancy and children. Based on our experience and analysis of publications, the authors suggest possible solutions.

врожденные инфекциивнутриутробныеклассификациярископределение случаясongenital infectionsintrauterineclassificationriskcase definitionReferencesHarper K, Zuckerman M, Harper M, et al. The origin and antiquity of syphilis revisited: An Appraisal of Old World pre-Columbian evidence for treponemal infection. Am J Phys Anthropol. 2011; 146 Suppl. 53: 99–133.Harper K, Zuckerman M, Harper M, et al. The origin and antiquity of syphilis revisited: An Appraisal of Old World pre-Columbian evidence for treponemal infection. Am J Phys Anthropol. 2011; 146 Suppl. 53: 99–133.Kolyadenko V.G. Ministetstvo lyikovannya. 2004; 6: 26-31.Kolyadenko V.G. Ministetstvo lyikovannya. 2004; 6: 26-31.Skripkin Yu.K. Syphillis. A brief historical essay. The skin and venereal diseases. The textbook for medical students. Мoscow.: Triad-pharm; 2005. (in Russian).Skripkin Yu.K. Syphillis. A brief historical essay. The skin and venereal diseases. The textbook for medical students. Мoscow.: Triad-pharm; 2005. (in Russian).Wolf A, Cowen D, Paige B. Human toxoplasmosis: occurrence in infants as an encephalomyelitis verification by transmission to animals. Science. 1939; 89:226–27.Wolf A, Cowen D, Paige B. Human toxoplasmosis: occurrence in infants as an encephalomyelitis verification by transmission to animals. Science. 1939; 89:226–27.Wolf A, Cowen D, Paige BH. Toxoplasmic encephalomyelitis. III A new case of granulomatous encephalomyelitis due to a protozoon. Am J Pathol. 1939;15: 657–94.Wolf A, Cowen D, Paige BH. Toxoplasmic encephalomyelitis. III A new case of granulomatous encephalomyelitis due to a protozoon. Am J Pathol. 1939;15: 657–94.Ackerknecht E. H. A short history of medicine. Baltimore: Johns Hopkins University Press; c 1982. 12 p.Ackerknecht E. H. A short history of medicine. Baltimore: Johns Hopkins University Press; c 1982. 12 p.Wesselhoeft C. Rubella and congenital deformities. N. Engl. J. Med. 1949; 240 (7): 258–61.Wesselhoeft C. Rubella and congenital deformities. N. Engl. J. Med. 1949; 240 (7): 258–61.Lancaster P.A. Gregg, Sir Norman McAlister (1892–1966). Australian Dictionary of Biography, National Centre of Biography, Australian National University [Internet]. Available at http://adb.anu.edu.au/biography/gregg-sir-normanmcalister-10362/text18351, accessed online 31 July 2014.Lancaster P.A. Gregg, Sir Norman McAlister (1892–1966). Australian Dictionary of Biography, National Centre of Biography, Australian National University [Internet]. Available at http://adb.anu.edu.au/biography/gregg-sir-normanmcalister-10362/text18351, accessed online 31 July 2014.Gökahmetoğlu S, Yağmur G, Mutlu Sarıgüzel F, Deniz E. Investigation of cytomegalovirus positivity in the peripheral blood samples of risky patients by shell-vial cell culture, antigenemia test and real-time polymerase chain reaction. Mikrobiyol Bul. 2011; 45 (2): 288-95.Gökahmetoğlu S, Yağmur G, Mutlu Sarıgüzel F, Deniz E. Investigation of cytomegalovirus positivity in the peripheral blood samples of risky patients by shell-vial cell culture, antigenemia test and real-time polymerase chain reaction. Mikrobiyol Bul. 2011; 45 (2): 288-95.Vasilev V.V. // Rossijskij semejnyj vrach. 2013; 17 (1): 36-9.Vasilev V.V. // Rossijskij semejnyj vrach. 2013; 17 (1): 36-9.Morgan-Capner P, Crowcroft N.S. Guidelines on the management of, and exposure to, rash illness in pregnancy (including consideration of relevant antibody screening programmes in pregnancy) Commun. Dis. Public Health. 2002; 5:.59–71.Morgan-Capner P, Crowcroft N.S. Guidelines on the management of, and exposure to, rash illness in pregnancy (including consideration of relevant antibody screening programmes in pregnancy) Commun. Dis. Public Health. 2002; 5:.59–71.Coll O, Benoist G, Ville Y, Weisman L.E. et al. Guidelines on CMV congenital infection: WAPM Perinatal Infections Working Group. J. Perinat. Med. 2009; 37 (5): 433-45.Coll O, Benoist G, Ville Y, Weisman L.E. et al. Guidelines on CMV congenital infection: WAPM Perinatal Infections Working Group. J. Perinat. Med. 2009; 37 (5): 433-45.Robert-Gangneux F , Dardy M.-L. Epidemiology of and diagnostic strategies for toxoplasmosis Clin. Microbiol. Rev. 2012; 25 (2): 264-96.Robert-Gangneux F , Dardy M.-L. Epidemiology of and diagnostic strategies for toxoplasmosis Clin. Microbiol. Rev. 2012; 25 (2): 264-96.Lobzin Yu.V. Zhurnal infektologii. 2010; 2 (2): 14-24.Lobzin Yu.V. Zhurnal infektologii. 2010; 2 (2): 14-24.Kitaima J, Inoue H, Ohga S, Kinjo T et al. Differential transmission and postnatal outcomes in triplets with intrauterine cytomegalovirus infection. J. Pediatr Dev Pathol. 2012 Mar- Apr;15(2):151-5.Kitaima J, Inoue H, Ohga S, Kinjo T et al. Differential transmission and postnatal outcomes in triplets with intrauterine cytomegalovirus infection. J. Pediatr Dev Pathol. 2012 Mar- Apr;15(2):151-5.Enders G, Diaminger A, Bader U et al. Intrauterine transmission and clinical outcome of 248 pregnancies with primary cytomegalovirus infection in relation to gestational age. /J.Clin.Virol. 2011 Nov; 52(3):244-6.Enders G, Diaminger A, Bader U et al. Intrauterine transmission and clinical outcome of 248 pregnancies with primary cytomegalovirus infection in relation to gestational age. /J.Clin.Virol. 2011 Nov; 52(3):244-6.Sato A, Hirano H, Miura H, Hosoya N et al. Intrauterine therapy with cytomegalovirus hyperimmunoglobulin for a fetus congenitally infected with cytomegalovirus J Obstet Gynaecol Res. 2007 Oct;33(5):718-21.Sato A, Hirano H, Miura H, Hosoya N et al. Intrauterine therapy with cytomegalovirus hyperimmunoglobulin for a fetus congenitally infected with cytomegalovirus J Obstet Gynaecol Res. 2007 Oct;33(5):718-21.Sidorova I.S.. Congenital infection: Management of pregnancy, labor and postpartum period: Manual for physicians. 3-d ed. Мoscow.; MEDpress-inform; 2011. (in Russian).Sidorova I.S.. Congenital infection: Management of pregnancy, labor and postpartum period: Manual for physicians. 3-d ed. Мoscow.; MEDpress-inform; 2011. (in Russian).Infection diseases: Manual 5-th year’s students. Editor – Lobzin Yu.V. SPb.; NWSMU n.a. I.I.Mechnikov; 2013. (in Russian).Infection diseases: Manual 5-th year’s students. Editor – Lobzin Yu.V. SPb.; NWSMU n.a. I.I.Mechnikov; 2013. (in Russian).Zaplatnikov A.L. Medicina neotlozhnih sostojanij. 2013; 1 (48): 25-33.Zaplatnikov A.L. Medicina neotlozhnih sostojanij. 2013; 1 (48): 25-33.Zaplatnikov A.L. Novosti meditsiny I farmacii. 2013; 8 (456):24-7.Zaplatnikov A.L. Novosti meditsiny I farmacii. 2013; 8 (456):24-7.International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). Version for 2010. [Internet]. Available at http://apps.who.int/classifications/ icd10/browse/2010/en#/P35-P39.International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). Version for 2010. [Internet]. Available at http://apps.who.int/classifications/ icd10/browse/2010/en#/P35-P39.National Notifiable Diseases Surveillance System (NNDSS). 2014 National Notifiable Infectious Conditions [Internet]. Available at http://wwwn.cdc.gov/NNDSS/ script/ConditionList.aspx?Type=0&Yr=2014.National Notifiable Diseases Surveillance System (NNDSS). 2014 National Notifiable Infectious Conditions [Internet]. Available at http://wwwn.cdc.gov/NNDSS/ script/ConditionList.aspx?Type=0&Yr=2014.National Notifiable Diseases Surveillance System (NNDSS). 2014 National Notifiable Infectious Conditions. Rubella, congenital syndrome [Internet]. Available at http://wwwn.cdc.gov/NNDSS/script/conditionsummary. aspx?CondID=127.National Notifiable Diseases Surveillance System (NNDSS). 2014 National Notifiable Infectious Conditions. Rubella, congenital syndrome [Internet]. Available at http://wwwn.cdc.gov/NNDSS/script/conditionsummary. aspx?CondID=127.Vasilev V.V. Toxoplasmosis. Manual for physicians. Editor – Lobzin Yu.V. SPb.; «Digit online»; 2014. (in Russian).Vasilev V.V. Toxoplasmosis. Manual for physicians. Editor – Lobzin Yu.V. SPb.; «Digit online»; 2014. (in Russian).National Notifiable Diseases Surveillance System (NNDSS). 2014 National Notifiable Infectious Conditions. Rubella, congenital syndrome [Internet]. Available at http://wwwn.cdc.gov/NNDSS/script/casedef.aspx?CondYrID=830&DatePub=1/1/1990.National Notifiable Diseases Surveillance System (NNDSS). 2014 National Notifiable Infectious Conditions. Rubella, congenital syndrome [Internet]. Available at http://wwwn.cdc.gov/NNDSS/script/casedef.aspx?CondYrID=830&DatePub=1/1/1990.National Notifiable Diseases Surveillance System (NNDSS). 2014 National Notifiable Infectious Conditions. Mumps. [Internet]. Available at http://wwwn.cdc.gov/NNDSS/script/casedef.aspx?CondYrID=783&DatePub=1/1/2012.National Notifiable Diseases Surveillance System (NNDSS). 2014 National Notifiable Infectious Conditions. Mumps. [Internet]. Available at http://wwwn.cdc.gov/NNDSS/script/casedef.aspx?CondYrID=783&DatePub=1/1/2012.Vasilev V.V. Rossiyskiy Vestnik Perinatologii i Pediatrii. 2013; 58 (3) : 92-7.Vasilev V.V. Rossiyskiy Vestnik Perinatologii i Pediatrii. 2013; 58 (3) : 92-7.Wallon M, Garweg JG, Abrahamowcz M, Cornu C et al. Ophthalmic outcomes of congenital toxoplasmosis followed until adolescence. Pediatrics. 2014 Mar; 133 (2): 601-8.Wallon M, Garweg JG, Abrahamowcz M, Cornu C et al. Ophthalmic outcomes of congenital toxoplasmosis followed until adolescence. Pediatrics. 2014 Mar; 133 (2): 601-8.Protocols for diagnosis, treatment and prevention of intrauterine infections in newborns of the Russian Association of Perinatology (systematical reccomenndations). Мoscow.; ARESMC MH RF; 2002. (in Russian).Protocols for diagnosis, treatment and prevention of intrauterine infections in newborns of the Russian Association of Perinatology (systematical reccomenndations). Мoscow.; ARESMC MH RF; 2002. (in Russian).Avelino MM, Amaral WN, Rodrigues IM, Rassi AR et al. Congenital toxoplasmosis and prenatal care state programs. BMC Infect Dis. 2014 Jan 18;14:33-46.Avelino MM, Amaral WN, Rodrigues IM, Rassi AR et al. Congenital toxoplasmosis and prenatal care state programs. BMC Infect Dis. 2014 Jan 18;14:33-46.Vasileva I.S. Vrozhdennyj toksoplazmoz (risk razvitija, profilaktika) [Congenital toxoplasmosis: the risk of and prophylaxis] [dissertation]. Saint-Petersburg (Russia): 2002. 162 p.(in Russian).Vasileva I.S. Vrozhdennyj toksoplazmoz (risk razvitija, profilaktika) [Congenital toxoplasmosis: the risk of and prophylaxis] [dissertation]. Saint-Petersburg (Russia): 2002. 162 p.(in Russian).Savicheva A.M. Zhurnal akusherstva i zhenskih boleznej. 2006; LV (2): 76-84. (in Russian).Savicheva A.M. Zhurnal akusherstva i zhenskih boleznej. 2006; LV (2): 76-84. (in Russian).Ostrovskaja O.V. Bjulleten’ Federal’nogo Centra serdca, krovi i jendokrinologii im. V.A. Almazova. 2010; 6: 50-55. (in Russian).Ostrovskaja O.V. Bjulleten’ Federal’nogo Centra serdca, krovi i jendokrinologii im. V.A. Almazova. 2010; 6: 50-55. (in Russian).The Ministry of Health of the Russian Federation. The order from November 1, 2012 N 572n «The establishment of policy for medical care on the profile «Obstetrics and Gynecology (except for the use of assisted reproductive technologies)»» [Internet resource]. Access: http://www.rosminzdrav.ru/documents/5828-prikaz-minzdravarossii-ot-12-noyabrya-2012g-572n.The Ministry of Health of the Russian Federation. The order from November 1, 2012 N 572n «The establishment of policy for medical care on the profile «Obstetrics and Gynecology (except for the use of assisted reproductive technologies)»» [Internet resource]. Access: http://www.rosminzdrav.ru/documents/5828-prikaz-minzdravarossii-ot-12-noyabrya-2012g-572n.Lodzin Yu.V. Infekcionnye bolezni. Novosti. Mnenija. Obuchenie. 2013; 1: 24-7. (in Russian).Lodzin Yu.V. Infekcionnye bolezni. Novosti. Mnenija. Obuchenie. 2013; 1: 24-7. (in Russian).

The authors declare that there are no conflicts of interest present.