Наукові праці. Кафедра інфекційних хвороб, дитячих інфекційних хвороб, фтизіатрії та пульмонології

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Пост-COVID-19 інтерстиційні захворювання легень як прояв постковідного синдрому
(2023) Ходош, Едуард Михайлович; Яковенко, Олег Костянтинович; Дзюблик, Ярослав Олександрович; Ханін, Олександр Григорович; Khodosh, Eduard; Yakovenko, Oleh; Dziybluk, Yaroslav; Khanin, Oleksandr
Мета дослідження – вивчити клінічні особливості пост-COVID-19 інтерстиційних захворювань легень (ІЗЛ) та визначити перспективи застосування протифібротичного препарату нінтеданібу у пацієнтів з середньотяжким та тяжким перебігом COVID-19. Матеріал та методи. Проведено проспективне когортне дослідження 266 пацієнтів (≥ 18 років) із середньотяжким та тяжким COVID19, які були госпіталізовані та виписані після лікування в стаціонарі КП «Волинська обласна клінічна лікарня» в період з вересня по листопад 2021 року. Дизайн дослідження передбачав телефонний контакт з пацієнтами через рік після виписки зі стаціонару, під час якого здійснювали збір скарг та анамнестичних даних по персистуючим пост-COVID-19 симптомам з метою виявлення та деталізації постковідного синдрому. Частина опитаних пацієнтів з персистуючою респіраторною симптоматикою була викликана на огляд та обстежена шляхом анкетування, оцінки об’єктивного статусу, лабораторних та функціональних методів дослідження. В дослідження увійшла група пацієнтів (n = 25) з пост-COVID-19 інтерстиційним захворюванням легень після перенесення тяжкої форми коронавірусної інфекції. У всіх випадках за допомогою комп›ютерної томографії була встановлена інтерстиційна пневмонія з радіологічним патерном хронічної організуючої пневмонії. Всі пацієнти з постковідним ІЗЛ в гострому та затяжному періодах COVID-19 отримували протягом 3–6 місяців глюкокортикостероїдну (ГКС) терапію метилпреднизолоном 16 мг/добу з поступовим зниженням дози до повної відміни. Крім того, частині пацієнтів (n = 9) з пост-COVID-19 ІЗЛ в затяжному періоді захворювання призначалася протягом 3-х місяців протифібротична терапія препаратом нінтеданібом по 300 мг/добу. Статистичний аналіз здійснювали у програмі SPSS Statistics 26 за допомогою біноміального тесту, асимптотичного T-тесту для ймовірностей успіху в двох незалежних схемах випробувань Бернуллі та непараметричних критеріїв Колмогорова-Смірнова, U Манна-Уітні та медіанного критерія. Результати та обговорення. У 9,4 % (n = 25) встановлено діагноз пост-COVID-19 ІЗЛ. У 76 % (n = 19) пост-COVID-19 ІЗЛ представлено як окрема респіраторна патологія у вигляді постковидного синдрому після перенесеного тяжкого COVID-19, 16 % (n = 4) — як дебют системного захворювання сполучної тканини (СЗСТ) внаслідок COVID-19 і у 8 % ( n = 2) пост-COVID-19 хронічні ІЗЛ (ХІЗЛ), які були вчасно діагностовані до появи пандемії COVID-19. При пост-COVID-19 ІЗЛ був встановлений радіологічний патерн фіброзоподібних змін у 64 % (n = 16) та у 36 % відзначено формування радіологічного патерну легеневого фіброзу (ЛФ), який у частині випадків був пов’язаний із СЗСТ (n = 4) або іншим хронічним ІЗЛ (n = 2). Виявлено, що респіраторна підтримка СІРАР значно не вплинула на наявність радіологічного патерну ЛФ (p = 0,774) та прогресування пост-COVID-19 ІЗЛ (p = 0,146). Не було виявлено значного зв’язку між наявністю радіологічного патерну ЛФ та статтю пацієнтів (p = 1,000 і p = 0,146, відповідно), а також не встановлено значної залежності між наявністю радіологічного патерну ЛФ та віком (p = 0,881 або р = 0,885). Незважаючи на виявлені в частині випадків аутоімунні маркери та встановлений діагноз СЗСТ, значної залежності радіологічного патерну ЛФ від аутоімунного процесу при постковидном синдромі у пацієнтів з пост-COVID-19 ІЗЛ не спостерігається (р = 0,146 та р = 1,000). Застосування нінтеданібу (n = 9) протягом 3-х місяців у затяжному періоді захворювання тяжкого COVID-19 не вплинуло на радіологічний патерн ЛФ (p = 1,000) та прогресування пост-COVID-19 ІЗЛ (p = 0,180), а також виявлено відсутність значних впливів цього препарату на зниження показника насичення крові киснем після тесту з 6 хв. ходьбою (p = 0,411 за медіанним критерієм та p = 0,329 за критерієм U Манна–Уітні) з відсутністю значного впливу на показник задишки після тесту з 6 хв. ходьбою (p = 0,451 або р = 0,422). На наш погляд, ПФТ при пост-COVID-19 ІЗЛ повинна носити лише персоніфікований підхід з використанням схеми ПФТ більше 3 місяців при наявності клінічно значущого радіологічного патерну ЛФ у пацієнтів з пост-COVID-19 ІЗЛ, але це питання потребує додаткового вивчення на основі проведення нових клінічних досліджень.
Туберкульоз в умовах війни. Чи загрожує новий спалах?
(2023-03-25) Рогожин, Антон Вікторович
Війна продукує додаткові фактори розповсюдження інфекційних захворювань і туберкульозу, зокрема. Великі переміщення біженців, скупченість у тісних приміщеннях, стреси, зниження рівня життя та бідність, обмежений доступ до медичної допомоги сприяють поширенню туберкульозу в Україні.
Conditions for the expansion of СOVID-19 in the regions of the Northern part of Ukraine Conditions for the expansion of СOVID-19 in Ukraine
(2023-09-07) Korzh, Alexei; Georgiyants, Marine; Podavalenko, Alla; Nessonova, Tetyana; Maslova, Valentyna; Bereznyakov, Vladislav; Asoyan, Irina
Background: The intensity of the COVID-19 epidemic process in the administrative territories of Ukraine differs. Risk factors for the spread of this infection have not been sufficiently studied, which prevents the development of adequate preventive and anti-epidemic measures at the local level. Objectives: Conduct an epidemiological analysis of the incidence of COVID-19 in the regions of the Northern part of Ukraine and identify the leading risk factors for spread. Material and Methods: The incidence of COVID-19 was analyzed for 73 weeks and 28 predictors. Fourier’s spectral analysis, Feature Selection and Variable Filtering method of the Data mining module, Irwin’s method, integral visual coefficient was used. Results. There were two rises in the incidence of COVID-19, the cyclicity was 18 - 24 weeks. The conditions for the spread of COVID-19 cases in the regions of the Northern part have been established, namely: the number of people and the elderly in the family, demographic and migration processes. Violation of regime-restrictive measures leads to abnormal rises in morbidity. Conclusions. The epidemic situation in the Northern part remains volatile, as there are conditions for the spread of COVID-19 that cannot be eliminated, as well as some, that need to be developed (tourism, demographic processes, financing, etc.). Therefore, compliance with restrictive measures and vaccination of the population of the region remain the main preventive measures.
Value of clinical blood analysis indicators of patients with COVID-19 infection
(SPC “Sci-conf.com.ua”, 2024) Andrusovych, Inna
Emerging in late 2019, the coronavirus disease (COVID-19) has quickly become global with extraordinary rates of morbidity and mortality. The World Health Organization defines COVID-19 as a severe acute respiratory syndrome caused by coronavirus type 2 (SARS-CoV-2). This is the third zoonotic coronavirus that has caused an epidemic in recent years. Bats can be considered the primary reservoir of infection, as the virus isolated from them has a high affinity to SARS-CoV-2. This type of coronavirus primarily affects the epithelium of the respiratory tract, entering the cells through interaction with the receptors of the angiotensin 2-converting enzyme.
Epidemiological characteristics and impact of sepsis on survival after osteoporotic pelvic fracture in Austria
(Nature Publishing Group, 2024) Sokhan, Anton; Haschka, Judith; Reichardt, Berthold; Zwerina, Jochen; Kocijan, Roland; Behanova, Martina
We performed a retrospective nationwide register-based cohort study which included all in-hospital patients aged≥ 50 with pelvic fracture (PF) between 2010 and 2018 inAustria. We identified patients who were hospitalized with sepsis within 180 days following a PF event.Aetiology of sepsis was divided by unspecified, gram positive, gram negative and other. Among 59,081 patients hospitalized with PF between 2010 and 2018 we identified 619 (1.05%) patients who were hospitalized with sepsis within 180 days following PF.The cumulative incidence risk of sepsis within 180 days after PF was significantly higher in males (1.4%, 95% CI 1.2%-1.5%) as compared to females (0.92%, 95% CI 0.83%-1.0%), p< 0.001. In the cohort of patients with sepsis, the one-year mortality was 50.4%. Mortality risk was greater for patients who developed sepsis, independently of age, sex and comorbidity status (HR 3.12, 95% CI 2.83–3.44, p< 0.001) as compared to patients without sepsis.With a very high one year mortality risk among those who develop sepsis, our study emphasizes the substantial impact of sepsis on long term survival in fractured patients.These findings underscore the critical need for sepsis prevention and early detection and management to mitigate its detrimental effects on patient outcomes.
Features of the course of toxoplasmic encephalitis in hiv-infected patients
(2024) Veliieva, Tunzala; Bodnia, Kateryna; Makarenko, Valentyna; Pavliy, V.; Krokhmal, I.
This article presents the results of a retrospective analysis of clinical characteristics and examination outcomes in 23 patients with toxoplasmic encephalitis (TE) among HIV-infected individuals. Among the examined individuals, 11 (47.8%) were men and 12 (52.2%) were women. The patients' ages ranged from 31 to 55 years, with an average age of 37.5 ± 0.38 years. The average CD4+ lymphocyte count was 102.5 ± 21.2 cells/μl, and the HIV RNA load in plasma was 292,773.8 ± 113,180 copies/mL. All patients were confirmed to have stage 4 HIV infection (according to the CDC classification, 1993). Toxoplasmosis infection was confirmed by blood serology (presence of anti-Toxoplasma IgG antibodies via ELISA), and toxoplasmic encephalitis was diagnosed through MRI with characteristic focal brain changes. According to our analysis toxoplasmic encephalitis in HIV-infected patients develops gradually, with cognitive and psychiatric disorders as primary manifestations, followed by focal neurological impairments (hemiparesis, seizures, speech problems). All HIV patients with detected Toxoplasma antibodies at the onset of the disease can be considered at risk for developing toxoplasmic encephalitis. TE in the brain manifests when CD4+ cell levels drop below 200 cells/μL and is characterized by polysymptomatic presentation, with an average of 5.67±0.37 symptoms in our patients. The data from our correlation analysis between altered blood parameters and the presence of symptoms in TE among HIV-infected patients showed that the greater the severity, activity, and duration of toxoplasmic infection (indicated by eosinophilia), the more diverse the symptoms. This, in turn, leads to an increase in ESR, the development of leukocytopenia, and hypochromic anemia.
Relation of the immunologic status of blastocystosis patients with the effectiveness of their therapy
(2024) Bodnia, Kateryna; Yurko, Kateryna; Bodnia, Igor
To study the presence of a relationship between the state of immunologic homeostasis and the effectiveness of blastocystosis therapy, the values of immunity indices were compared in 300 patients with blastocystosis in alternative groups: group A − with good therapeutic effect (n = 162) and group B − with satisfactory effect (n = 138). Group A included patients who had an overall clinical symptom regression rate of ≥33% after 1 month of treatment, and group B included patients who had an overall regression rate of ≤32%. When comparing the correlation structures of immunity indices in the groups, it was found that they differ significantly (by 90%) in their “portrait” properties (nature of correlation). In patients with a good therapeutic effect in comparison with the alternative group is characterized by a more pronounced antibodyalogenesis of all classes of antibodies (Ig M, Ig A, Ig G and IgE), which indicates their leading role in the formation of protective reactions in patients with blastocystosis. The established significant (90%) differences in the nature of relationships in the groups indicate that in patients depending on the effectiveness of their therapy, fundamentally different pathogenetic matrices of immune homeostasis are formed, which substantiates the possibility of using immune indicators as predictors.
Determination of the degree of inflammatory response in patients with COVID-19 infection by interleukin-6 levels
(MDPC Publishing, 2024) Andrusovych, Inna
An inflammatory reaction and subsequent severe organ damage play an undeniable role in the pathogenesis of disorders in patients with COVID-19 infection. Clinically, this is manifested by severe acute respiratory syndrome, which is characterized by diffuse damage to the alveoli at the level of hyaline membranes. The immune response in this case can manifest itself in the form of a cytokine storm: in the vast majority of patients, there is a significant increase in the levels of interleukin (IL)-6, IL-17A and tumor necrosis factor-α.
Коагулопатичні прояви інфекції COVID-19
(BoScience Publisher, 2024) Адрусович, Інна Володимирівна; Andrusovych, Inna
Інфекція COVID-19 є гострим комплексним системним захворюванням, яке в найбільш тяжкому своєму прояві призводить до таких ускладнень, як інтерстиціальна пневмонія, що прогресує до гострого респіраторного дистрес-синдрому, сепсису та значної поліорганної недостатності. Хоча на сьогодні вже й визначені основні патофізіологічні механізми розвитку коронавірусної інфекції COVID-19 та розроблені протоколи її лікування, точні механізми її розвитку та найбільш дієві методи боротьби з цією глобальною пандемією ще й досі повністю не доведені. Тому, визначення основних патофізіологічних механізмів розвитку найбільш тяжких ускладнень даної інфекції (таких, як гострий респіраторний дистрес-синдром) є досить актуальним питанням сучасної світової медицини.
Human-Beta-Defensin-1, Ferritin, Interleukin-6 and their Relationship with Clinical and Laboratory Parameters of the Severity of the Tuberculosis Process
(2024) Shevchenko, O.; Todoriko, L.; Shevchenko, R.; Matvyeyeva, S.; Tudor, Е.; Ovcharenko, I.; Shvets, O.; Pohorielova, O.
Establishing relationships between clinical and laboratory parameters, such as general patient’s state, parameters of complete blood count and blood biochemistry and markers of the course of tuberculosis in the future can be used to predict the severity of dysfunction of various organs and tissues in patients with tuberculosis and in particular in patients who receive anti-tuberculosis treatment. Objective - to investigate the relationship between biochemical markers, namely Human-beta-defensin-1, ferritin and interleukin-6, and clinical and laboratory indicators of the severity of the tuberculosis process. Materials and methods. 100 patients diagnosed with pulmonary tuberculosis were included in the study. After receiving 60 doses of anti-tuberculosis treatment, the patients were retrospectively divided into 2 groups. Group 1 (n = 77) consisted of patients in whom sputum conversion was observed after 60 doses of treatment, determined by sputum microscopy. Group 2 (n = 23) comprised patients in whom bacterial secretion was maintained after 60 doses of treatment, as detected by microscopy. In addition to the routine studies provided for the monitoring of patients with tuberculosis by the current orders of the Ministry of Health of Ukraine, the levels of Human-beta defensin-1, ferritin and interleukin-6 (IL-6) in the fasting blood were additionally measured by ELISA at the beginning of treatment and after 60 days. Statistical data processing was carried out using the Statistica 8.0 software environment. Results. A comparison of the investigated parameters between groups at the beginning of treatment showed significantly higher values of Human-beta-defensin-1 (Group 1 — (18.97 ± 2.42) pg/ml, Group 2 — (55.02 ± ± 15.69) pg/ml), ferritin (Group 1 — (94.86 ± 6.02) ng/ml, Group 2 — (141.61 ± 24.66) ng/ml) and IL-6 (Group 1 — (80.33 ± 5.03) pg/ml, Group 2 — (110.13 ± 10.35) pg/ml) in patients with positive sputum micros copy after 60 doses of treatment, p < 0.05. All studied markers demonstrated a reliable positive relationship with the massiveness of bacterial excretion, a conditional indicator of the severity of clinical symptoms and signs, ESR and urea level, as well as reliable negative correlations with creatinine level. In addition, patients with a lower body mass index were found to have higher levels of Human-beta-defensin-1 and ferritin. Higher levels of Human-beta defensin-1 and ferritin are associated with lower hemoglobin levels (Human-beta-defensin-1 was also negatively correlated with erythrocyte count). An increase in the leukocytes level is accompanied by a significant increase in the level of Human-beta-defensin-1 and IL-6. Additionally, a significant negative correlation was found between the level of glucose and ferritin, as well as between the level of bilirubin and ferritin and IL-6. Conclusions. The determined significantly higher levels of Human-beta-defensin-1, ferritin and interleukin-6 in patients in whom sputum microscopy was positive after 60 doses of treatment allow considering the investigated biochemical parameters as markers of the ineffectiveness of anti-tuberculosis therapy. The identified positive relationships with the severity of clinical symptoms indicate the possibility of using the studied parameters as markers of the severity of the tuberculosis course. The possibility of using Human-beta-defensin-1 and ferritin as markers of anemia was also found. Correlations with parameters of blood biochemistry allow us to talk about increased levels of Human-beta-defensin-1, ferritin and interleukin-6 against the background of kidney damage.
Clinical predictors of blastocystosis treatment efficacy
(2024) Bodnia, Kateryna; Bodnia, Igor; Maslova, Valentyna; Ogienko, Viktoria; Pavliy, Viktoria
Improvement of methods and criteria for diagnostics of human blastocystosis and selection of drugs for etiotropic therapy remain urgent scientific tasks of the present day. Clinical manifestations of blastocystosis in humans are diverse, and in this regard, their influential role on the effectiveness of blastocystosis therapy cannot be excluded.
Clinical and immunological features of rotavirus infection in children infected with herpesviruses
(Group of Companies Med Expert, LLC, 2024) Sliepchenko, M.; Olkhovska, O.; Kolesnyk, Ya.; Gavrylov, A.
The basis for conducting the study was the absence in the scientific literature of works devoted to the study of clinical and immunological features of rotavirus infection (RVI) in children against the background of the latent form of herpesvirus infection (lHVI) caused by cytomegalovirus (CMV) and human herpesvirus type 6 (HHV-6). The aim - to identify clinical and immunological features of RVI in children with lHVI caused by CMV and HHV-6 that will contribute to the early diagnosis of lHVI in patients. Materials and methods. A total of 81 children aged 12-36 months with RVI were examined. The Group 1 included 33 children who were not found to be infected with any of the herpesviruses. The Group 2 included 17 children who were suffering from RVI against the background of lHVI caused by CMV. The Group 3 included 31 children suffering from RVI against the background of lHVI caused by HHV-6 type. Statistical processing of the results was carried out using the IBM® SPSS® 25.0 program for Microsoft® Windows®. The results. The presence of lHVI caused by CMV in the acute period (AP) of RVI leads to lower indicators of temperature reaction, lower frequency of vomiting, a decrease in the immunoregulatory index (IRI) against the background of an increase in the level of CD8+ T-lymphocytes. In addition to lower numbers of the temperature reaction, the level of IgA was increased in children with lHVI caused by HHV-6. During the convalescent period (CP), CMV is associated with an increase in the duration of fever and diarrhea, an increased content of CD8+ T-cell counts, and lower IRI, CD16+, CD22+ T-cells, and IgM scores. In patients with lHVI caused by HHV-6, fever, diarrhea, and catarrhal syndrome persisted longer against the background of reduced levels of IRI, CD22+ T cells, and IgM. Conclusions. lHVI is caused by CMV and HHV-6, it has different effects on clinical and immune indicators in children with RVI.
Clinical and laboratory characteristics of patients with coronavirus infection covid-19 and its comorbidity
(Клінічна та профілактична медицина, 2024) Andrusovych, Inna; Yurko, Kateryna
The coronavirus disease has reached an alarming epidemic scale with extraordinary morbidity and mortality rates for the entire world population. The majority of patients with COVID-19 note damage to the respiratory tract and state a more severe course of the disease with the development of systemic damage. A more severe course of COVID-19 is associated with the presence of comorbid diseases.
Фактори постембріонального онтогенезу: зв’язок з ефективністю хіміопрофілактики туберкульозу в дітей
(2024) Бодня, Катерина Ігорівна; Зосімов, Анатолій Миколайович; Асоян, Ірина Миколаївна; Навєт, Тетяна Іванівна; Макаренко, Валентина Дмитрівна; Ходош, Едуард Михайлович; Кондратюк, Вадим Валентинович; Bodnia, Kateryna; Asoyan, Irina; Navet, Tatiana; Zosimov, Anatoly; Makarenko, Valentyna; Khodosh, Eduard; Kondratyuk, Vadym
Дитячий організм як функціональна система формується починаючи з внутрішньоутробного періоду. Тому аналіз навіть віддалених у часі ситуацій дозволяє виявити фактори, які впливають на функціонування дитячого організму в теперішньому часі. Теорія ембріонального походження вивчає критичний вплив внутрішньоутробного розвитку на соматичне й психічне здоров’я людини (Ward А., 2014; Романів О.П., Надь Б.Я., 2017). Встановлено, що формування імунологічної пам’яті під впливом вірусів ще в дитинстві є основою часткової резистентності протягом усього подальшого життя ( Gostic K.M. et al., 2019). Тому цілком імовірний вплив факторів постембріонального онтогенезу на ефективність хіміопрофілактики туберкульозу в дітей.
The Impact of External Migration on the Epidemiology of Tuberculosis in Eastern Europe
(2024) Todoriko, L.; Lesnik, E.; Shevchenko, O.; Slyvka, V.
The Role of Microbiological and Radiological Tests in the Diagnosis of Pulmonary Tuberculosis in the Conditions of the Pandemic COVID-19
(2024) Lesnic, E.; Todoriko, L.; Yeremenchuk, I.; Shevchenko, O.; Slyvka, V.
The impact of the methods for diagnosis of pulmonary tuberculosis is perceived in the fastness in setting up the actions aiming to isolate the source infection and to treat it in due time. Objective - to establish the role of microbiological and radiological tests in diagnosis of pulmonary tuberculosis in actual epidemiological context of tuberculosis associated to the COVID-19 pandemics (2020—2022). Materials and methods. It was conducted a case-control study which included 172 patients diagnosed with pulmonary tuberculosis, as new case, distributed in two groups, the 1st group - 116 patients diagnosed through the radiological methods and the 2nd group — 56 patients, diagnosed through microbiological methods. Results and discussion. The main peculiarities of patients diagnosed with tuberculosis regardless of methods of investigation were male gender, low social and economic state and high prevalence of the harmful habits with impact on the health state. Patients diagnosed through the microbiological methods were residing more frequently in rural areas, with low accessibility to healthcare services, identified through a long-evolving symptomatology, late detection, expressiveness of the clinical symptomatology and a high rate of poor treatment outcome. Recommendations were established that systematic screening for tuberculosis should be performed in all social-vulnerable groups, fortified by the individualised therapeutic approach. Conclusions. The case-control study identified that the main peculiarities of patients diagnosed with tuberculosis regardless of methods of investigation were male gender, low social and economic state and high prevalence of harmful habits such as smoking and alcohol consumption. Patients diagnosed through the microbiological methods were residing more frequently in rural areas, with low accessibility to healthcare services, concluded through a long-lasting symptomatology, late detected forms of tuberculosis, high expressiveness of the clinical symptomatology and severe evolution, followed by a high rate of poor treatment outcomes, including death. Patients diagnosed through the radiological methods were more frequently from urban sectors, from tuberculosis clusters, with comorbidities with high risk for tuberculosis sickness, such as HIV infection, diabetes and mental disorders which constituted included in active screening programs. The lack of positive microbiological assay results was the consequence of the unilateral and limited forms of pulmonary and determined a higher rate of treatment success rate.
Predicting the risk of death in patients with covid-19 infection
(2024) Andrusovych, Inna
The article presents the associations of clinical, laboratory, and clinical and instrumental features of patients with COVID-19 with increased risks of death and survival. The final model for predicting the risks of developing a lethal outcome in COVID-19 was determined, which has high classification qualities (optimal threshold value of the calculated model is equal to -1.6149; sensitivity – 97.1%; and specificity – 82.6%. The purpose of our study was to determine the risks of developing fatal outcomes in patients with COVID-19 based on their clinical, laboratory and instrumental features. The study was performed at the Department of Infectious and Pediatric Infectious Diseases, Parasitology, Phthisiology and Pulmonology of the Kharkiv National Medical University in accordance with the current bioethical norms and rules. All patients signed informed consent. 179 patients with COVID-19 aged 20–88 years (average age was [58.75±13.82] years) were observed. Medical and statistical calculations were performed using the IBM SPSS 25.0 software package. The associations of indicators with the binomial dependent variable were calculated using multiple logistic regression analysis with the calcula-tion of β coefficients. The significance of differences was determined using the Mann-Whitney U-test with a threshold of statistical significance p=0.05. Based on the results, the final prog-nostic model of the risk of developing a lethal outcome of COVID-19 indicates an increased risk of death in COVID-19 with increasing age (by 13.9%), leukocyte count (by 14.4%), D-dimers (by 0.001%) on day 5–7. According to the model, an increase in the probability of sur-vival in COVID-19 was significantly proved with an increase in hemoglobin (by 6.1%) at the day of hospitalization, monocyte count (by 17.1%) on day 5–7 and the use of ceftriaxone (by 87.8%).
Зв’язок факторів постембріонального онтогенезу з ефективністю хіміопрофілактики туберкульозу у дітей
(ГО «Всеукраїнська асоціація інфекціоністів», 2024) Бодня, Катерина Ігорівна; Зосімов, Анатолій Миколайович; Асоян, Ірина Миколаївна; Навєт, Тетяна Іванівна; Кондратюк, Вадим Валентинович; Bodnia, Kateryna; Zosimov, Anatoly; Asoyan, Irina; Navet, Tatiana; Kondratyuk, Vadim
Дитячий організм як функціональна система формується, починаючи з внутрішньоутробного періоду. Тому аналіз навіть віддалених у часі ситуацій дозволяє виявити фактори, які впливають на функціонування дитячого організму у теперішньому часі і, можливо, на ефективність хіміопрофілактики туберкульозу у дітей.
Оцінка рівня матриксної металопротеїнази-9 і тканинного інгібітора матриксних металопротеїназ-1 у хворих на туберкульоз із множинною лікарською стійкістю із різним ВІЛ-статусом на тлі лікування
(2024) Овчаренко, І.А.; Шевченко, О.С.; Овчаренко, С.С.; Погорєлова, О.О.
Effect of adequacy of empirical antibiotic therapy for hospital-acquired bloodstream infections on intensive care unit patient prognosis: a causal inference approach using data from the Eurobact2 study
(Elsevier B.V., 2024) Loiodice, Ambre; Bailly, Sebastien; Ruckly, Stephane; Buetti, Niccolo; Barbier, François; Staiquly, Quentin; Tabah, Alexis; Timsit, Jean-François; Sokhan, A.; Burma, Ya.
Objectives: Hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU) are common life-threatening events. We aimed to investigate the association between early adequate antibiotic therapy and 28-day mortality in ICU patients who survived at least 1 day after the onset of HA-BSI. Methods: We used individual data from a prospective, observational, multicentre, and intercontinental cohort study (Eurobact2). We included patients who were followed for - 1 day and for whom time-to appropriate treatment was available. We used an adjusted frailty Cox proportional-hazard model to assess the effect of time-to-treatment-adequacy on 28-day mortality. Infection- and patient-related variables identified as confounders by the Directed Acyclic Graph were used for adjustment. Adequate therapy within 24 hours was used for the primary analysis. Secondary analyses were performed for adequate therapy within 48 and 72 hours and for identified patient subgroups. Results: Among the 2418 patients included in 330 centres worldwide, 28-day mortality was 32.8% (n ¼ 402/1226) in patients who were adequately treated within 24 hours after HA-BSI onset and 40% (n ¼ 477/1192) in inadequately treated patients (p < 0.01). Adequacy within 24 hours was more common in young, immunosuppressed patients, and with HA-BSI due to Gram-negative pathogens. Antimicrobial adequacy was significantly associated with 28-day survival (adjusted Hazard Ratio (aHR), 0.83; 95% CI, 0.72e0.96; p 0.01). The estimated population attributable fraction of 28-day mortality of inadequate therapy was 9.15% (95% CI, 1.9e16.2%). Discussion: In patients with HA-BSI admitted to the ICU, the population attributable fraction of 28-day mortality of inadequate therapy within 24 hours was 9.15%. This estimate should be used when