RESUMEN
The aim of the study was a comparative analysis of diagnostic value of different laboratoty methods conducted on the basis of results of examination of patients during Legionnaires' disease outbreak in town Verkhnyaya Pyshma. Retrospective analysis of laboratory data from 74 patients with diagnosis of Legionnaires' disease was performed. Complex of laboratory methods was used (polymerase chain reaction (PCR), enzyme immunoassay (EIA), immunochromatography). In group of patients with Legionnaires' disease, the highest proportion of positive results (73%) was obtained by the EIA determining total specific antibodies in urine. Determination of antigen in urine by immunochromatographic express-test yielded 52% of positive results. PCR testing of blood specimens yielded positive results in 65% of samples but was low specific, due to that in 19% of patients from control group false-positive results were obtained. Testing of 3 autopsy samples showed that all specimens contained DNA of the causative agent. Performed analysis allowed to recommend complex use of immunochromatographic express-test of antigen detection and identification of total specific antibodies by EIA during mass people examination.
Asunto(s)
Cromatografía de Afinidad , Técnicas para Inmunoenzimas , Legionella , Legionelosis/diagnóstico , Reacción en Cadena de la Polimerasa , Anticuerpos Antibacterianos/sangre , Anticuerpos Antibacterianos/orina , Antígenos Bacterianos/orina , ADN Bacteriano/análisis , ADN Bacteriano/genética , Reacciones Falso Positivas , Humanos , Legionella/genética , Legionella/inmunología , Legionelosis/sangre , Legionelosis/orina , Estudios Retrospectivos , Federación de Rusia , Sensibilidad y EspecificidadRESUMEN
Issues of reliability, uniformity, and timeliness of reporting and sharing of information during outbreaks of infectious diseases are basic for establishment of tactics and strategy of organizational, antiepidemic, and clinical measures. Analysis of experience in sharing of information between medical care organization service and services ensuring sanitary-epidemiological welfare of population during outbreak of Legionnaires' disease in town Verkhnyaya Pyshma in July-August 2007 was performed in the article.
Asunto(s)
Personal Administrativo , Enfermedades Transmisibles Emergentes/prevención & control , Infecciones Comunitarias Adquiridas/prevención & control , Brotes de Enfermedades , Servicios de Información/organización & administración , Enfermedad de los Legionarios/prevención & control , Gobierno Local , Comportamiento del Consumidor , Conducta Cooperativa , Hospitales Urbanos , Humanos , Federación de Rusia/epidemiologíaRESUMEN
Data on organization of medical care during outbreak of Legionnaires' disease in July-August, 2007 in town Verkhnyaya Pyshma in Sverdlovsk region are presented. Special feature of this outbreak was spreading of infection in boundaries of the town with total population of 70,600 people. Results of organizational work of health authorities in order to provide timely and adequate medical care for patients with Legionnaires' disease on both outpatient and inpatient levels of care, conduction of preventive measures in foci of infection, coordination of interaction between different medical organizations and services are summarized in the article.
Asunto(s)
Infecciones Comunitarias Adquiridas/epidemiología , Brotes de Enfermedades , Hospitales Urbanos/organización & administración , Enfermedad de los Legionarios/epidemiología , Adulto , Niño , Preescolar , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/microbiología , Notificación de Enfermedades , Desinfección , Humanos , Legionella pneumophila/clasificación , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/diagnóstico , Cuarentena , Federación de Rusia/epidemiologíaRESUMEN
The method of blood stabilization using sodium citrate ("Glugicir") has been elaborated. The experimental hemosorptions (HS) have shown that reliable blood stabilization in extracorporeal sorption contour was achieved with Glugicir/blood ratio 1 to 10, no considerable changes in the basic clearance characteristics of the sorbents have been observed. The method elaborated was used in 135 HS sessions performed in 100 patients. It has been shown that sodium citrate causes no changes in the patients' hemostasis. The method of regional blood stabilization with sodium citrate may be recommended for HS in patients with bleeding or high risk of its development. Mild symptoms of citrate intoxication (3.7%) were associated with technical inaccuracy and were easily eliminated either by discontinuation of excessive Glugicir introduction into the contour or by intravenous injection of calcium salts.
Asunto(s)
Sangre/efectos de los fármacos , Citratos/farmacología , Hemoperfusión/métodos , Intoxicación/terapia , Ácido Cítrico , HumanosRESUMEN
A method for the diagnosis of blood hypercoagulation is suggested, based on recalcification principle in conditions of low contact activation of the coagulation system. A specific feature of the method is employment of lesser amounts of ionized calcium than is necessary for balanced recalcification of citrate blood, promoting recovery of the initial concentration of ionized calcium. Use of this method in examinations of 232 patients has demonstrated its higher diagnostic potential in the detection of blood hypercoagulation as against balanced recalcification technique.