Shigella differentiation according to R factor affiliation with incompatibility groups taking into account antibiotic resistance spectra

The study on 198 Shigella strains isolated from dysentery patients and cultures from 3 different dysentery foci showed a possibility of intraspecies typing of the causative agents according to the R factor incompatibility groups with regard to the antibiotic resistance spectra. The procedure was most effective in defining the similarity of the strain origin from the epidemiological foci.     

Conditions and factors determining the etiological structure of dysentery and its changes. Report 1. Epidemiological theory of etiological selectivity of the main (primary) pathways of infection and their differences in various nosological forms of dysentery]

The authors present the elaborated and formed epidemiological theory ("conformity theory") according to which the etiological structure of dysentery is determined by the etiological selectivity of the main (primary) waves of transmission of the infection differing in various nosological forms of dysentery. In Grigoriev-Shiga dysentery the domestic way of the spread of infection plays the main role, in Flexner and Newcastle dysentery--the water way, and in Sonne dysentery--the food way (particularly through the milk). Evolution of the etiological structure of dysentery serves as the reflection of evolution of the principal ways of transmission. The complex of prophylactic and antiepidemic measures in individual noslogical forms of dysentery should be differentiated and be directed in epidemiological sense to the neutralization of the corresponding main (primary) way of transmission of the infection.     

Formation of the dysentery epidemic process in three small towns]

Data are presented concerning the epidemiological analysis of Sonnei dysentery outbreaks in three towns connected by common nutrition and water supply. The epidemic processes in these populated localites were strongly interrelated. Possibilities of the effect of the water factor on the extent of Sonnei dysentery incidence were studied as well. The results of studies led to the conclusion on the presence of numerous action forms of the water factor which should be taken into consideration in carrying out prophylactic and antiepidemic measures in Sonnei dysentery.     

The formulation of epidemiological hypotheses by using the methods of multivariate statistical analysis

The work demonstrates the main approaches to the use of the methods of multidimensional analysis for the creation of a hypothesis on the mechanism of the epidemiological process of dysentery in organized groups. The main risk factors have been established, and their role in the formation of annual, all-the-year-round and seasonal dysentery morbidity has been quantitatively evaluated. The results of analysis show the existence of diverse variants of the alimentary route of the transmission of infection, maintaining the epidemic process of dysentery, and the necessity of differentiating measures for the prophylaxis of all-the-year-round and seasonal morbidity.     

Results of treatment of dysentery patients with streptomycin-dependent vaccine in comparison with other methods of treatment]

Comparative study of various methods of treatment was carried out on 777 patients suffering from acute dysentery with a bacteriologically confirmed diagnosis. To assess the therapeutic efficacy, along with consideration of clinical signs of the disease, immunoglobulin level was examined in the blood and coprofiltrates; also the state of reparative processes in the mucosa was appreciated by the histological examination of the biopsy material. Results of the work carried out indicated the inexpediency of the treatment of this disease with a combination of levomycetin and phthalazol. The use of live streptomycin-dependent dysentery vaccine was indicated in protracted torpid dysentery and was of no avail in acute form of the disease. A good therapeutic effect was observed with the application of pathogenetic therapy alone.     

Effectiveness of the antibacterial therapy of patients with various forms of dysentery]

The analysis of the efficacy of various methods of antibacterial therapy in 1382 patients with obliterated, light and moderately severe forms of dysentery as compared to the patients subjected only to patholgenic therapy showed that broad spectrum antibiotics lost their role in treatment of such patients. Furazolidon proved to be one of the most active drugs. The authors suppose that treatment of patients with obliterated forms of dysentery with antibacterial drugs is not obligatory and is indicated only in cases with repeated isolation of the causative agent.     

Assessment of the diagnostic effectiveness of antigenic preparations from Sonne shigellae]

The authors studied the diagnostic possibilities of 4 diagnistic agents from Sh. sonnei. A total of 1500 from 1122 persons were investigated. Specificity and sensitivity of the diagnostic agents from Sh. sonnei were determined. Methodical priciples of the objective assessment of the diagnostic efficacy of the antigenic preparations in the controlled epidemiological trial were elaborated. A possibility of establishment of the etiological diagnosis of Sonne dysentery in the passive hemagglutination or blast agglutination tests by the results of testing with the diagnostic agents of the serum obtained from the patient once or by determining the dynamics of the antibody titre rise in coupled serum portions was not great.     

The mechanism of the development of the epidemic process in Sonne dysentery

An epidemic outbreak of Sonne dysentery has been studied. The data of epidemiological monitoring before and after the epidemic have been analyzed. The real prognostication value of controlling the biological properties of Shigella sonnei and the increase of their intrapopulation heterogeneity at the period of the activation of the epidemic process of Sonne dysentery has been established.     

Grigor'ev-Shiga dysentery: a new epidemic threat. Its global tendencies and features of its spread

In this article, based on the data contained in literature, the development of the pandemic of Grigor'ev-Shiga dysentery, which began in 1960-ies, is followed. The stages of the formation of three powerful hyperpandemic foci in Central America, South-East Asia and Central Africa are characterized. The characterization of the epidemiological features of the spread of this disease and its clinical distinction are presented. The biological properties of the causative agent, and in particular its multiple medicinal resistance facilitating the spread of the disease throughout the world, is considered. The stable character of the foci of infection in developing countries, which actually present a threat also for this country, is pointed out. For this reason, the epidemiological surveillance on Grigor'ev-Shiga dysentery should be drastically strengthened.     

2009年全国其他感染性腹泻报告病例分析

目的了解我国2009年其他感染性腹泻的流行特点和病原学信息,提出改善建议,为更好的控制其他感染性腹泻病的流行提供数据支持。方法收集中国疾病控制信息系统"疾病监测信息报告管理系统"中2009年其他感染性腹泻的病例报告,对其流行病学及病原学信息进行描述性统计分析。结果 2009年全国共报告655 965例其他感染性腹泻病例,其中≤5岁儿童分别占报告总病例的50.38%和死亡病例的70.0%。实验室确诊病例占报告病例数的5.04%,其中病毒性感染占92.79%,细菌性感染占6.92%。结论≤5岁的散居儿童应为其他感染性腹泻的重点监测人群。其他感染性腹泻报告病例中约有95%为临床诊断病例。我国其他感染性腹泻的病原学诊断率及病原学诊断结果的报告率亟待提高。     

Use of intraspecific differentiation of Sh. sonnei for the purpose of studying patterns in the epidemic process of dysentery]

The use of complex typing of Sh. sonnei by the colicinogenic and enzymatic properties in epidemiological analysis of dysentery caused by Sh. sonnei, apart from establishment of epidemiological connections in the foci, offered a possibility of introducing significant corrections in the determination of the sizes and duration of existence of the epidemic foci, as well as in detection of the sources and factors of transmission of the infection established in epidemiological examination. Typing of Sh. sonnei also aided in ascertaining that, apart from general regularities in the individual territories, the epidemic process in individual groups of the population and in different seasons of the year could also course autonomously.     

Population migrations and the epidemic process of Flexner and Sonne dysentery

Analysis of the materials from the Khabarovsk Territory for the representative period of 25 years (1956-1980) revealed the influence of the migration of the population on the level and dynamics of morbidity in different kinds of dysentery, Flexner's dysentery shown to occur more frequently than Sonne dysentery. Intensive migrations increase the proportion of susceptible persons among the population, thus facilitating the formation and circulation of Shigella strains with pronounced virulence.     

Effectiveness of social hygiene and organized preventive measures in dysentery in preschool institutions]

The work presents the data on the development and realization of the complex of social and hygienic, as well as organizational and preventive measures for dysentery control at institutions for children of preschool age in one of the regions of our country. This complex comprises the improvement of "epidemiological" knowledge of the staff, preventive orientation in the work of the epidemiological section of the local Sanitary Epidemiological Station, the spread of sanitary and hygienic knowledge children and in their families, the improvement of material and technical equipment of children's institutions. The complex proved to be highly effective: at institutions for children of preschool age morbidity -ate in dysentery decrease 4--5 times, and its specific falue dropped from 40% to 5.4%, the frequency of positive results given by tests for the presence of intestinal microflora in washings from various objects decreased more than 25 times. Morbidity rate at institutions for children of preschool age decreased 4--5 times as compared with that among children not attending such institutions. The above data suggest the necessity of introducing this experience in other regions of our country.     

Some aspects of the use of the level of bacteriological confirmation in the epidemiological analysis of dysentery morbidity]

On the basis of studying the seasonality and the age composition of dysentery morbidity in comparison with the corresponding levels of bacteriological confirmation the authors suggested a method of recalculation of morbidity with consideration to this parameter. This method could be used in epidemiological analysis.     

The excretion of Shigella antigens in persons recovering from dysentery]

Shigella antigens can be detected in the excreta of convalescents after dysentery for a long time. Most frequently these antigens occur in feces, less frequently in urine and rarely in saliva. According to indirect data, S. flexneri 1-6 antigens can be detected in excreta for a longer period after convalescence than S. sonnei antigens. When antigen indication is used for the diagnosis of dysentery and epidemiological analysis is carried out, one should bear in mind the length of the agent persistence in the body, related to Shigella type.     

The Role of Probiotics in the Treatment of Dysentery: a Randomized Double-Blind Clinical Trial

Diarrhea is considered as an important cause of morbidity and mortality, even though one of the main reasons of death following diarrhea is initiated by dysentery. In recent years, the consumption of probiotics has been proposed for the treatment of infectious diarrhea. Despite most of the studies on probiotics have focused on acute watery diarrhea, few studies in the field of dysentery have found beneficial effects of probiotics. This study is a randomized double-blind clinical trial. The patients were randomly placed into control and case groups. In the intervention group, the patients received probiotics in the form of Kidilact® sachet, which contained high amounts of 7-strain friendly bacteria strains of Lactobacillus casei, Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus bulgaricus, Bifidobacterium infantis, Bifidobacterium breve, and Streptococcus thermophiles. On the other hand, the patients in the control group received placebo sachets on a daily basis for 5 days. It is notable that the treatment protocol of acute dysentery was done on both groups. The results of this study showed significant differences in the duration of blood in diarrhea between probiotic consumers (2.62 days) and the control group (3.16 days) (P value = 0.05). Additionally, significant differences in the average length of hospitalization in probiotic consumers (3.16 days) and control (3.66 days), (P value = 0.02) could be claimed that the consumption of probiotics is effective in reducing the duration of dysentery and diarrhea. The results of this study suggest that the use of probiotics can be effective in reducing the duration of blood in diarrhea. This study was also recorded in the Iran center of clinical trials registration database (IRCT2014060617985N1).     

Effect of a live enteral dysentery vaccine from spontaneous Flexner mutant 2a 516m on the immunoglobulin-producing cell count in the large intestine mucosa in dysentery

The influence of vaccinal therapy with live oral dysentery vaccine prepared from S. flexneri 2a 516M on the content of immunoglobulin-producing cells in the mucous membrane of the large intestine was studied. A considerable increase in the number of IgA- and IgM-synthetizing cells was shown to occur in the course of the infectious process in acute dysentery. In chronic dysentery the content of IgA- and IgM-synthetizing cells in patients was considerably lower than in a smooth course of acute dysentery. The use of the vaccine for the therapy of patients with chronic and especially acute dysentery resulted in a considerable rise in the number of plasma cells synthetizing IgA, IgM and IgG.     

Epidemiology of bacillary dysentery in Algeria. II. The seasonality of dysentery

Morbidity rises during the period of summer and autumn are characteristic of bacterial dysentery in Algeria. During the last 18 years no essential changes in the seasonal character of bacterial dysentery were observed in the country taken as a whole. However, in different climatic and geographical zones of the country the seasonal character of dysentery greatly varies from one zone to another and essentially differs from the seasonal character of dysentery morbidity, typical of the country as a whole for many years. The most pronounced manifestations of seasonal rises are observed in the Sahara zone. The seasonal character of dysentery is formed mainly by morbidity among patients belonging to 3 age groups. The seasonal rises of dysentery can be probably explained by the complex of social and climatic factors, as well as by the biological features of the causative agents of this disease.     

The rapid diagnosis of salmonellosis by a determination of the antigen in the biosubstrates of patients using the coagglutination reaction]

The diagnostic potential of the coagglutination test was checked with the aim of improving the laboratory diagnosis of Salmonella infections by the detection of Salmonella specific antigen in different biological materials (feces, urine, saliva and immune complexes in blood sera). The study of all specimens resulted in the confirmation of the diagnosis in 78% of patients, often during the first days of the disease. The proportion of nonspecific reactions, as shown in the control groups of healthy donors and patients with dysentery and other acute enteric infections, did not exceed 5%.     

Detection of Shigella antigens in the feces of patients with acute intestinal diseases using a coagglutination reaction

A total of 113 patients with acute intestinal diseases have been examined with the use of the coagglutination test. 84.95% of the patients showed the presence of different Shigella antigens. In patients with bacteriologically confirmed dysentery the corresponding Shigella antigens were detected in 96.97% of cases in S. sonnei dysentery, in 90% of cases in S. flexneri dysentery, in 75% of cases in S. newcastle dysentery and in 100% of bases in S. boydii dysentery. In 81.6% of patients with acute intestinal diseases of unknown etiology the coagglutination test revealed the presence of various Shigella antigens.