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Клинико-эпидемиологические особенности гафниоза человека

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Семей аймаыны территориясында жабайы да, ауылшаруашылы жануарларында да H. alvei-мен жпалануды дегейі жоары екені аныталды. Гафниоз, ауылшаруашылы жануарларында сау бактерия иеленушілік трінде тетіні басымыра екені аныталды. Жабайы табиатта гафниозды негізгі резервуары ср егеуйры пен й тышаны екені жне гафниозды негізгі ошатары зендер жаасыны тмен айматары мен зен жаалауы ландшафтары мен рельфті тмендеуіне сйкес келуімен шартталатыны аныталды.

Гастроинтенстиналды гафниоз зіні эпмидемиологиялы кріністері бойынша, тама арылы берілуі басымыра, деттегі бактериялы ішек жпасы ретінде крінеді. Адамдарды гафниозбен сыраттануыны кп жылды динамикасыны су тенденциясы алыптыдан крнекіге дейін тербелетіні аныталды. Бл гафний биотиптеріні аурухана ішілік штаммдарыны блініп шыуымен жне ауруханадан тыс жпалар тудыратын еркін озалатын изоляттар вируленттігіні кшеюімен жретін экологиялы екшелуімен байланысты болуы ммкін.

Асазан-ішек гафниозымен ауыран науастар арасында ер адамдарды жалпы санында да (61,05%), р трлі жас тобында да (балаларды арасында лдар – 60,27%, ересектер арасында ерлерді лес салмаы 63,64%) басымыра екені аныталды.

Сау бактерия иеленушілік пен гафниозды гастроинтестиналды шкін тріні негізгі ауіп тобы 1 жаса дейінгі балар болып табылатыны аныталды (82,6%). H. alvei-мен шартталан ауыр дрежелі дисбактериоз гафниозды шкін трі болуы да ммкін.

Zhumagel'dina Zaure Tursyngaliievna

CLINICAL AND EPIDEMIOLOGICAL FEATURES OF HUMAN

HAFNIOSIS

14.00.30 – epidemiology

14.00.10 – infectious diseases

SUMMARY

In this dissertation we summarized results of the long-term (2003-2008) complex clinical, epidemiological and microbiological researches on studying of distribution, clinical features and variants of the clinical course of the human extrahospital hafniosis in Kazakhstan. The problem's topicality is obvious and results from a wide circulation of hafniae in environment (including artificial) and among wild and agricultural animals, from their ability to remain at a wide range of characteristics of environment (including in the vacuum packed products in the conditions of a household refrigeration cabinet), and also absence of similar works in the domestic literature.

The present work is devoted to achievement of the purpose of studying of epidemic potential of Hafnia alvei as an agent of infectious diseases in people and structure of clinical implications of the extrahospital hafniosis in children and adults.

Materials and methods of the investigation:

Researches which laid down in a basis of this work were carried out in the period from 2003 till 2008 on the basis of town infectious diseases hospitals and offices of infectious diseases of town out-patient departments of Semey and Ust- Kamenogorsk. During the period of time specified above under our observation there were 44 adults and 146 children with the bacteriologically verified extrahospital hafniosis with prevalence in clinics of disease of intestinal implications (gastrointestinal or the gastroenteric form of hafniosis according our>

Epizootological investigations

Work was carried out in 2003-2004. For epizootological characteristics of hafniosis was estimated natural contamination with H. alvei of 337 wild animals' individuals of different species, and also 436 heads of agricultural animals and pets (dogs). As research materials was used intestinal contents of animals.

Epidemiological investigations

The analysis of the hafniosis's incidence level in people was carried out by us for a primary estimation of epidemiological and social value of this nosology in the Semipalatinsk district of the East Kazakhstan oblast. For this purpose during the period from 2001 till 2008 on the basis of the clinical and laboratory data (including bacteriological acknowledgement of the diagnosis and an agglutination test with autostrain) we selected 190 confirmed cases of the human gastrointestinal extrahospital hafniosis for the subsequent analysis. We carried out calculation of indices of an incidence for year in relation to a population of the East Kazakhstan oblast (the risk population – 1416.4 thousand persons). Long-term dynamics of the hafniosis incidence (definition of the tendency, periodicity) was studied. For revealing of the basic trend in development of an epidemic process (growth, depression) alignment of dynamic rows by means of calculation of theoretical level of an incidence by a method of the least squares was used.

Obtained results:

High level of bacterial contamination with Hafnia alvei both wild, and agricultural animals in territory of Semipalatinsk district was established. In agricultural animals hafniosis proceeds mainly in the form of a healthy carriage. The basic reservoir of hafniae in the wild nature are the grey rat and the house mouse that causes a linkage of the natural foci of hafniosis to water meadows of the rivers, water meadows' landscapes and to relief droppings.

Gastrointestinal hafniosis by its epidemiological implications represents a typical bacterial intestinal infection with prevalence of an alimentary way of transfer. In long-term dynamics of the hafniosis incidence in people the tendency of its growth fluctuating from moderated to expressed takes place, that can be bound to ecological differentiation of biotypes of hafniae with allocation of intrahospital strains and intensifying of virulence of natural isolates causing extrahospital infections.

It is established that among patients with gastroenteric hafniosis males prevailed as in whole (6.05 %), and in each of age groups (among children the specific weight of boys was 60.27 %; among adults the specific weight of men was 63.64 %).

The basic group of risk of the healthy carriage and the erased form of gastrointestinal hafniosis development are children aged till 1 year (82.6 %). The dysbacteriosis of severe degree caused Hafnia alvei, apparently, represents the erased form of hafniosis.



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