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.     

Determination of the O antigen of Shigella sonnei by a competitive immunoenzyme method

A technique for immunoenzymatic diagnosis of dysentery by Shigella sonnei O-antigen was developed. For induction of antibodies to O-antigen rabbits were immunized by intravenous administration of a commercial antidysentery vaccine. Specific antibodies to O-antigen belonging to class G immunoglobulins and not binding to O-antigens of Sh. flexneri and Salmonella typhimurium were obtained. beta-Lactamase of Bacillus licheniformis 749/c was used as a marker enzyme in the immunoenzymatic assay. To increase the sensitivity, beta-lactamase molecules were preliminarily linked with glutaric aldehyde into oligomers. Conjugates of Sh. sonnei O-antigen with the oligomers of B. licheniformis 749/c beta-lactamase were prepared with the periodate method by oxidizing O-antigen. The conjugate was used in competing solid phase immunoenzymatic assay for determination of Sh. sonnei O-antigen in blood serum of patients with dysentery. The sensitivity of the assay is 0.5-1 ng per 1 ml of O-antigen.     

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.     

Experience with the diagnosis of dysentery in adults by determining antibodies to Shigella in the saliva]

Concentration of immunoglobulins and titres of antibodies to Sh. sonnei, Sh. flexneri and enteropathogenic E. coli 0111 was determined in mixed saliva and the blood serum of patients suffering from Sonne dysentery, acute intestinal diseases of unknown etiology, and healthy individuals. The sum total immunoglobulin concentration in mixed saliva proved to be 53--81 times less than in the blood serum, but in the first substrate there was 53--75, and in the second--15% of immunoglobulin A. There proved to be distinct changes in the specific IgA-antibodies in the saliva of patients with Sonne dysentery. A preponderant accumulation of IgG-antibodies was noted in the blood serum. Elevation of both types of antibodies was maximal during the second week of the disease. Sonne dysentery was diagnosed in 80% of the patients by recording the intensity of shifts in the specific antibodies in the saliva, and in 63%--in the blood. The expediency of immunological testing of saliva for the diagnosis of dysentery is substantiated.     

The modulation of hela cells secretory patterns by invasive Shigella spp. and enteroinvasive E. coli bacterial cells and their soluble components

Considering the important role of cytokines in the initiation and evolution of the inflammatory process induced by Shigella and EIEC strains, the purpose of this study was the characterization of the secretory patterns of HeLa cells induced by Shigella ssp. and EIEC strains and to link the obtained results with the invasiveness level of bacterial strains on this cellular line. During this study there were analyzed two EIEC strains and 12 strains of the following Shigella species: 2 Sh. flexneri 2a, 2 Sh. flexneri 3a, 2 Sh. flexneri 4a, 2 Sh. boydii, 2 Sh. sonnei strains isolated in Romania during 2005 from children with dysentery and diarrhoea and confirmed for their invasive ability by Sereny test. The level of the main pro and anti-inflammatory cytokines, IL-1 beta, IL-6, IL-10, IL-13, IL-17 and TNF-alpha induced by whole bacterial cultures as well as by their soluble mediators was determined by an ELISA test. Our results showed that HeLa cells can be used not only for the qualitative and quantitative assessment of Shigella and EIEC strains invasion ability, but also as a simple work procedure for the investigation of an in vitro complex crosstalk communication mechanisms that involves physical interactions between bacterial cells and epithelial cells (adhesins and complementary receptors) and pro- and anti-inflammatory molecules regulation.The majority of the analyzed Shigella serogroups, with the exception of Shigella sonnei and EIEC strains, inhibited the inflammatory response by reducing the expression of majority of pro-inflammatory cytokines, i.e., IL-1 beta, IL-6, TNF-alpha and IL-17. The reduced cost of the in vitro procedure, the possibility of results interpretation and the strict regulations concerning the use of animals for experimental purposes are the main reasons that support the implementation of such an in vitro test in the research labs.     

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.     

Comparative diagnostic value of methods for detecting dysentery antigens in substrates of the patient's body

The comparative evaluation of different immunological methods, such as the enzyme immunoassay, the aggregate hemagglutination test and the complement fixation test, used for the detection of specific Shigella antigens in biological body substrates obtained from 287 patients with acute dysentery caused by S. sonnei, S. flexneri and S. newcastle has been carried out. The enzyme immunoassay and the aggregate hemagglutination test most effective (97.5 +/- 0.5 and 92.4 +/- 0.9, respectively), the object of study being the patients' blood taken at the early stages of the disease. The diagnostic specificity of these methods has proved to be 98.7 +/- 6.7 and 95.2 +/- 1.4, respectively.     

福氏志贺氏2a及Y变种保护性抗原的研究

福氏志贺菌Y变种曾经作为一种痢疾疫苗的候选株,其特有的抗原结构在疫苗的有效性抗原研究中起主要作用。以Y变种毒株与无毒株、野生型F2a株与T32株及失去Ⅱ型抗原结构的T32-1株之间分别进行了各种毒力表型的检测、四种外膜侵袭蛋白表达、菌株的外膜蛋白提取物(OMPs)分析、质粒DNA图谱和小鼠主动免疫、被动保护试验的对比分析,了解其抗原特性。结果显示：细菌外膜蛋白抗原和具有完整型特异性抗原结构的福氏菌LPS在动物机体免疫中都发挥着重要的作用。这些抗原物质的共同存在似乎能达到更好的免疫效果。     

Manifestations of the cyclic nature of the epidemic process in dysentery

Different forms of dysentery, especially those caused by Sh. sonnei and Sh. flexneri, have been found to differ considerably in their cyclic recurrence. The development cycles of the epidemic processes of dysentery have an objective character, occur in the presence of any tendencies in the morbidity rate, and depend on the natural factors. Thus, the cycles of increase and decrease in morbidity are 3, 6, 9, 12 years for dysentery caused by Sh. sonnei and 6, 7, 8 years for dysentery caused by Sh. flexneri.     

Expression of flagella and motility by Shigella

Since the discovery of Shigella as the aetiologic agent of acute dysentery almost 100 years ago, this organism has been described as a non-motile and non-flagellated organism that invades the human colonic mucosa. In this study, the production of flagella by prototypic strains of all four Shigella species and, moreover, by fresh clinical isolates was demonstrated by electron microscopy. The fla gellum of Sh igella (flash) is ∼10 µm long and 12–14 nm in diameter and is typically seen emanating from one pole of the bacterium. Flash is composed of a putative structural polypeptide subunit of 33–38 kDa that shares immunological similarities with Escherichia coli , Salmonella spp., and Proteus mirabilis flagellins, and with the recently described recombinant Shigella flagellins (FliC_SS and FliC_SF) expressed in E. coli K-12. A fliC_SS -specific oligo probe hybridized with all four Shigella species, while a fliC_SF probe hybridized with all Shigella flexneri and Shigella dysenteriae strains, but not with all Shigella sonnei or Shigella boydii strains, indicating genetic divergence among their flagellin genes. Shigella exhibits motility in low-concentration motility agar under physiological growth conditions. The expression of flash and motility appears to be strictly regulated by unidentified genetic and environmental factors. These heretofore undescribed features may allow the bacteria to circumvent the natural intestinal mucosal defences leading to bacterial colonization and disease. The motility of shigellae may represent an evolutionary adaptation important for bacterial survival.     

Search for host specificity systems in Shigella using DD-series phages]

A total of 712 Shigella strains were studied with the use of dysentery diagnostic phages DD II, DD VI and DD VII in order to reveal the systems of host DNA specificity. The study comprised 4 tests: mass screening by the intensity of phagolytic reaction of phages in various strains; and the determination of the parameters of adsorption. As a result, an effective modification and restriction systems were revealed in Sh. sonnei 311 with the use of phage DD II. Bacteriophage DD VII was effectively restricted in E. coli CK, BB and BB/T4. Cross titration showed that the modification and restriction systems of E. coli BB and BB/T4 differed from the specificity system of E. coli CK. Phage DD VI had an exceptionally broad spectrum of activity and was not sensitive to any known restriction system.     

Modern methods of intraspecies typing of Sonne shigellae. II. Spread of Sonne shigellae of different biochemical types]

The paper presents the results of studying peculiarities of the Sh. sonnei of different biochemical types spread established by their typing scheme suggested by the authors earlier according to rhamnose, xylose and maltose. The epidemic process in dysentery both during the years of the rise and of the decline of its incidence at various territories of the countries proved to be maintained on account of circulation of Sh. sonnei of various biochemical types. The results of studying their dissociative and virulent properties confirmed the biological separation of individual biochemical types. An interrelationship between the character of the biochemical pattern of Shigellae sonnei at the individual territories and the persisting activity of different ways of dysentery transmission was determined. The results of studying the biochemical pattern could be used as an indicator of the degree of activity of individual ways of dysentery spread at various territories.     

Determination of Shigella antigens in the feces of people, immunized with enteral vaccine prepared from S. flexneri antigen

The dynamic determination of the presence of the specific antigen and its activity in the excreta of humans subjected to enteral immunization with vaccine prepared from S. flexneri antigen was made in the agglutination test and neutralization test with the use of, respectively, antibody and antigenic erythrocyte diagnosticums. In the feces and urine of the vaccinees antibodies occurred less commonly and, as a rule, they were less active than those detected in dysentery patients at the corresponding time from the beginning of the disease. The occurrence of Shigella antigens in the feces of the vaccinees was greater than in their urine at the corresponding time. Similarities and differences in the dynamics of the isolation of Shigella antigen from dysentery patients and from the vaccinees receiving enteral vaccine prepared from S. flexneri antigens were established.     

一株有争议的志贺氏菌的抗原分析与血清型检定

对中国医学细菌保藏管理中心所存,1935年国外分离,国内检定结果不一的一株志贺氏菌51331进行了详细的抗原分析,确定为福氏志贺氏菌X变种。 该菌能与国内外出品的福氏3型特异血清发生交叉凝集的原因,主要是由于上述诊断用血清中交叉反应性抗体尚未吸收纯净,至少没用类似51331这样的菌株参与成品血清检定的缘故。因此,建议在生产福氏3型特异血清时,应用本菌种参与检定以提高制品质量。本菌种作为诊断血清检定时用的菌种是十分有价值的。     

Cellular immunity factors in dysentery]

Cellular immune response was studied in 89 adult patients suffering from various clinical forms of acute dysentery, with the use of the lymphocyte blast-cell transformation reaction under the action of a specific antigen (dysenterin) and a nonspecific mitogen (phitohemagglutinin). Functional value of T-lymphocytes proved to be retained in patients with acute dysentery; there was also lymphocyte stimulation by a specific antigen in patients with moderately severe and severe forms of dysentery during the first week of the disease. Specificity of blast-cell transformation of sensitized lymphocytes under the action of dysenterin was shown. Patients with a high percentage of the lymphocyte blast forms displayed a more rapid positive progress of the main clinical indices at the height of the disease than analogous patients with a low blast percentage in the blood. The expediency of using the blast-cell transformation reaction for differential diagnosis and prognosis of moderately severe and severe forms of acute dysentery is discussed.     

Resistance of Shigella to antibiotics

Antibiotic sensitivity of 104 Shigella clinical strains and 104 Escherichia coli strains isolated from patients with acute dysentery not treated with antibiotics in 1986-1987 was studied. It was shown that 100 per cent of the dysentery pathogens and colon bacilli were antibiotic resistant. Strains resistant simultaneously to chloramphenicol, ampicillin, streptomycin, tetracycline, monomycin and kanamycin were the most frequent among the dysentery pathogens. Colon bacilli and dysentery pathogens isolated from the same patient had specific sets of antibiotic resistance markers. Pathogenetic therapy of dysentery and exclusion of antibiotic use for several years did not result in lower numbers of Shigella antibiotic resistant strains.     

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.     

Characteristics and trends in the development of an epidemic process of Sonne and Flexner dysentery among preschool children

The results of studies indicate that the morbidity rates of dysentery among children attending preschool institutions and children brought up at home converged in recent years. This phenomenon was most pronounced among children of the kindergarten age group. At the same time dysentery caused by Sh. sonnei and Sh. flexnery produced a higher morbidity rate among children attending nursery in comparison with that among children of the same age group brought up at home. Group infections in preschool institutions were caused by Sh. sonnei in 89.1% of cases and by Sh. flexneri in 10.9% of cases. Outbreaks due to the transfer of infection through everyday contacts were observed only in dysentery caused by Sh. sonnei, constituting 71.4% of the total number of dysentery outbreaks.     

Current methods of intraspecies typing of Shigella sonnei. 3. Bacteriophage typing]

Data are presented concerning the study of the phage type of Sh. sonnei isolated in various regions of the USSR. The strains isolated belonged to 64 phage types corresponding to the Hammarstr?m's scheme. A variety of Shigella sonnei phage types both in one and in different territories of the country provided future prospects for successful use of phage typing for the purpose of epidemiological supervision and analysis of dysentery morbidity.     

The structure of the population morbidity with specific intestinal infections in areas with different intensities in the development of the epidemic process and an evaluation of its manifestations]

The authors analyze the morbidity structure in five enteric infections (typhoid fever, dysentery caused by Shigella flexneri and Shigella sonnei, hepatitis A, and hepatitis E (non A, non B) with the fecal/oral mechanism of the agent transmission) in three towns of Turkmenia and in the town of Novomoskovsk, Tula Province. The incidence of S. sonnei dysentery was found higher in Novomoskovsk and that of the rest enteric infections under study in Turkmenia. The incidence of typhoid fever and hepatitis E was the highest among schoolchildren and adults, whereas preschool children suffered mostly from hepatitis A and S. sonnei dysentery. The authors discuss the specific features of the epidemic process manifestation in enteric infections.