We observed 100 patients with mucormycosis from 2002 to 2024. We used the EORTC/MSGERC 2019, 2020 criteria for diagnosing mucormycosis. Mucormycosis developed against the background of type 2 diabetes mellitus in 10% of patients, type 1 in 7%, in 83% – after coronavirus infection COVID-19 and glucocorticosteroid therapy. The average glycemia level on the day of diagnosis of mucormycosis was 17 mmol / l. Other risk factors were ketoacidosis – 48%, use of glucocorticosteroids – 85%, lymphocytopenia 44%. The main clinical variant was rhinoorbitocerebral mucormycosis – 93%. Less frequently were mucormycosis of brain (37%), skin (25%), lungs (8%), kidneys (1%). Antifungal therapy was used in 96% of patients: рosaconazole (69%), amphotericin B deoxycholate (59%), lipid forms of amphotericin B (25%), isavuconazole (17%). Surgical treatment used 97%. 12 weeks overall survival was 80%.

Микобактерии представляют собой неоднородную группу кислотоустойчивых микроорганизмов, которые могут вызывать различные заболевания человека. Микобактерии, входящие в Mycobacterium avium complex, чаще других регистрируются у больных микобактериозами. К факторам риска, определяющим возможность инфицирования, относят обструктивные хронические заболевания лёгких: бронхиальную астму, бронхоэктазы, туберкулёз и наличие остаточных изменений после его излечения; работу в условиях вредного производства, способствующую развитию заболеваний лёгочной системы. Mycobacterium avium включает 4 подвида: Mycobacterium avium subspecies avium, Mycobacterium avium subspecies silvaticum, Mycobacterium avium subspecies paratuberculosis и Mycobacterium avium subspecies hominissuis. Подвиды Mycobacterium avium отличаются фенотипически и обладают различной патогенностью и влиянием на течение микобактериоза.

Objective. To evaluate the efficacy and safety of the direct-acting antiviral drug riamilovir under different dosing regimens for the prevention of acute respiratory viral infections in young adults living in an organized collective setting.

Materials and methods. A prospective comparative study was conducted involving 450 male participants aged 18– 22 years. Volunteers were divided into three groups: riamilovir 500 mg/day (n=150), riamilovir 250 mg/day (n=150), and a control group without prophylaxis (n=150). The drug was administered orally for 15 days, and follow-up lasted 30 days. The incidence of acute respiratory infections, temporal distribution of cases, duration and severity of key symptoms, PCR test results, and the frequency of adverse events were assessed.

Results. During the observation period, the incidence of ARVI was 13.3% in the 500 mg group, 18.0% in the 250 mg group, and 28.7% in the control group (χ²=11.58; p=0.003). A statistically significant reduction in acute respiratory viral infections incidence was observed in the 500 mg group compared to the control (p=0.0017). Participants receiving riamilovir showed higher median cycle threshold (Ct) values (31.08 and 31.90 versus 25.68 in the control group), which may indicate lower viral loads. The drug significantly reduced the duration of fever (p=0.0079) and general infectious intoxication syndrome (p=0.047), as well as the severity of cough and intoxication (p<0.01). No adverse events were reported.

Conclusion. Riamilovir demonstrated prophylactic efficacy against acute respiratory viral infections by reducing the incidence and severity of clinical manifestations, with a favorable safety profile. The drug may be considered as a means of nonspecific pharmacological prevention of respiratory viral infections in organized collectives.

Objective: to characterize the clinical, laboratory and epidemiological features of respiratory mycoplasmosis in children during the period 2021–2024.

Materials and methods: A single-center retrospective study was conducted at the Federal State Budgetary Institution Federal Research and Clinical Center for Infectious Diseases of the Federal Medical and Biological Agency of Russia during the period 2021-2024, including 236 pediatric patients with laboratory-confirmed infection caused by M. pneumoniae. Statistical data processing was performed using statistical analysis methods in Statistica 7.0 and Microsoft Excel. Differences were considered statistically significant at p<0.05.

Results: The hospitalization rate was highest in 2024 (53.0%). The peak incidence was recorded in the autumn (44.1%). School-age children predominated in the age structure (60.6%). Patients were admitted to hospital late in the course of the disease – Me 8 days (IQR 5-13 days), indicating a subacute course of the infection. Contact with an acute respiratory infection was noted in a quarter of cases (25%). The clinical picture was dominated by fever (Me 38.9°C (IQR 38.0-39.5°C) lasting 6 days (IQR 2-9 days), cough developed in 91.9% of cases, predominantly frequent (51.3%), dry and/ or unproductive (62.3%) lasting 15 days (IQR 11-21 days). The leading cause of hospitalization was lower respiratory tract infection (83.9%). In 2024, the most common diagnosis was “Community-Acquired Pneumonia” (56.0%), which is significantly more common than in other years (p<0.001). Clinical blood tests revealed no significant inflammatory changes in most cases, and C-reactive protein levels remained within normal limits in 46.2%. ELISA was used more frequently (91.5%) than PCR (61.9%) to determine the etiology of the disease, due to the late stages of hospitalization. Macrolides were predominantly used as the etiological therapy, with doxycycline prescribed as monotherapy in 1.3% of cases.

Conclusion: Clinical, epidemiological, and laboratory features of respiratory mycoplasmosis in children have been identified; however, further research is required to optimize approaches to diagnosis and treatment.

The ratio of hepatitis C virus (HCV) genotypes in the Russian Federation and in individual regions is a dynamic process that requires regular research within each region of the country. Such studies have become particularly relevant in the context of widespread access of patients with HCV infection to modern antiviral therapy.

The aim of the study was to analyze the dynamics of the ratio of different HCV genotypes in patients with HCV infection in St. Petersburg in 2024-2025, as well as to evaluate gender and age indicators and the severity of liver fibrotic changes. Materials and methods. The retrospective continuous cross-sectional study included all patients with chronic HCV infection who were prescribed antiviral therapy (HTP) at the Botkin Clinical Infectious Diseases Hospital from 01.01.2024 to 31.12.2025 (n=4122). During the studied period, antiviral therapy was performed using various antiviral drugs (genotype-specific and pangenotypic), in accordance with current clinical guidelines of the Ministry of Health of the Russian Federation.

Results. In 2024, the frequency of genotype 3a was 37.6%, 1b – 50.8%, 1a – 3.7%, 2 – 7.5%, unverified – 0.4%, mixed genotypes were not registered. In 2025– 3a – 46.8%, 1b – 37.8%, 1a – 5.1%, 2 – 9.9%, unverified – 0.2%, mixed – 0.1% (χ²=71.244, p<0.001). Patients with different genotypes significantly differed in age: the youngest were patients with genotype 1a, 45 (41; 50) years old, followed by patients with genotype 3a, 49 (44; 56) years old, genotype 1b, 56 (47; 65) years old, and genotype 2, 57 (49; 66) years (Kruskal-Wallis Н 323,881, p<0.001). In 2025, patients were slightly younger than in 2024: 51 (45; 60) years old versus 52 (45; 62) years old (Mann-Whitney U 1917299.0, p=0.015). Men slightly prevailed – 53%, women made up 47%. There was no significant change in the male/female ratio in 2025 compared to 2024. Fibrosis of stage 0-1 was detected in 50.3%, stage 2 – 27.4%, stage 3 – 10.5%, stage 4 – 11.8%. In 2025, compared to 2024, the number of patients with 0-1 fibrosis decreased and increased with other stages of fibrosis (χ²=10.943, p=0.012).

Conclusion. A decrease in the proportion of patients with genotype 1b and an increase in patients with genotype 3a over the period 2024-2025 was revealed, with a slight increase in the proportion of genotypes 2 and 1a, as well as a decrease in the dynamics of patient age, the absence of significant changes in the gender structure, and an increase in the proportion of patients with moderate and severe stages of fibrosis. The decrease in the proportion of genotype 1b is probably related to the wider treatment of HCV genotype 1b patients in 2024.

Shigellosis remains a significant public health concern, particularly in regions with poor sanitation and limited access to healthcare. The disease is characterized by acute intestinal inflammation, leading to diarrhea, fever, and systemic intoxication. Standard treatment involves rehydration, antibiotics, and symptomatic therapy. However, the growing antimicrobial resistance of Shigella strains necessitates exploring adjunctive treatments to enhance therapeutic outcomes.

Objective: To study the clinical-epidemiological and laboratory characteristics of shigellosis and current approaches to treatment, with a focus on the efficacy of Polisorb in improving clinical outcomes.

Methods: A comparative analysis was conducted on 140 patients diagnosed with shigellosis, divided into two groups. The first group (n=62) received standard therapy supplemented with Polisorb, while the second group (n=65) received only standard therapy. Clinical symptoms, laboratory parameters, and recovery dynamics were assessed. Statistical analysis included Student’s t-test and non-parametric methods.

Results: Patients treated with Polisorb demonstrated a more rapid resolution of intoxication symptoms, normalization of stool frequency, and improvement in laboratory markers of inflammation compared to the standard therapy group. The duration of fever, diarrhea, and abdominal pain was significantly shorter in the Polisorb group (p < 0.05). Additionally, economic evaluation indicated reduced hospitalization duration and lower treatment costs in this group.

Conclusion: The inclusion of Polisorb in the treatment regimen for shigellosis contributes to a faster clinical recovery, improved laboratory parameters, and potential cost-effectiveness. This suggests that Polisorb can be an effective adjunctive therapy in managing shigellosis.

Objective: to characterize specific changes in the intestinal microbiome profile associated with progressive liver fibrosis in patients with chronic HCV infection

Materials and methods: a single-center cross-sectional clinical study of 88 patients with chronic HCV infection (51 people with chronic viral hepatitis C and 37 people with liver cirrhosis of viral C etiology) was conducted, in which the profile of the gut microbiota was determined by 16S rRNA metagenomic sequencing. High-throughput sequencing was performed using a MiSeq genetic analyzer (Illumina, USA) using a protocol based on the analysis of variable regions of the 16S rRNA gene. The data was analyzed using Kraken2. The significance level is assumed to be 0,05.

Results: significant changes in gut microbial diversity have been described in patients with severe liver fibrosis and cirrhosis. In patients with progressive fibrosis, there was a significant increase in representatives of the Enterobacteriaceae, Lactobacillus, Streptococcus, Enterococcus, Lactococcus and Leuconostoc families. Atypical microorganisms such as Photobacterium, Spiroplasma, Candidatus Portiera are also noted in the gut microbiota. The combination of these changes indicates a shift in microbial equilibrium. On the contrary, in the group of patients without liver fibrosis, there is an increase in the number of Odoribacter and Intestinimonas, which are butyrate producers. As well as Akkermansia and Barnesiella, which indicates the normal functioning of the intestinal microbial community.

Conclusions: changes in the intestinal microbiota in severe fibrosis result in the formation of a stable and self-sustaining pathological microbial community. The identified changes can be used to develop corrective methods aimed at restoring the balance of the intestinal microbiota.

In the pathogenesis of hemorrhagic syndrome in COVID-19, on the one hand, the development of heparin-induced coagulopathy cannot be excluded, on the other hand, the development of critical conditions accompanied by the release of proinflammatory factors into the bloodstream may occur. SARS-CoV-2 – associated endotheliopathy is considered as an additional link in the pathological process. At the same time, during the diagnostic process, it becomes necessary to identify markers that contribute to the development of gastrointestinal bleeding.

The aim of the study was to determine the main risk factors for gastrointestinal bleeding in COVID-19 patients based on a comprehensive clinical, laboratory and instrumental examination, as well as to analyze the effectiveness of hemostasis methods in patients with gastroduodenal bleeding. The study involved 332 patients with COVID-19 and developed gastrointestinal bleeding.

When creating a prognostic model using logistic regression with the ROC-curve construction, a correlation was established between the development of gastrointestinal bleeding and the level of APTT, D-dimer, the degree of lung parenchymal involvement according to CT, history of cardiac rhythm disorders, and the method of providing respiratory support (р 0,05).

An immunohistochemical investigation using monoclonal antibodies to CD31, CD34, CD68 and vWF receptors expressed on the endothelial surface revealed an alteration of the endothelial monolayer, contributing to the occurrence of a hemorrhagic event. Thus, an increase in the frequency of gastrointestinal bleeding in COVID-19 patients is directly related to the direct cytopathic effect of the SARS-CoV-2 on endotheliocytes (destruction of the vascular wall due to degradation of the endothelial layer).

Based on a model constructed by binary logistic regression, a prognostic risk scale for the development of gastroduodenal bleeding from the upper gastrointestinal tract in patients with COVID-19 was created (Eurasian Patent for Invention No. 047178 dated 06.17.2024). The sensitivity of the method was 64.3%, specificity 72.1%, accuracy 68%. The risk scale for the development of gastroduodenal bleeding from erosive and ulcerative mucosal defects in patients with COVID-19 is a highly informative method that allows to predict hemorrhagic events in a timely manner.

Also, the effectiveness of combined hemostasis methods in patients with gastrointestinal bleeding has been confirmed.

COVID-19 may increase the risk of adverse pregnancy outcomes and subsequent health problems in the child.

Objective: To study the possible consequences of COVID-19 in pregnant women on the health and development of children during the first three years of life.

Materials and Methods: Primary medical records of children born in 2020–2022 were analyzed. The study group consisted of 50 individuals whose mothers had contracted the novel coronavirus infection (NCVI) during pregnancy; the control group included 30 individuals whose mothers had not contracted COVID-19 during pregnancy.

Results: Complicated pregnancies were observed in 64% of expectant mothers who had contracted COVID-19 (compared to 47% of those who had not contracted NCVI). Preterm birth at 35 weeks of gestation occurred in only 4% of women. All newborns had good Apgar scores, but 22% showed signs of intrauterine malnutrition (compared to 7% in the control group). Pathological conditions identified included choroid plexus cysts (34%), congenital malformations and minor developmental anomalies (22%), and delayed ossification of the femoral heads (40%). By age two, the body mass index of all children was “average” or “above average.” In the first year of life, a gradual delay in motor development was observed in 46% of cases. By age two, motor impairments persisted in 28% of children, and a gradual delay in speech development was first identified in 8%. By age three, the proportion of children with speech impairments had increased to 20%.

Conclusion. Impaired health and development in children with antenatal exposure to NKVI is possible even with asymptomatic and mild maternal disease. Long-term monitoring of these children is necessary, as some neurological disorders may manifest at an older age.

The COVID-19 pandemic posed an unprecedented challenge, impacting all spheres of society. Its profound effect on political institutions, the economy, social interactions, and technological development necessitated a comprehensive analysis of the consequences for various communities.

Aim. To conduct a PEST analysis for a comprehensive assessment of the impact of the COVID-19 pandemic on various professional communities globally and in Russia, with a focus on identifying the organizational and social consequences for the medical community.

Materials and Methods. The structured survey involved 1,768 respondents from three cities in the Central Federal District of Russia (Moscow, Yaroslavl, Smolensk), representing various professional groups. A scoping review of scientific literature and regulatory-analytical documents from 2020–2025 was conducted in parallel, following the PEST analysis methodology. The keywords used for the search were: «COVID-19», «healthcare», «public policy», «fiscal support», «social impact», «telemedicine», «mandatory vaccination», «vaccine technology», and others.

Results. The pandemic had a complex impact on all spheres of society, which proved to be highly specific. Key consequences included: tightened government regulation (political sphere), a decline in small business revenues (69.5% among respondents), and disruption of global supply chains (economic sphere); increased social inequality and psychological burden, especially among healthcare workers (social sphere); and accelerated digitalization and the adoption of telemedicine technologies (technological sphere). The PEST analysis helped structure these consequences into four key domains, revealing the unique nature of the impact on different professional communities, which is supported by the survey data.

Conclusion. The impact of the pandemic was extensive and multifaceted, affecting all key sectors of society. The obtained data can serve as a basis for developing effective policies and initiatives aimed at strengthening the resilience of the healthcare system and society as a whole to future challenges.

Encephalitis caused by Varicella zoster virus is one of the unpredictable diseases that complicate both the course of chickenpox (Varicella (chickenpox) encephalitis) and herpes zoster (zoster-encephalitis) that develops as a result of viral reactivation. In the pathogenesis of encephalitis, the significance of the brain vessels, myelin, astroglia and neurons. Biochemical markers of central nervous system damage are astroglia-specific S-100B protein and neuron-specific enolase (NSE).

The aim is to determine the value of NSE and S-100B protein levels in blood serum and cerebrospinal fluid in the diagnosis of the severity of brain damage and the prognosis of neurological outcomes in chickenpox encephalitis in children.

Materials and methods. Clinical and laboratory examination of 35 children aged from 5 months to 18 years who were hospitalized to the clinic of Federal Scientific and Clinical Center of Infectious Diseases with the diagnosis of chickenpox encephalitis. The study was conducted in groups of patients differing in the severity of the disease, specific features of residual neurological deficit after discharge from the hospital. The levels of S-100B protein and NSE in the blood serum and cerebrospinal fluid were determined by enzymelinked immunosorbent assay.

Results. A significant increase in the S-100B protein level in cerebrospinal fluid was found in extremely severe cases of the disease. The effectiveness of determining the level of NSE in cerebrospinal fluid for predicting the duration of neurological deficit was revealed. Comparison of neurospecific proteins level with MRI parameters allowed us to establish a reliable increase in the blood serum of NSE and S-100B protein in cerebrospinal fluid in children with more evident structural and functional changes according to MRI.

Conclusion. Identification of the levels of neurospecific proteins in the blood serum and cerebrospinal fluid in children with varicella encephalitis has diagnostic and prognostic significance, which allows to identify risk groups for unfavorable disease outcomes with long-term neurological deficit, and thus can serve as a basis for immediate therapy correction and early medical rehabilitation.

An increasing number of young adults with perinatal HIV infection (PHIV) are reaching adulthood and transitioning to adult care networks for continued treatment. Data on the disease course in adult PHIV patients tracked longitudinally from diagnosis is limited.

Objective. To perform a clinical and laboratory analysis of the course of HIV infection in young adults infected perinatally.

Materials and Methods. This retrospective-prospective study included 105 PHIV patients aged 18-25 years (50.4% male, 49.6% female) registered at the St. Petersburg AIDS Center. The study employed epidemiological (duration of infection, timing of diagnosis and ART initiation), clinical (assessment of HIV disease stage using CDC-1994 and Russian Federation-2006 classifications), and laboratory (analysis of CD4+ lymphocyte counts, HIV RNA levels, detection of antiretroviral drug (ARV) resistance over time) research methods. Statistical analysis was performed using STATISTICA 10, with statistical significance set at p < 0.05.

Results. The mean age at HIV diagnosis was 2.6±4.3 years. By age 6, 70% of children already had advanced disease stages (CDC-1994 stages B3 and C). The mean age at ART initiation was 7.2±4.5 years. An inverse correlation was found between delayed ART initiation and the severity of immunodeficiency (r = -0.42, p < 0.001). In the first ART regimen, 95.2% of children received protease inhibitors (PIs). The mean number of ART regimens per child during follow-up was 3.4±1.08 (min=2, max=7). At transition to adult care, 22% of patients had immunodeficiency of varying severity; this prevalence increased to 25.6% after 3 years of observation. Post-transition, 22% of patients were lost to follow-up (LTFU). The use of fixed-dose combinations (FDCs) significantly improved treatment adherence (p < 0.05). High adherence was associated with female gender (increased odds by 3.8 times, p < 0.01), while low adherence was associated with an HIV infection duration exceeding 20 years (risk of low adherence increased by 2.8 times, p < 0.05).

Conclusion. Perinatal HIV infection in this cohort resulted from: low coverage of preventive measures, high rates of substance use and HCV co-infection among the mothers, and low adherence to antenatal monitoring and treatment during pregnancy. The absence of clear, regulated timelines for early HIV testing in children led to late diagnosis. Treatment initiation criteria followed a watchful waiting approach, resulting in delayed ART initiation for a significant proportion of children, often amidst progressive immunodeficiency. Most children started ART late, against a background of advanced HIV stages and varying degrees of immunodeficiency. Threequarters of PHIV patients demonstrated good adherence to prescribed ART after transitioning to adult care, while onequarter were lost to follow-up.

Group A streptococcus (GAS) is the leading bacterial cause of acute tonsillopharyngitis, as well as infections in other locations, most commonly skin infections, phlegmon, and erysipelas. It is important to start early specific antibacterial therapy in a timely manner especially to prevent possible complications.

Rapid antigen tests have high sensitivity and specificity (95-97%), facilitate the rapid and accurate detection of GAS antigen in throat swabs.

Objective: validation of the rapid test “RAPID-Streptococcus-A-LF” for detecting GAS (Streptococcus pyogenes) antigen in throat swabs from patients with suspected Streptococcal tonsillopharyngitis using the RAPID-StreptococcusALF immunochromatographic assay and to determine its diagnostic characteristics (sensitivity, specificity, and crossreactivity with Streptococcus agalactiae).

Materials and Methods: sample type – throat swabs from patients with acute tonsillopharyngitis. 34 rapid antigen tests “RAPID-Streptococcus-A-LF” were tested on 28 samples with different colony-forming unit (CFU) counts of GAS and 6 comparison samples. The study was performed in two phases: the first phase involved sample selection according to the study plan and determination of CFU values in the samples, while the second phase included testing biological samples on the antigen tests and recording the results.

Results: the “RAPID-Streptococcus-A-LF” antigen test showed high diagnostic sensitivity (93-100%) and specificity (100%) similar to the leading imported tests on Russian market.

Conclusion: rapid testing, as an auxiliary method for detecting GAS, can significantly optimize the diagnostic algorithm for acute tonsillopharyngitis, ensuring timely etiotropic treatment of GAS infection and reducing the incidence of unnecessary antibiotic therapy.

Introduction. The legislative framework of the Russian Federation does not limit the range of tests used for detection of blood-borne infections. Screening blood donors for anti-HBc antibodies makes it possible to identify donors with potential HBV infection and prevent the transmission of the virus.

The purpose of the study: to assess the prevalence of total anti-HBc and anti-HBc IgM among donors to evaluate the effectiveness of testing for additional hepatitis B markers in the Republic of Tatarstan.

Materials and methods. The prevalence of HBsAg, total anti-HBc, and anti-HBc IgM among donors was analyzed based on screening results among 490,497 blood donors in 2006-2023.

The results of the study. In the early 1990s, the Republic of Tatarstan had a high incidence of hepatitis B, reaching 235.4 per 100,000 population, which is 6 times higher than the incidence of hepatitis C. At the same time, the subclinical forms of hepatitis B amounted to 81.3%, which determined the introduction of additional screening of blood donors for anti-HBc antobodies. In 1994-2005, HBsAg detection rate in donors was 0.67±0.01%, with a decrease in 2006–2023 to 0.32±0.01%. In 2006–2023, total anti-HBc antibodies were detected in 2.73±0.02% of donors, their share among hepatitis B markers identified in donors was the largest and amounted to 79%. Anti-HBc IgM antibodies were detected in 0.4%±0.01% of donors (11.6% among all hepatitis B markers). The proportion of donors with HBV markers increased 5.1 times in 2006–2023 due to testing for additional HBV markers.

Conclusion: Universal vaccination against HBV has reduced the incidence of hepatitis B, wich had a significant correlation with decrease in detection rates of HBV markers among donors (r=-0.8677, p<0.05). However, taking into account the presence of a large cohort of persons with subclinical or occult forms of HBV infection, the introduction of routine screening for HBc antibodies in the blood service of the Republic of Tatarstan is a reasonable decision aimed at preventing posttransfusion HBV infection.

The etiology of pneumonia remains a subject of close interest for researchers and practicing physicians. Many authors have noted a low rate of etiological identification for community-acquired pneumonia in the Russian Federation. Sample-based researches in these conditions are an important source of information.

The purpose. To analyze the etiological structure of community-acquired pneumonia among hospitalized patients.

Materials and Methods. The epidemiological retrospective descriptive observational research was conducted. We analyzed medical records (electronic health records) of patients (adults and children) hospitalized with pneumonia in the period from January 2024 and December 2024, inclusive at infectious diseases hospital in Moscow. The etiology of pneumonia was considered based on the patient’s final diagnosis. The sample size was 4,807. Inclusion criteria were: laboratory-confirmed diagnosis of community-acquired pneumonia, influenza with pneumonia, or COVID-19 with pneumonia; biological material was collected within the first 24 hours of hospitalization. Exclusion criteria included: patients with diagnoses “pneumonia without specifying the pathogen “; “pneumonia in diseases classified elsewhere”; patients with HIV infection, viral hepatitis B and/or C; and patients hospitalized at other medical organizations in the previous 14 days for a period of more than 48 hours.

Data were analyzed using descriptive statistics. Statistical processing was carried out in the IBM SPSS Statistics 20 program, visualization in Microsoft Excel.

Results. The most frequent etiologies of communityacquired pneumonia among hospitalized patients were: M. pneumoniae (28.7%; 95% CI 27.3–30.2), SARS-CoV-2 (21.1%; 95% CI 19.8–22.4), S. pneumoniae (11.8%; 95% CI 10.8–12.8), H. influenzae (10.7%; 95% CI 9.7–11.7), and rhinovirus (5.6%; 95% CI 4.9–6.3), with other pathogens occurring less frequently. Mixed etiology pneumonia accounted for 19.4% (95% CI 17.8–21.1) of cases.

The predominant pathogens varied by age group: S. pneumoniae, H. influenzae, and M. pneumoniae prevailed among children; M. pneumoniae was the leading cause in adults aged 18–34; S. pneumoniae, H. influenzae, and M. pneumoniae were most common in the 35–64 age group; SARS-CoV-2, S. pneumoniae, and H. influenzae predominated in the 65–84 group; and SARS-CoV-2, influenza viruses, S. pneumoniae, and H. influenzae were most prevalent in patients aged 85 and older.

A shift in the prevailing pathogen was observed throughout the year: from January to March, viral pneumonias had the highest proportion (caused by influenza in January, and SARS-CoV-2 and non-influenza respiratory viruses in February and March). Bacterial pathogens (S. pneumoniae, H. influenzae, etc.) predominated during the spring-summer period (April to July), while M. pneumoniae was most prevalent from August to November, followed by an increase in influenza-related pneumonia cases in December.

Conclusion. In conclusion, the most frequent pathogens of community-acquired pneumonia among hospitalized patients in 2024 were M. pneumoniae, SARS-CoV-2, S. pneumoniae, H. influenzae, and rhinovirus. The results demonstrate varying levels of pathogen significance across different age groups, seasonal shifts in the predominant agents throughout the year, and a substantial proportion of mixedetiology pneumonia cases.

Streptococcus pseudoporcinus – это бета-гемолитический стрептококк, который был впервые описан в 2006 г. Изначально S. pseudoporcinus рассматривался как колонизатор урогенитального тракта женщин. В дальнейшем S. pseudoporcinus был обнаружен и в других анатомических областях, включая раны, мочу, плаценту и даже молочные продукты. Изначально S. pseudoporcinus связывали с инфекциями мягких тканей, редко прогрессирующими до некротизирующего фасциита, и с осложнениями беременности (преждевременные роды, хориоамнионит и внутриутробная гибель плода). Начиная с 2017 г., появились данные, свидетельствующие о способности S. pseudoporcinus вызывать инвазивные и потенциально угрожающие жизни инфекции. В литературе наиболее часто описываются случаи возникновения S. pseudoporcinus инфекции у взрослых, только в единичных статьях есть данные о возникновении тяжелой инфекции у детей. В данной статье мы приводим клинический случай тяжелой инвазивной S. pseudoporcinus-инфекции у ранее здорового ребенка 2 лет. Особенностью данного случая является выделение из крови мультирезистентного штамма S. Pseudoporcinus.

In Russia and abroad there has been an upward trend in the proportion of elderly patients with newly diagnosed HIV infection in recent years. Moreover, the diagnosis of HIV in patients of the older age group is often made at the later stages. This situation increases the risks of developing severe opportunistic diseases, greatens the unfavorable prognosis and burdens the health care system. We have described a case of an unfavorable outcome of HIV infection in a 72-year-old female patient with the disease first detected at the 4В stage (Russian classification of HIV infection) and rapidly progressed despite treatment.

This article describes a clinical case of secondary otogenic meningoencephalitis complicated by the formation of multiple brain abscesses in an adolescent patient. The pathological process developed against the background of long-standing chronic suppurative otitis media with a torpid course. The key premorbid conditions were secondary immunodeficiency caused by extrahepatic portal hypertension, as well as the absence of vaccination against pneumococcal and other preventable infections. The disease course was characterized by the development of severe intracranial complications: thrombosis of the sigmoid sinus and internal jugular vein, epidural empyema, and multiple abscesses of cerebral structures. Treatment tactics included emergency surgical intervention (canal wall-down mastoidectomy), long-term staged empirical and subsequent targeted antimicrobial therapy using drugs with a high ability to penetrate the blood-brain barrier. A favorable outcome was achieved thanks to the coordinated actions of a multidisciplinary team (infectious disease specialists, otorhinolaryngologists, neurosurgeons, neurologists, immunologists). This clinical observation serves as a basis to discuss risk factors, difficulties of differential diagnosis, the need to improve microbiological diagnostic methods, and the critical importance of interdisciplinary collaboration in the management of patients with severe intracranial infectious complications.