Treatment of complicated skin and soft-tissue infections caused by resistant bacteria: value of linezolid, tigecycline, daptomycin and vancomycin

Antibiotic-resistant organisms causing both hospital-and community-acquired complicated skin and soft-tissue infections (cSSTI) are increasingly reported. A substantial medical and economical burden associated with MRSA colonisation or infection has been documented. The number of currently available appropriate antimicrobial agents is limited. Good quality randomised, controlled clinical trial data on antibiotic efficacy and safety is available for cSSTI caused by MRSA. Linezolid, tigecycline, daptomycin and vancomycin showed efficacy and safety in MRSA-caused cSSTI. None of these drugs showed significant superiority in terms of clinical cure and eradication rates. To date, linezolid offers by far the greatest number of patients included in controlled trials with a strong tendency of superiority over vancomycin in terms of eradication and clinical success

Sanitary and Epidemiologic Wellbeing and Health of School Children in Modern Conditions

Introduction: Inadequate physical activity, eating disorders, irrational factors of the educational environment and a poor motivation for a healthy lifestyle are often observed among youngsters and act as their health risk factors. At the present stage, they hamper ensuring optimal living conditions and achieving better health of schoolchildren and require a new approach to solving the tasks. The objective of the study was to assess provision of sanitary and epidemiologic wellbeing at schools and health of schoolchildren to substantiate priorities for management decision making. Materials and methods: The study was conducted in two comprehensive schools of the city of Penza and involved 2,672 children and 720 parents. We used sanitary, hygienic, physiological, sociological, and statistical methods of research. Results: The level of sanitary and epidemiologic wellbeing in the experimental school with an up-to-date model of hygienic education and development of a healthy lifestyle integrated in the educational process where students have the opportunity to receive health-improving and rehabilitation medical care, was significantly higher than in the control one. Introduction of the new model of upbringing and functioning of the department for disease prevention and rehabilitation contributed to an increase in students’ motivation for a healthy lifestyle and skill consolidation in the behavior of youngsters as confirmed by a larger proportion of such students in the experimental school compared with the control one (75–89% against 50–74%, respectively; p &lt; 0.001). Conclusion: Implementation of management decisions including the upgrade of the system of hygiene education, creation of a healthy lifestyle of students, and organization of the department for disease prevention and rehabilitation on the basis of the educational establishment had a positive effect on students’ health.</jats:p

Provision of Safe Drinking Water to the Local Population within the Clean Water Project Implemented in the Penza Region

Introduction: Drinking water from centralized drinking water supply systems is not always safe due to its natural pollution with various chemicals and microbiological contamination occurring in the distribution system. In this regard, the role of the service exercising governmental water quality surveillance is growing. The purpose of the study was to assess the quality of drinking water and the associated health risk and to substantiate priority measures aimed at improving the quality of water in the centralized water supply systems of the region. Materials and methods: We examined the results of drinking water quality testing performed within the implementation of sanitary and epidemiological surveillance and socio-hygienic monitoring and incidence rates in morbidity of population in 27 districts of the Penza Region and the regional center for the years 2014–2019. Health risks from oral exposures to waterborne chemicals were assessed in accordance with Guidelines R 2.1.10.1920–04. The statistical relationship was studied by the correlation method. Results: We established that water quality in the centralized water supply systems fed by underground sources is determined by the chemical composition of the exploited aquifers that divide the territory of the Penza Region into four zones. The worst water quality was observed in the fourth zone where concentrations of natural iron, fluorides and boron in tap water were many times higher than their maximum permissible levels and the hazard quotient for fluorides exceeded the limit value (HQ = 2.845 for children and 1.219 for adults). In the third zone, iron posed the highest risks of diseases of mucosa and skin (HI = 0.296), the immune system (HI = 0.311), and hematopoietic system (H = 0.473) in children; we also established a strong correlation between the average annual concentration of iron in tap water and the incidence of genitourinary disorders, gastritis and duodenitis in the child population. Although the share of the population supplied with safe drinking water from centralized water supply systems increased from 86.5 % in 2014 to 89.4 % in 2019, the target set within the Regional Clean Water Project for 2019 was not achieved. Conclusion: The study results were taken into account when making additions to the Regional Clean Water Project in 2020 envisaging construction of iron removal plants and water well drilling in areas with low fluorine levels.</jats:p