STREPTOCOCCAL (GROUP A) INFECTION IN RUSSIA: STATE OF THE PROBLEM AND DEVELOPMENT TRENDS

Aim. To assess the current situation on streptococcal (group A) infection in Russia, to study the molecular properties and antimicrobial susceptibility of group A streptococcus isolated from patients with soft tissue infection.Materials and methods. We performed a descriptive epidemiological study using official statistics. A total of 97 cases of soft tissue infection caused by group A streptococci were investigated for emm-types, the presence of genes of bacteriophage toxins and integrases by PCR and sequencing. We tested 91 strains for antimicrobial susceptibility by the micro dilution methods.Results. From 2009 through 2017, 2.8 million cases (563 thousand primary cases) of group A streptococcal disease were reported. There was a decrease in the incidence of scarlet fever in Russia (31.5 per 100 000 population). In 2009–2017 the incidence of rheumatic fever and rheumatic heart diseases increase slightly but the prevalence of this forms group A streptococcal disease are decrease. Annually 2600 people die from the rheumatic fever and rheumatic heart diseases. Of the 97 cultures of group A streptococci, 33 were associated with invasive infection. We identified 33 different emm-type. All cultures contained speB gene. Some strains contained speA, and others speC genes. We did not find any correlation between the presence of bacteriophage toxin genes and the invasive properties of streptococci. Tetracycline and macrolides are ineffective in patients with of soft tissue infectionConclusion. Streptococcal (group A) infection continues to be of significant social and economic importance for Russia. The streptococcus cultures isolated from patients with invasive forms were heterogeneous in molecular and biological properties and remained sensitive to penicillin antibiotics.