The etiological structure of shigellosis in the former USSR--an indicator of the activity of the main routes of infection transmission]

The data on the etiological structure of Shigella infections in the USSR in 1988-1989 are presented. The study showed the dominating role of S. flexneri with S. sonnei also retaining great importance in Shigella infections. The process of the liquidation of S. dysenteriae and S. boydii infections began in some large cities. The domination of dysentery caused by S. flexneri and a high typhoid rate, particularly in Central Asia, were due to poor water supply of the population. The spread of dysentery caused by S. sonnei was completely independent of the water factor. The decisive role in the transmission of S. sonnei in infective doses was explained by decentralized milk supply.     

Mathematical modeling and prognosis of incidence of enteric anthroponoses with aqueous route of transmission

Using data on long-term dynamics of epidemic process of acute enteric infections enteric with aqueous route of transmission (typhoid fever, shigellosis caused by Shigella flexneri, hepatitis A, rotavirus gastroenteritis, etc.)the equation of regression was developed with the help of Chebyshev's polynoms. Predicted incidences of these infections for 2005 were on 61.2-99.5% in agree with the real ones on two territories of north region of West Siberia. Predicted incidence for 2006 is reflecting tendencies of epidemic process of mentioned infections.     

志贺菌基因组进化研究进展

志贺菌属(Shigella)是引起全球范围内细菌性痢疾的重要病原菌.近年来,多重耐药型和新血清型志贺菌的不断出现给志贺菌的监测和防控带来了新的挑战.基因组学的快速发展为深入了解志贺菌的进化来源、变异机制及传播规律等提供了极大的帮助,对控制细菌性痢疾的蔓延具有重要的科学意义.本文首先从遗传来源角度探讨志贺菌与大肠杆菌的进化关系及其可能的分子机制,随后对福氏、宋内和1型痢疾志贺菌的基因组进化进展进行了总结,详细描述了它们的时空分布特点以及耐药基因变异在进化中所发挥的作用,以期为志贺菌的研究和防控提供参考.     

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.     

Nature of the epidemic process in Sonne and Flexner dysenteries and the causes of its induction

A comparative study of the epidemic process in Sh. sonnei and Sh. flexneri dysentery in different regions of the USSR revealed that the morbidity level of Sh. sonnei dysentery changed simultaneously in the regions under study at intervals of 2-3 years. Sh. flexneri dysentery showed morbidity rises occurring at intervals 6-8 years, and their occurrence did not coincide with the periods of elevated morbidity in Sh. sonnei dysentery. The data obtained in the cohort analysis and in the study of recurrent morbidity suggest that Sh. flexneri dysentery produces more pronounced postinfection immunity than Sh. sonnei dysentery, and the immunological factor probably affects the dynamics of the epidemic of these Shigella infections.     

Protection of monkeys against experimental shigellosis with a living attenuated oral polyvalent dysentery vaccine

Formal, Samuel B. (Walter Reed Army Institute of Research, Washington, D.C.), T. H. Kent, H. C. May, A. Palmer, and E. H. LaBrec. Protection of monkeys against experimental challenge with a living attenuated oral polyvalent dysentery vaccine. J. Bacteriol. 91:17-22. 1966.-Virulent strains of Shigella flexneri 1b, S. flexneri 3, and S. sonnei I were mated with an Hfr strain of Escherichia coli K-12, and hybrids were selected for the xylose marker. One hybrid strain of each of the serotypes was chosen for study of their biological characteristics. Their capacity to cause a fatal enteric infection in starved guinea pigs was reduced, they failed to cause dysentery when fed to monkeys, they caused keratoconjunctivitis in the guinea pig eye, and they penetrated HeLa cells. Two doses of a polyvalent oral vaccine composed of S. flexneri 1b, 2a, and 3, and S. sonnei I hybrid strains were fed to groups of monkeys at an interval of 4 to 7 days, and they, together with controls, were challenged 10 days after the last dose with one or another of the virulent parent dysentery strains. A significant degree of protection was afforded in all vaccinated groups with the exception of one group challenged with S. flexneri 6, a component not included in the vaccine. When animals were challenged with virulent S. flexneri 2a 1 month after oral vaccination, they were also protected. The vaccine produced a rise in serum antibody, but we were not able to detect coproantibody in saline extracts of feces from animals which received the vaccine.     

The determination in saliva of IgA antibodies to Shigella ribosomes for the diagnosis of dysentery

The levels of antiribosomal antibodies to Shigella ribosomes in serum and saliva samples from 38 dysentery patients (15 S. sonnei cases and 23 S. flexneri cases), 14 patients with salmonellosis and 136 healthy adults were determined in ELISA with ribosomes from S. sonnei R-mutant used as solid-phase antigen. High levels of "normal" antiribosomal IgA, IgG and IgM antibodies were revealed in the sera of healthy persons while the level of salivary IgA antibodies was very low. In dysentery infection no increase in the levels of serum IgG and IgM antibodies and only a slight increase in the level of IgA antibodies were revealed. Local immune response was manifested by the early (on days 2-4 from the onset of infection) and significant augmentation (12- to 16-fold) of salivary antiribosomal IgA antibodies. An increase in the level of these antibodies was registered in 95-100% of dysentery patients but not in patients with salmonellosis, which made it possible to recommend the method for diagnosing shigellosis. Immune response to Shigella ribosomal antigens, in contrast to the response induced by Shigella O-antigen, is almost exclusively local.     

Etiologic structure of bacterial dysentery in the USSR in 1983-1985

The etiological structure of dysentery in the USSR in 1983-1985 is characterized. Sonne dysentery was found to prevail in the territories with adequate water supply, while dysentery caused by Shigella flexneri prevailed at the territories with unsatisfactory water supply. S. dysenteriae and S. boydii were found to play a limited role in the etiology of dysentery. In the presence of global pandemic, an increase in the isolation rate of S. dysenteriae I in the USSR is observed. The data on the biochemical structure of S. sonnei are presented.     

Possible mechanisms underlying the slow lactose fermentation phenotype in Shigella spp.

A Southern hybridization analysis revealed that the region homologous to Escherichia coli lacZ was present on the chromosomal DNAs of beta-galactosidase-positive Shigella strains, such as Shigella dysenteriae serovar 1 and Shigella sonnei strains, whereas this region was absent from chromosomal DNAs of beta-galactosidase-negative strains of Shigella flexneri and Shigella boydii. We found that the lacY-A region was deficient in S. dysenteriae serovar 1 and believe that this is the reason for the slow fermentation of lactose by this strain. S. sonnei strains possessed the region which hybridized with E. coli lacY-A despite their slow hydrolysis of lactose. The whole lactose-fermenting region was cloned from S. sonnei and compared with the cloned lac operon of E. coli K-12. Both clones directed the synthesis of beta-galactosidase in an E. coli K-12 strain lacking indigenous beta-galactosidase activity (strain JM109-1), and we observed no difference in the expression of beta-galactosidase activity in S. sonnei and E. coli. However, E. coli JM109-1 harboring the lactose-fermenting genes of S. sonnei exhibited the slow lactose fermentation phenotype like the parental strain. S. sonnei strains had no detectable lactose permease activities. E. coli JM109-1 harboring the lactose-fermenting genes of S. sonnei had a detectable permease activity, possibly because of the multicopy nature of the cloned genes, but this permease activity was much lower than that of strain JM109-1 harboring the lac operon of E. coli K-12. From these results we concluded that slow lactose fermentation by S. sonnei is due to weak lactose permease activity.     

Possible mechanisms underlying the slow lactose fermentation phenotype in Shigella spp.

A Southern hybridization analysis revealed that the region homologous to Escherichia coli lacZ was present on the chromosomal DNAs of beta-galactosidase-positive Shigella strains, such as Shigella dysenteriae serovar 1 and Shigella sonnei strains, whereas this region was absent from chromosomal DNAs of beta-galactosidase-negative strains of Shigella flexneri and Shigella boydii. We found that the lacY-A region was deficient in S. dysenteriae serovar 1 and believe that this is the reason for the slow fermentation of lactose by this strain. S. sonnei strains possessed the region which hybridized with E. coli lacY-A despite their slow hydrolysis of lactose. The whole lactose-fermenting region was cloned from S. sonnei and compared with the cloned lac operon of E. coli K-12. Both clones directed the synthesis of beta-galactosidase in an E. coli K-12 strain lacking indigenous beta-galactosidase activity (strain JM109-1), and we observed no difference in the expression of beta-galactosidase activity in S. sonnei and E. coli. However, E. coli JM109-1 harboring the lactose-fermenting genes of S. sonnei exhibited the slow lactose fermentation phenotype like the parental strain. S. sonnei strains had no detectable lactose permease activities. E. coli JM109-1 harboring the lactose-fermenting genes of S. sonnei had a detectable permease activity, possibly because of the multicopy nature of the cloned genes, but this permease activity was much lower than that of strain JM109-1 harboring the lac operon of E. coli K-12. From these results we concluded that slow lactose fermentation by S. sonnei is due to weak lactose permease activity.     

Acanthamoeba: could it be an environmental host of Shigella?

Shigellosis is a serious public health problem in Korea, because large outbreaks of Shigella sonnei infections were recorded in many parts of the country during the period 1998-2000. However, the epidemiological features of shigellosis are not well known. In this study, we devised conditions suitable for the growth and replication of Shigella in an amoebic intracellular environment, and investigate whether medium conditions affect the survival and replication of Shigella within Acanthamoeba. We evaluated the uptake rates of invasive and non invasive S. sonnei strains by three Acanthamoeba species, namely, A. castellanii Neff, A. astronyxis Ray & Hayes, and A. healyi OC-3A. When A. castellanii Neff was infected with S. sonnei 99OBS1 or 80DH248, shigellae was maintained for a longer time in cytoplasms than in other Acanthamoeba species. S. sonnei 99OBS1 strain (a virulent strain) was recovered in higher numbers than the non-virulent S. sonnei 80DH248 strain in all experiments. Moreover, S. sonnei was more easily engulfed by Acanthamoeba at 18 degrees C. The shigellae uptake rates of Neff strain, which was cultured in free-media (less nutrition), were higher (>10-fold) than those observed in original amoeba culture media (PYG medium) in all time points. S. sonnei 99OBS1 was localized, with an intact membrane, to the vacuoles of Acanthamoeba. We conclude that free-living amoebae more likely act as environmental hosts for shigellae, and thus, may have contributed to outbreaks of shigellosis in Korea.     

Specific antibodies bound to secretory IgA in the sera of patients with intestinal infections]

Specific IgA and sIgA antibodies were studied in the sera of patients suffering from various intestinal diseases (dysentery, salmonellosis, typhoid fever, chronic typhoid carrier state) and in the sera of healthy persons immunized by parenteral route with typhoid alcohol vaccine. The nature of antibodies was identified in Coombs' test, using monospecific antisera to alpha-chain and to the secretory component. IgA and sIgA antibodies were revealed most frequently in the sera of dysentery patients and of chronic typhoid carriers. No sIgA antibodies were found in the sera of subcutaneously immunized persons. The presence of specific sIgA antibodies in the serum reflects the participation of local immune mechanisms in the formation of systemic immunity in the intestinal infections.     

Isolation and characteristics of Shigella antigens during the course of dysentery

In 2,436 fecal samples and 1,272 urinary samples taken from 633 patients with dysentery caused by S. flexneri, S. newcastle and S. sonnei, Shigella antigens were detected by means of the passive hemagglutination test with antibody diagnostic agents and the antibody neutralization test. The antigen-binding activity of shigellae in urine dynamically increased in the course of dysentery. The comparison of the parallel results of both serological tests made it possible to evaluate the dispersion of the released antigen: it dynamically increased in the course of the disease, this increase being particularly high in feces. The dispersion of Shigella antigens in urine was greater than in feces over the entire course of the disease. These regularities in the release of the antigens and especially the specific features of the serological tests determined the scheme of the serological diagnosis of dysentery by the indication of Shigella antigens.     

Evaluation of Trimethoprim-sulphamethoxazole Compound in Treatment of Salmonella Infections

Fifty patients suffering from infections caused by various salmonella species were treated with trimethoprim-sulphamethoxazole compound. Twenty-three had enteric fever and two were biliary carriers of Salmonella typhi. The other 25 suffered from infections caused by salmonella species other than S. typhi or S. paratyphi B. Twenty-one of the patients with enteric fever responded clinically to the drug, one failed treatment, and one died. Two patients suffering from typhoid fever relapsed and three temporarily excreted S. typhi in stools following treatment. One of the typhoid carriers was successfully treated. All patients with infections caused by salmonella species other than S. typhi or S. paratyphi B responded to treatment but 17 continued to excrete the organism in their stools after the course of trimethoprim-sulphamethoxazole compound. Four patients developed rashes during therapy and two became anaemic.     

Dynamics of bacterial polysensitization in acute dysentery in children depending on the species of the causative agent

Studies on polysensitization, evaluated by the neutrophil damage index, have been made with the use of dysenterin and the allergens of hemolytic staphylococci, enterococci and Escherichia coli. The studies have revealed that both specific and nonspecific sensitization to hemolytic staphylococci and enterococci is higher in dysentery caused by Shigella flexneri than in dysentery caused by S. sonnei and has the tendency to increase in the course of the disease.     

Estimating the Burden of Paratyphoid A in Asia and Africa

Despite the increasing availability of typhoid vaccine in many regions, global estimates of mortality attributable to enteric fever appear stable. While both Salmonella enterica serovar Typhi (S. Typhi) and serovar Paratyphi (S. Paratyphi) cause enteric fever, limited data exist estimating the burden of S. Paratyphi, particularly in Asia and Africa.We performed a systematic review of both English and Chinese-language databases to estimate the regional burden of paratyphoid within Africa and Asia. Distinct from previous reviews of the topic, we have presented two separate measures of burden; both incidence and proportion of enteric fever attributable to paratyphoid. Included articles reported laboratory-confirmed Salmonella serovar classification, provided clear methods on sampling strategy, defined the age range of participants, and specified the time period of the study.A total of 64 full-text articles satisfied inclusion criteria and were included in the qualitative synthesis. Paratyphoid A was commonly identified as a cause of enteric fever throughout Asia. The highest incidence estimates in Asia came from China; four studies estimated incidence rates of over 150 cases/100,000 person-years. Paratyphoid A burden estimates from Africa were extremely limited and with the exception of Nigeria, few population or hospital-based studies from Africa reported significant Paratyphoid A burden.While significant gaps exist in the existing population-level estimates of paratyphoid burden in Asia and Africa, available data suggest that paratyphoid A is a significant cause of enteric fever in Asia. The high variability in documented incidence and proportion estimates of paratyphoid suggest considerable geospatial variability in the burden of paratyphoid fever. Additional efforts to monitor enteric fever at the population level will be necessary in order to accurately quantify the public health threat posed by S. Paratyphi A, and to improve the prevention and treatment of enteric fever.     

Quantitative research on the cyclic fluctuations of the epidemic process in a number of infectious diseases in Bulgaria

The cyclic nature of the epidemic process in Bulgaria was studied by various methods (spectral analysis, etc.), forming a system. The morbidity dynamics in 10 infectious diseases (scarlet fever, rubella, measles, epidemic parotitis, whooping cough, diphtheria, typhoid fever, enterocolitis, bacterial dysentery, viral hepatitis) over the years of 1909-1983 were studied and cycles covering the periods of 3-4, 5-6, 10-11 and over 16 years were established. The data on the relative part of cyclic processes in the registered morbidity of infectious diseases, as well as information on the prognostication of the spread of infections in the absence of vaccinal prophylaxis, are presented.     

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.     

Experience in the study of the epidemiology and prevention of intestinal infections under conditions of the extreme north of western Siberia]

A study was made of peculiarities of typhoid and dysentery and of conditions promoting the spread of these infections in the Yamalo-Nenetsk National Area. The efficacy of antiepidemic measures conducted against these infections under conditions of the extreme north was assessed. A sharp fall of typhoid incidence was reached. As to dysentery-the complex of measures carried out could not significantly influence the direction of the epidemic process (for this purpose elaboration of special prophylactic measures is required).     

Comparative immunomorphological study of the immunogenic activity of dysentery vaccines produced by different methods

The morphological study of the ophthalmic mucosa of guinea pigs immunized locally with different dysentery vaccines has demonstrated the advantages of live dysentery vaccine prepared from Shigella sonnei 6S over heated vaccine and Shigella antigen extracts. The protective properties of dysentery vaccines, their capacity for protecting the mucous membrane from the penetration and intracellular multiplication of shigellae correlates with the degree of the manifestation of vaccine-induced plasmatocellular reaction in the epithelial and subepithelial zones. The importance of the virulence of the strains used for the preparation of vaccines, as well as the method of their preparation, for the immunogenic potency of vaccines is shown.