Epidemiology and Infectious Diseases

BACKGROUND: Identification of Helicobacter pylori pathogenicity factors is crucial for improving diagnosis and understanding the pathogenesis of associated diseases.

AIM: The study aimed to establish the detection rates of markers associated with major H. pylori pathogenic factors in patients with chronic gastritis and peptic ulcer.

METHODS: The study included 67 patients with chronic gastritis and 57 patients with peptic ulcer. All participants underwent a fibroesophagogastroduodenoscopy with a rapid urease test (AMA LLC, Russia), followed by a histological examination for H. pylori. The following were also tested: stool filtrates for H. pylori antigen using an immunochromatographic assay (H. pylori test, Novamed Ltd., Israel); serum for anti-CagA antibodies via enzyme-linked immunosorbent assay (Anti-Helicobacter pylori CagA ELISA, ECOlab JSC, Russia); and fecal and salivary samples for O antigen (LPS), VacA, and CagA antigens using a coagglutination test (Gamaleya National Research Center for Epidemiology and Microbiology, Russia).

RESULTS: Positive rapid urease test results were obtained in 61.9% of patients. Serum CagA antibodies were detected in 51% of patients, and H. pylori antigen was detected in the feces of 27.9% of patients (p ≥ 0.05). The coagglutination test demonstrated the highest diagnostic performance: O antigen, VacA, and CagA antigens were detected in the fecal and/or salivary samples of 83.1% of patients at a diagnostic titer threshold of ≥1:8, which was significantly higher than that achieved by other tests. The rate of CagA antibody detection in serum was twice as high with a positive rapid urease test result. Esophagogastroduodenoscopy and rapid urease testing revealed H. pylori in 40.3% (27) of patients with chronic gastritis and in 56.1% (31) of patients with peptic ulcers. The coagglutination test detected VacA and/or CagA antigens in 90.6% of stool filtrate samples and 88.5% of salivary samples. Both antigens simultaneously were detected in 67.5% and 65.1% of the fecal and salivary samples, respectively. The rate of simultaneous detection of VacA and CagA antigens in feces was significantly higher in patients with peptic ulcers and positive rapid urease test results compared with other subgroups. There was no significant difference in the rate of simultaneous detection of these antigens in saliva across patient subgroups.

CONCLUSION: The primary advantage of the coagglutination test is the non-invasive, simultaneous detection of three key, synergistic H. pylori pathogenicicty factors in feces and/or saliva: O antigen (a marker of replication), VacA antigen (vacuolating cytotoxin), and CagA antigen (a pathogenicity island marker and Class I bacterial co-oncogene) The study confirmed that saliva can be used to detect H. pylori in children and older patients, when invasive testing is not an option.

BACKGROUND: The polymorphism of chronic opisthorchiasis is associated with cardiovascular symptoms and lipid disorders. Therefore, highly sensitive markers of cardiovascular events are required. This work is the first to evaluate the role of extracellular vesicles in this invasion.

AIM: This study aimed to evaluate the blood levels of extracellular vesicles and their potential association with symptoms of cardiovascular disorders and lipid profile in patients with chronic opisthorchiasis.

METHODS: The study group included 63 patients with chronic opisthorchiasis aged 18 to 55 years. The control group included 31 healthy volunteers. Using flow cytometry, we quantified microvesicles derived from platelets (CD41⁺CD31⁺), endothelial cells (CD41^–CD31⁺), and leukocytes (CD45⁺), and vesicles expressing the inflammatory marker CD54 (ICAM-1).

RESULTS: The study group demonstrated an increase in the following extracellular vesicle counts: CD41⁺ (p = 0.035), CD31⁺ (p = 0.033), CD54⁺ (p = 0.033), and CD45⁺ (panleukocyte-derived, p = 0.0411). The counts of platelet-derived and endothelial-derived vesicles (p = 0.033 and p = 0.026), respectively) and CD54⁺-positive leukocyte-derived vesicles (p = 0.017) were increased. The results showed an increase in CD9⁺-positive endothelial-derived vesicles: 46.2% in the study group and 23.3% in the control group. Differences in levels of extracellular vesicles in all study fractions (CD41⁺, CD31⁺, CD54⁺, CD45⁺, CD41⁺CD31⁺, CD41^–CD31⁺, CD45⁺CD54⁺, CD9⁺CD41⁺CD31⁺, CD9⁺CD41^–CD31⁺, СD9⁺CD45⁺) were predictive for patients with hypersympathicotonia. A positive correlation was found between heart rate and the inflammatory markers CD54⁺ (r = 0.435, p < 0.05) and CD45⁺CD54⁺ (r = 0.403, p < 0.05), and between the atherogenicity index and endothelial-derived extracellular vesicles (CD31⁺, CD41^–CD31⁺, r = 0.613, p = 0.047).

CONCLUSION: Microvesicles serve as potential highly sensitive markers of inflammation and endothelial dysfunction in chronic opisthorchiasis. The correlation revealed between the counts of inflammatory and endothelial-derived extracellular vesicles, heart rate, and the atherogenicity index indicates an association between these levels and cardiovascular markers. Therefore, vesicle levels can serve as a new marker of cardiovascular risk, comparable to routine clinical tests.

Antimicrobial resistance in opportunistic microorganisms is a significant challenge to global public health. Despite extensive research, data on the prevalence of resistant opportunistic pathogens in postpartum women is limited and highly heterogeneous.

This article summarizes current data on the prevalence of antimicrobial-resistant opportunistic pathogens colonizing the birth canal in postpartum women and analyzes the factors determining their detection likelihood. The study reviewed 45 papers published between 2000 and 2025. The following keywords were used to search the PubMed and Google Scholar search engines and in the electronic scientific libraries eLibrary.ru and the National Center for Biotechnology Information (NCBI): условно-патогенные микроорганизмы (opportunistic infections), резистентность к антимикробным препаратам (drug resistance, microbial), родильницы (postpartum period), колонизация родовых путей (birth canal colonization), генетические детерминанты резистентности (genetic determinants of resistance). A total of 7179 articles were selected.

A review of publications showed that the most prevalent resistant opportunistic microorganisms detected in postpartum women were Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Enterococcus spp. Studies reported critical levels of resistance to beta-lactams, including third-generation cephalosporins and carbapenems, with substantial differences in resistance levels across regions. Key risk factors for birth canal colonization with antimicrobial-resistant opportunistic pathogens in postpartum women included invasive obstetric interventions, inappropriate antibiotic therapy, and prolonged hospitalization. Such colonization can lead to clinically significant consequences, including a higher risk of postpartum infectious complications, increased maternal mortality rates, and vertical transmission of antimicrobial-resistant pathogens to neonates.

The review suggests the need for a strategy to control colonization of the birth canal by antimicrobial-resistant opportunistic microorganisms in postpartum women. This strategy should include optimizing screening, antibacterial prophylaxis and treatment, and genomic surveillance for postpartum purulent-septic infections.

Echinococcosis is a human parasitic disease widespread in many countries because of population migration, occupational risk factors, and increased tourism. The clinical symptoms are non-specific and manifest late. Echinococcosis is often discovered incidentally in clinical practice. Diagnostic errors can result from low awareness of healthcare professionals regarding echinococcosis in regions with low incidence rates.

This article describes a case report of imported echinococcosis in a patient with chickenpox (varicella) diagnosed at Infectious Diseases Clinical Hospital No. 2 of the Moscow Healthcare Department in April 2021. The patient came from Kyrgyzstan, where he worked as a sheep farmer. Inpatient ultrasound and computed tomography of the abdomen and retroperitoneum revealed multiple cystic liver lesions of parasitic origin. An enzyme-linked immunosorbent assay revealed the IgG antibodies to Echinococcus antigens.

This clinical case highlights the ongoing relevance of echinococcosis in Russia and underscores the need for a comprehensive analysis of clinical, epidemiological, laboratory, and imaging data. These findings also suggest the importance of raising awareness among healthcare professionals about this infection, especially when treating migrants from endemic regions with cystic liver lesions and patients in high-risk groups.