urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.23.5.77PZNXRFurmj-1608Research ArticleОригинальные статьи | Original articlesOriginal articlesМладенческая смертность вне стационара, ассоциированная с герпесвирусамиOut-of-Hospital Infant Mortality Associated with Herpesviruseshttps://orcid.org/0000-0001-5823-5257ЧалапаВ. И.ChalapaV. I.

Владислав Игоревич Чалапа — научный сотрудник лаборатории энтеральных вирусных инфекций

Екатеринбург

Vladislav I. Chalapa - Researcher of the Laboratory of Enteric Viral Diseases

Ekaterinburg

chalapa_vi@niivirom.ruhttps://orcid.org/0000-0003-0858-9529СабитовА. У.SabitovA. U.

Алебай Усманович Сабитов — доктор медицинских наук, профессор, заведующий кафедрой инфекционных болезней, фтизиатрии и пульмонологии

Екатеринбург

Alebai U. Sabitov - Doctor of Sciences (Medicine), Professor, Head of the Department of Infectious Diseases, Phthisiology and Pulmonology

Ekaterinburg

kafdrdi@gmail.comhttps://orcid.org/0000-0002-5784-8673СергеевА. Г.SergeevA. G.

Александр Григорьевич Сергеев — доктор медицинских наук, профессор, главный научный сотрудник отдела индикации и диагностики вирусных инфекций; профессор кафедры медицинской микробиологии и клинической лабораторной диагностики

Екатеринбург

Alexandr G. Sergeev - Doctor of Sciences (Medicine), Professor, Principal Investigator of the Diagnostics Department of Viral Infections; Professor of the Department of Medical Microbiology and Clinical Laboratory Diagnostics

Ekaterinburg

aldr131250@yandex.ruhttps://orcid.org/0000-0002-2113-6543ИтаниТ. М.ItaniT. M.

Тарек Мохамедович Итани — кандидат биологических наук, ведущий научный сотрудник, заведующий лабораторией энтеральных вирусных инфекций

Екатеринбург

Tarek M. Itani - Candidate of Sciences (Biology), Leading Researcher, Head of the Laboratory of Enteric Viral Diseases

Ekaterinburg

itani_tm@niivirom.ruhttps://orcid.org/0009-0007-2894-0896КунгурцеваМ. С.KungurtsevaM. S.

Мария Сергеевна Кунгурцева — стажер-исследователь лаборатории энтеральных вирусных инфекций

Екатеринбург

Maria S. Kungurtseva - Intern Researcher of the Laboratory of Enteric Viral Diseases

Ekaterinburg

kungurceva_ms@niivirom.ruhttps://orcid.org/0009-0002-3118-1054ШароваА. А.SharovaA. A.

Анна Алексеевна Шарова — кандидат медицинских наук, доцент кафедры инфекционных болезней, фтизиатрии и пульмонологии

Екатеринбург

Anna A. Sharova - Candidate of Sciences (Medicine), Associate Professor of the Department of Infectious Diseases, Phthisiology and Pulmonology

Ekaterinburg

kafdrdi@gmail.comhttps://orcid.org/0000-0003-3967-0442СлаутинВ. Н.SlautinV. N.

Василий Николаевич Слаутин — младший научный сотрудник лаборатории энтеральных вирусных инфекций; аспирант кафедры патологической физиологии

Екатеринбург

Vasilii N. Slautin - Junior Researcher of the Laboratory of Enteral Viral Infections; Postgraduate Student of the Department of Pathological Physiology

Ekaterinburg

slautin_vn@niivirom.ruhttps://orcid.org/0009-0009-5284-222XКорейшаМ. Н.KoreishaM. N.

Мария Николаевна Корейша — заместитель начальника по организационно-методической работе

Екатеринбург

Maria N. Koreisha - Deputy Head for Organizational and Methodological Work

Ekaterinburg

mnkor11@gmail.comГришанинД. П.GrishaninD. P.

Дмитрий Павлович Гришанин — заведующий отделом судебно-медицинской экспертизы трупов

Екатеринбург

Dmitriy P. Grishanin - Head of the Department of Forensic Medical Examination of Corpses

Ekaterinburg

smet@uralsudmed.ruФедеральный научно‑исследовательской институт вирусных инфекций «Виром»РоссияFederal Research Institute of Viral Infections “Virome”Russian FederationУральский государственный медицинский университетРоссияUral State Medical UniversityRussian FederationФедеральный научно‑исследовательской институт вирусных инфекций «Виром»; Уральский государственный медицинский университетРоссияFederal Research Institute of Viral Infections “Virome”; Ural State Medical UniversityRussian FederationБюро судебно‑медицинской экспертизыРоссияBureau of Forensic Medical ExaminationRussian Federation20241710202423577–88Copyright © Чалапа В.И., Сабитов А.У., Сергеев А.Г., Итани Т.М., Кунгурцева М.С., Шарова А.А., Слаутин В.Н., Корейша М.Н., Гришанин Д.П., 20242024Чалапа В.И., Сабитов А.У., Сергеев А.Г., Итани Т.М., Кунгурцева М.С., Шарова А.А., Слаутин В.Н., Корейша М.Н., Гришанин Д.П.Chalapa V.I., Sabitov A.U., Sergeev A.G., Itani T.M., Kungurtseva M.S., Sharova A.A., Slautin V.N., Koreisha M.N., Grishanin D.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1608

Актуальность. Младенческая смертность является общепризнанным показателем социального благополучия населения. Доля детей, умерших вне стационара, к общему числу умерших детей до 1 года в России составляет 19,6 %. Очевидной является необходимость проведения углубленного анализа причин и факторов, приводящих к смерти младенцев на дому, в т. ч. определение этиологии инфекционных заболеваний, ставших основной причиной смерти.Цель исследования — определить долю вирусов группы герпеса в структуре смерти младенцев, умерших вне стационара.Материалы и методы. Проведено исследование образцов аутопсийного материала (кровь, тонкая кишка, сердце, легкие, печень, головной мозг) у 23 младенцев, умерших на дому, на наличие ДНК и РНК вирусов из различных семейств, включая герпесвирусы, ортомиксовирусы, парамиксовирусы, пикорнавирусы, аденовирусы, коронавирусы, парвовирусы, а также кишечные вирусы.Результаты. Из 23 случаев смерти младенцев на дому в 10 обнаружена ДНК вирусов герпеса во внутренних органах и крови погибших (43,5 %). Среди обнаруженных вирусов герпеса преобладал цитомегаловирус (34,8 %), в т. ч. в комбинации с вирусами Эпштейна — Барр и герпеса человека 6 типа. У всех младенцев при жизни отсутствовали клинические признаки, характерные для генерализованной герпетической инфекции. У одного погибшего ребенка с гипертрофической кардиомиопатией в образцах внутренних органов обнаружен генетический материал коронавируса, энтеровируса и ротавируса.Заключение. Результаты исследования показали доминирующую роль вирусов герпеса в развитии генерализованной инфекции с летальным исходом в случаях смерти младенцев на дому.

Introduction. Infant mortality is a universally recognized indicator for social well-being of the population. There is a need for an in-depth analysis of the causes and factors leading to the death of infants at home, including determining the etiology of infectious diseases potentially causing death.The purpose of the study — to determine the implication of herpesviruses in infant out-of-hospital death.Materials and methods. Samples from autopsy material of 23 infants (blood, small intestine, heart, lungs, liver, brain), who died at home from various causes, were analyzed by PCR for the presence of viral DNA and RNA from herpesviruses, orthomyxoviruses, paramyxoviruses, picornaviruses, adenoviruses, coronaviruses, parvoviruses, as well as intestinal viruses.Results and discussion. Positive PCR results were found in 11 cases (43.5 %), of which herpesviruses DNA was detected in 10 cases. In these samples, cytomegalovirus predominated, in association with Epstein — Barr virus and human herpesvirus type 6. This association was detected in blood and internal organs samples from four infants diagnosed with generalized viral infection, and from two infants with acute respiratory viral infection. This suggests the presence of a causal relationship between the lethal outcome and the detection of these viruses. Not all infants showed clinical signs characteristic of generalized herpes infection. In one infant with hypertrophic cardiomyopathy, coronavirus, enterovirus and rotavirus DNA was found in samples of internal organs.Conclusion. Results showed the dominant role of the herpesviruses in out-of-hospital infant death cases.

младенческая смертность на домугерпесвирусыцитомегаловирусПЦР аутопсийных тканейгенерализованная вирусная инфекцияOut-of-hospital infant mortality at homeherpesvirusescytomegalovirusPCR of autopsy tissuessystemic viral infectionИсследование выполнено в рамках НИОКТР Федерального научно-исследовательского института вирусных инфекций «Виром» по теме «Генетическая характеристика возбудителей генерализованной вирусной инфекции с летальным исходом у детей первого года жизни» (регистрационный номер 121041500041-1 от 11 мая 2023 г.).The study was conducted as part of the research work of the Federal Research Institute of Viral Infections “Virome” on the topic of “Genetic Characteristics of Pathogens in Generalized Viral Infection with Fatal Outcome in Children of the First Year of Life” (Registration Number 121041500041-1 dated 11 May 2023).ReferencesBlencowe H, Calvert PhD C, Lawn JE, Cousens S, Campbell OMR. Measuring maternal, foetal and neonatal mortality: Challenges and solutions. 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The authors declare that there are no conflicts of interest present.