Research work “Dynamics and spread of gastrointestinal diseases among children and adolescents in the city of Bryansk. Epidemiological assessment of possible risk factors for contracting intestinal infections Risk factors for the development of acute intestinal and
Anti-epidemic measures when identifying a patient
with acute bacterial intestinal infection (hereinafter referred to as ABI),
gastroenterocolitis, dysentery, salmonellosis,
intestinal infection of unknown etiology
1. A doctor who has identified a patient or suspected case of OBCI immediately isolates the patient and calls an infectious disease specialist for a consultation.
3. The attending physicians (doctors on duty) must conduct a complete collection of epidemiological anamnesis. When writing out contact persons in the epicrisis, indicate contact with an infectious patient.
4. The head nurse of the department (charge nurse) fill out all columns, except 13.14, in the “Infectious Diseases Log”, form No. 060/u.
5. If the clinical diagnosis is confirmed, the patient must be hospitalized in a city infectious diseases hospital.
6. The epidemiologist needs to identify contact persons (including medical personnel), draw up lists, conduct a one-time bacteriological examination for pathogenic intestinal flora (feces, vomit, washing water), and take swabs from environmental objects. If necessary, catering staff are examined for epidemiological reasons.
7. The medical staff of the department must monitor contact persons for 7 days (examination, thermometry 2 times a day, palpation of the abdomen, examination of stool) and record all data in the “Contact Observation Journal.”
8. From the moment a patient is identified until his hospitalization in an infectious diseases hospital, it is necessary to carry out ongoing disinfection of environmental objects in the room where the patient is identified. All items used by the patient, patient care items, and room furnishings are subject to disinfection, followed by quartz treatment. Disinfect work surfaces by wiping, using disinfectants used in the department according to the appropriate regime. Patient care items, dishes, linen and other various items are completely immersed in a container with disinfectant. For the biomaterial, use a Javel Solid solution - 0.06% (4 tablets per 10 liters of water) with an exposure of 1 hour.
9. After hospitalization of the patient in the appropriate hospital, it is necessary to carry out final disinfection followed by collection of swabs. All of the above items, as well as the special clothing of medical personnel, are disinfected. Medical waste is disposed of in containers and bags for class B.
10. In exceptional cases (for health reasons), the patient is left in the department in compliance with the conditions of isolation and all necessary (according to indications) bacteriological studies (vomit and feces, rinsing water, etc.).
11. The patient is provided with individual dishes, care products, and overalls for the attending physician, nurse and junior medical staff; separate cleaning equipment is provided to the ward.
After each use of the listed items, everything is disinfected in the above manner. Replace protective clothing daily and when soiled. Used linen and workwear should be disinfected in the disinfection chamber of the laundry.
12. When caring for a patient, medical personnel use personal protective equipment as much as possible (rubber gloves, masks, and, if necessary, a moisture-resistant apron). Observe personal hygiene rules.
Wash your hands with liquid soap and use a skin antiseptic.
13. Conduct repeated conversations in the department for the prevention of intestinal infections and enter data into the patient’s education sheet.
14. Feeding the patient and carrying out wet cleaning in the ward should be done last.
15. Limit visits to the patient’s relatives.
16. Timely report to the deputy head, head of the department, head of the department and epidemiologist about the detection of repeated cases and measures taken to localize the source of infection, etc.
Causative agents of intestinal infections
Specify the main routes of transmission for acute intestinal infections (AI):
A. contact-household
B. food
V. aquatic
G. parenteral
D. wound
2. Name the genera of the family Enterobacteriaceae, representatives of which are pathogenic for humans:
3. The family Enterobacteriaceae is characterized by:
A. Gr-sticks
B. do not form a dispute
V. have a facultative anaerobic type of respiration
G. capable of fermenting carbohydrates to acid or acid and gas
D. catalase positive
E. oxidase negative
G. all of the above are true
4. All enterobacteria are characterized by recycling:
sucrose
arabinose
5. Based on what main characteristics the Enterobacteriaceae family is divided into genera:
according to morphological
on cultural
on biochemical
by antigenic
according to sensitivity to bacteriophages
all of the above are true
6. What bacterial cell structures are the pathogenicity of enterobacteria associated with:
Cell wall LPS
nuclear substance
flagella
All of the above are true
7. Name the antigens of enterobacteria:
All of the above are true
8. Name the representatives of the family Enterobacteriaceae that have flagella:
salmonella
Escherichia
serrations
all of the above are true
9. According to the type of respiration, all enterobacteria are:
obligate aerobes
obligate anaerobes
facultative anaerobes
capnophiles
microaerophiles
aerotolerant microorganisms
10. Indicate representatives of the family Enterobacteriaceae that can cause nosocomial infections:
a) Escherichia
b) Klebsiella
c) salmonella
d) proteus
e) Enterobacter
e) all of the above are true
11. The main method of laboratory diagnosis of acute intestinal infections caused by
enterobacteria:
bacterioscopic
bacteriological
serological
biological
skin-allergic
12. auxiliary method for laboratory diagnosis of acute intestinal infections caused by enterobacteria:
bacterioscopic
bacteriological
serological
biological
skin-allergic
13. Name possible epidemiological markers of enterobacteria:
A. serovars
B. biovariants
B. colicin variants
G. phage variants
D. resistant products
E. all of the above are true
14. Enterobacteria can form:
microfibrils
all of the above are true
15. E. coli can cause the following diseases:
a) Escherichiosis
b) salmonellosis
c) purulent-inflammatory
d) food poisoning
e) dysentery
e) all of the above are true
16. When performing a bacteriological examination of material for enterobacteria, on the 1st day of the study the following is performed:
17. When performing a bacteriological examination of material for enterobacteria, on the 2nd day of the study the following is performed:
screening of characteristic colonies on 2- and 3-sugar media
study of the enzymatic properties of a culture in a minimal differentiating series; indicative tests with polyvalent agglutinating sera, bacteriophages
serological identification with monoreceptor agglutinating sera, if necessary, additional biochemical tests
inoculation of the prepared material on plate differential diagnostic media and enrichment media
18. When performing a bacteriological examination of material for enterobacteria, on the 3rd day of the study the following is performed:
screening of characteristic colonies on 2- and 3-sugar media
study of the enzymatic properties of a culture in a minimal differentiating series; indicative tests with polyvalent agglutinating sera, bacteriophages
serological identification with monoreceptor agglutinating sera, if necessary, additional biochemical tests
inoculation of the prepared material on plate differential diagnostic media and enrichment media
19. When performing a bacteriological examination of material for enterobacteria, on the 4th day of the study the following is performed:
screening of characteristic colonies on 2- and 3-sugar media
study of the enzymatic properties of a culture in a minimal differentiating series; indicative tests with polyvalent agglutinating sera, bacteriophages
serological identification with monoreceptor agglutinating sera, if necessary, additional biochemical tests
inoculation of the prepared material on plate differential diagnostic media and enrichment media
20. The differentiating factor of Endo and Levin culture media is:
a) agar-agar
b) sucrose
c) magenta
d) glucose
e) sodium chlorine
e) lactose
21. To study the saccharolytic activity of bacteria, cultures are made on:
a) Olkenitsky environment
b) whey agar
c) Hiss environment
d) Russell medium
d) blood agar
22. What diseases do salmonella cause in humans?
typhoid fever
gastroenteritis
septicemia
dysentery
all of the above are true
23. Indicate the main routes of transmission of salmonellosis:
A. food
B. aquatic
V. contact
G. parenteral
D. airborne dust
E. all of the above are true
24. The classification of Salmonella according to Kaufman and White is based on the distinction:
morphological properties
enzymatic activity
antigenic structure
cultural properties
sensitivity to bacteriophages
25. Salmonella are divided into serogroups according to specificity:
O-antigens
H-antigens
K antigens
All of the above
26. Differentiation of Salmonella into serovars within a serogroup is carried out according to specificity:
O-antigens
H-antigens
K antigens
All of the above
27. Most Salmonella pathogenic for humans belong to the subspecies:
28. The source of infections caused by S.typhi, S.paratyphi A is:
some animals
insects
all of the above are true
anthroponoses
zooanthroponoses
sarpronoses
30. The name of the disease, typhoid fever, comes from the Greek word meaning in Russian:
stomach ache
reason
31. How pathogens of typhoid and paratyphoid are released into the environment from an infected person:
with feces
with saliva
all of the above are true
32. The main pathogenicity factor of S.typhi is:
endotoxin
exotoxin
neurotoxin
Hemolysin
33. Indicate the localization of S.typhi in the human body during the incubation period:
in enterocytes of the small intestine
in enterocytes of the large intestine
in macrophages of the lymphoid apparatus of the small intestine
on the oral mucosa
34. Name the main method of laboratory diagnosis of typhoid fever in the 1st week of the disease:
bacterioscopic
bacteriological with the isolation of urine, duodeno- (bilino-) and coproculture
serological
35. What microbiological methods are used to diagnose typhoid fever:
a) microscopic
b) bacteriological
c) serological
d) biological
d) allergic
e) all of the above are true
36. Name the main method of laboratory diagnosis of typhoid fever at the end of the 2nd, 3rd week of the disease:
bacterioscopic
bacteriological with blood culture isolation
bacteriological with the isolation of urine-, bilino- and coproculture
4) serological
37. What clinical material can be used in the bacteriological diagnosis of typhoid fever and paratyphoid fever:
B. feces
D. scrapings from roseola
E. bone marrow
G. all of the above are true
38. What is the purpose of phage typing of Salmonella typhi:
to select an antibacterial drug
to identify the source of the pathogen
for the production of autovaccine
for the prevention of typhoid fever
to create an attenuated vaccine
all of the above are true
39. What are Salmonella typhi Vi-phages:
bacteriophages containing Vi-antigen
all bacteriophages that lyse Salmonella typhi
diagnostic kits that are used for serological reactions
neutrophil leukocytes loaded with Vi antigens
phages that lyse only Salmonella having Vi antigen
40. “Salmonella paratyphi A” is the name:
antibiotic variant
serovariant
phage variant
41. Why are freshly isolated cultures of Salmonella typhi often not agglutinated by typhoid O-9 serum:
due to competition between O and H antigens
due to lack of specificity of O-serum
due to their lack of O-antigen
due to reduced O-antigen content
due to shielding of the O antigen by the Vi antigen
42. What is the main mechanism of infection for typhoid fever:
airborne
fecal-oral
transmissible
contact
all of the above are true
43. Who is susceptible to typhoid fever:
in the wild - artiodactyls
in rural areas there are mainly pigs
only human
humans and domestic animals (pigs)
humans and small rodents
all of the above are true
44. To obtain a duodeno- or bilino-culture, take from the patient:
excreta
Bone marrow
45. To obtain coproculture from the patient, take:
excreta
Bone marrow
46. By what properties do the causative agents of typhoid fever and paratyphoid fever differ from each other:
A. morphological
B. tinctorial
B. biochemical
G. antigenic
D. cultural
E. for all of the above
47. For serodiagnosis of typhoid and paratyphoid fever the following is used:
A. RA according to Vidal
B. RA according to Gruber
D. Wright reaction
E. Bacteriolysis reaction
48. When diagnosing Vidal RA, diagnosticums are used:
A. "O" - and "N" - typhoid
B. “ON”-paratyphoid (A and B)
B. Vi – erythrocyte
G. diagnosticums prepared from autostrains
D. all of the above are true
49. High titers of antibodies to the O-antigen and low titers to the H-antigen of S. typhi are characteristic of:
the height of typhoid fever
convalescence
typhoid bacteria carriage
post-vaccination immunity
50. Specify the nutrient media used to isolate Salmonella from feces:
B. bismuth sulfite agar
V. Ploskireva
D. magnesium environment
D. selenite medium
E. all of the above are true
51. Which colonies form the majority of salmonella on Endo medium:
1) small, transparent, medium-colored, in S - shape
2) medium size, red with a metallic sheen and imprint on the medium, in S-shape
3) medium size, pink with a red raised center, wavy edges
4) large, pink with a rough surface
52. Which colonies form the majority of salmonella on bismuth sulfite agar:
1) colorless, translucent, round in shape with smooth edges
2) grayish-black, rough, with jagged edges, radial striations
3) brown or greenish, without a rim or imprint on the medium, S - shape
4) black, with a metallic sheen, with a black rim and imprint on the medium, in an S-shape
53. What is the role of Salmonella typhi bacteria carriers in the epidemiology of typhoid fever:
A. leading role
B. the main role belongs to rodents
B. minor
D. the main role belongs to domestic animals (pigs)
D. are a reservoir of the pathogen
54. When characterizing the enzymatic activity of salmonella, take into account:
A. fermentation of glucose, lactose, dulcite to acid and gas
B. urease activity
B. release of hydrogen sulfide
D. decarboxylation of amino acids
D. utilization of sodium citrate and acetate
E. all of the above are true
55. The most specific syndrome in the early stages of typhoid fever (fever and foggy consciousness):
A. caused by enterotoxin
B. observed during bacteremia
B. is caused by the action of the pathogen endotoxin
G. is accompanied by excretion of the pathogen in feces
D. accompanied by diarrhea
E. all of the above are true
56. To prevent typhoid fever:
A. no vaccine has been developed
B. antitoxic serum is administered
B. use tableted bacteriophage
D. use a chemical sorbed vaccine
D. destroy mosquitoes (larvae) by breeding Gambusia
57. The most common causative agent of foodborne toxic infections are bacteria of the following genus:
4. Staphylococcus
58. Reasons for the development of food toxic infections:
A. long-term storage of food at room temperature
B. accumulation of bacterial toxins in food
B. accumulation of a large number of living pathogens in food
D. accumulation of a large number of dead bacteria in food
D. cooking in galvanized dishes
59. How many serovars are included in the genus Salmonella?
5. more than 2000
60. Serological diagnosis of salmonellosis involves
A. immunofluorescent detection of the pathogen in the patient’s feces
B. study of paired sera
B. bone marrow puncture examination
D. detection of antibodies in a patient
D. staging the neutralization reaction
61. An important element in the pathogenesis of salmonellosis is the reproduction of the pathogen
1. in the lumen of the large intestine
2. in the lumen of the small intestine
3. inside the cells of the mononuclear phagocyte system
4. on the surface of enterocytes
5. inside intestinal epithelial cells
62. Name sugar media that can be used for the primary biochemical identification of Salmonella and other enterobacteria:
1) Kligler
2) Ressel
3) Olkenitsky
5) all of the above are true
63. To study the antigenic structure of Salmonella and determine the serovar, use:
1) extensive Gruber agglutination reaction with polyvalent Salmonella serum
2) a detailed Widal agglutination reaction with O- and H-salmonella diagnosticums
3) agglutination reaction on glass with monoreceptor O- and H-salmonella sera
4) all of the above are true
64. In Salmonella bacteria carriers, predominantly immunoglobulins of the following class are found in the blood serum:
65. Name Salmonella, which currently most often causes gastroenteritis. This is all except:
1) S. typhimurium
66. Nosocomial strains of salmonella differ:
1) multidrug resistance
2) resistance to the action of disinfectants. solutions of normal concentration
3) stability in the external environment
4) all of the above are true
67. For the bacteriological diagnosis of Salmonella gastroenteritis, the following clinical samples can be used:
D. gastric lavage and vomit
D. feces
E. food products
G. all of the above are true
68. Name the most significant transmission factors for Salmonella gastroenteritis:
A. meat and meat products
B. milk and dairy products
B. poultry eggs
G. cream products
D. fish, shellfish
E. all of the above are true
69. For specific prevention of typhoid fever the following are used:
A. corpuscular alcohol vaccine from the S. typhi Ty 2 strain
B. polysaccharide vaccine from Vi antigen
B. polyvalent typhoid bacteriophage
G. polyvalent salmonella serum ABCDE
D. cephalosporin and fluoroquinolone antibiotics
E. all of the above are true
70. The causative agent of bacterial dysentery is microorganisms of the following genus:
5) Campilobacter
6) all listed
71. According to the international classification, the genus Shigella is divided into the following species, with the exception of:
1) S. dysenteriae
72. Most virulent for humans:
1) S. dysenteriae
73. Name the pathogenicity factors of S. dysenteriae. This is all except:
1) invasiveness antigen
2) cytotoxin
3) leukocidin
4) endotoxin
5) exfoliatin
6) all of the above are true
74. In the human body, Shigella colonizes:
1) small intestine with penetration into the lymphoid-macrophage apparatus
2) large intestine with invasion of the epithelium and its destruction, the formation of erosions, ulcers
3) large intestine with penetration into the blood and parenchymal organs
4) stomach with penetration into the bile ducts and gallbladder
75. What properties are inherent in the causative agent of dysentery:
A. emit hydrogen sulfide
B. has a rod-shaped
B. ferment carbohydrates more often without gas formation
G. lacks flagella
D. form spores
E. all of the above are true
76. The causative agent of dysentery in the patient’s body:
A. is located in the lumen of the small intestine
B. is located inside the epithelial cells of the large intestine
V. affects the mucous membrane of the large intestine
G. affects the mucous membrane of the small intestine
D. attached to the villi of enterocytes
77. Name the main method for diagnosing shigellosis:
1) bacterioscopic
2) bacteriological
3) serological
4) biological
5) allergological
78. What clinical material can be used for bacteriological diagnosis of dysentery:
G. feces
D. vomit
E. gastric lavage water
G. all of the above are true
79. Specify a highly selective medium intended for the isolation of Shigella:
2) bismuth sulfite agar
3) Ploskireva
4) Wilson-Blair
80. The following have the ability to slowly decompose lactose and sucrose:
1) S. dysenteriae
81. Treatment of dysentery is carried out:
A. using keratolytic agents
B. using antibacterial drugs
B. using antitoxic serums
G. using virulent bacteriophages
D. using temperate bacteriophages
82. Colonies suspected of belonging to Shigella:
A. have oxidase activity
B. do not have oxidase activity
V. are colored crimson on the differential diagnostic medium Endo
G. form a mucous coating on the surface of the medium
D. lactose-negative on Endo medium
83. Which of the following pathogenicity factors are found in diarrheagenic Escherichia coli:
A. protein A
B. exfoliative toxin
G. cytotoxin
D. erythrogenin
E. all of the above are true
1. anthroponoses
2. zooanthroponoses
3. zoonoses
85. What features characterize the pathogenicity of Shigella:
A. is due to the osteoclastic action of flagella
B. caused by LPS
V. manifests itself only in the presence of calcium ions in the medium
G. is associated with the production of shigotoxin (cytotoxin)
D. is associated with the production of invasin (outer membrane protein)
E. all of the above are true
86. On the Endo and Ploskirev agar plate, Shigella more often forms colonies:
1) small, delicate, round, translucent, colorless, with even edges and a smooth surface
2) medium-sized, round, red in color with a metallic sheen, with straight edges and a smooth surface
3) medium in size, irregular in shape, with uneven edges and a dull, rough surface, colorless, flat
4) large, pink with uneven edges and a rough surface
87. When serotyping Shigella, use:
A. agglutinating polyvalent sera against S.sonnei and S.flexneri
B. erythrocyte diagnosticum Flexner
B. erythrocyte diagnosticum Grigoriev-Shiga
G. erythrocyte diagnosticum Sonne
D. all of the above are true
88. Name the main properties by which Shigella is identified to species:
A. morphological and tinctorial
B. cultural
B. enzymatic
G. antigenic
D. sensitivity to bacteriophages
E. antibiotic sensitivity
89. Indicate the role of non-pathogenic strains of E. coli, which are normal inhabitants of the human intestine:
1) are antagonists of pathogenic microorganisms
2) determine colonization resistance
3) participate in the processes of metabolism of proteins, fats, transformations of bile acids
4) participate in the synthesis of some vitamins and hormones
5) all of the above are true
90. What diseases can Escherichia cause in humans:
acute intestinal infections
diseases of the gastrointestinal tract
diseases of the urogenital tract
bacteremia, meningitis
respiratory diseases
all of the above
91. What pathogenicity factors can E.coli have:
B. heat labile enterotoxin
B. heat-stable enterotoxin
G. endotoxin
D. adhesiveness factor
E. shiga-like toxin
G. all of the above are true
ETEC (enterotoxigenic Escherichia coli)
EIEC (Entero Invasive Escherichia coli)
EPEC (enteropathogenic Escherichia coli)
EHEC (enterohemorrhagic Escherichia coli)
EAEC (enteroadhesive Escherichia coli)
94. What does the antigenic formula of Escherichia coli reflect:
serovariant designation
pathogenicity for mice
belonging to a biovar
type of flagellar antigen
variants of secreted toxins
95. Which of the following pathogenicity factors have ETEC (enterotoxigenic Escherichia coli):
c) colonization factor
e) enterotoxin (cytotonin)
96. Which of the following pathogenicity factors have EIEC (enteroinvasive Escherichia coli):
a) the ability to penetrate the cells of lymphoid organs
b) the ability to multiply in enterocytes
c) invasion factor
d) Shiga-like toxin (cytotoxin)
e) erythrogenin
97. Which of the following pathogenicity factors have ENEC (enterohemorrhagic Escherichia coli):
a) the ability to penetrate the cells of lymphoid organs
b) the ability to multiply in enterocytes
c) adhesion factor (pili)
d) Shiga-like toxins and verotoxin (cytotoxins)
d) intimin
98. What is the mechanism of action of enterotoxins produced by diarrheagenic Escherichia coli:
a) increase the intracellular level of cyclic nucleoside monophosphates
b) increase the contractility of smooth muscle fibers of the large intestine
c) reduce the threshold of excitability of the sensory endings of N.vagus
d) stimulate the production of ATP in mitochondria
e) cytotonic
99. Cholera-like toxin is produced by Escherichia, belonging to the category:
ETEC (enterocoxigenic Escherichia coli)
EIEC (enteroinvasive Escherichia coli)
EPEC (enteropathogenic Escherichia coli)
EHEC (enterogamorrhagic Escherichia coli)
EAEC (enteroadhesive Escherichia coli)
100. What clinical material can be used in the bacteriological diagnosis of escherichiosis:
all of the above are true
101. Specify the nutrient media used to isolate Escherichia from feces:
B. Ploskireva
B. bile broth
G. Rappoport
D. Olkenitsky
E. selenite broth
102. To detect the E.coli K-antigen, the following is used:
Vidal's reaction
103. To detect the O-antigen of E. coli put:
RA on glass with OKA-polyvalent Escherichia serum
Detailed agglutination reaction with live culture and OK-escherichiosis sera
Full-scale agglutination reaction with heated culture and OK-escherichiosis sera
4) Vidal reaction
104. Yersinia belongs to the family:
Pseudomonadaceae
Enterobacteriaceae
Mycobacteriaceae
105. The natural reservoir of Yersinia can be all of the following, except:
rodents
pets
farm animals
molluscs, crustaceans
person
106. The leading route of transmission of yersiniosis is:
airborne
contact
transmissible
nutritional
vertical
107. The most common causes of yersiniosis are:
1. fresh food
2. products stored at low temperatures
3. foods stored at room temperature
4. heat-treated products
5. all of the above are true
108. When bacteriologically diagnosing yersiniosis, the following is examined:
excreta
mucus from throat
food products, water
all of the above are true
109. The pathogenicity of Yersinia is controlled by:
plasmid genes
chromosomal genes
Col plasmids
genes of temperate bacteriophages
all of the above are true
110. Specify pathogenicity factors and virulence determinants of yersiniosis pathogens:
endotoxin
enterotoxic factor
invasins
virulence plasmids
all of the above are true
111. In smears for pathogens of yersiniosis it is typical:
presence of dispute
presence of a pronounced capsule
bipolar staining
pairwise arrangement
all of the above
112.Y.entnerocolitica forms colonies on Endo medium:
medium size, translucent, convex lumpy, with scalloped area, medium colors
small, transparent, shiny, convex, with smooth edges, medium colors
large, transparent, shiny, flat, with smooth edges, red with a metallic sheen
small, crimson with a metallic sheen and smooth edges
113. Microorganisms of the genus Vibrio are characterized by the following properties, with the exception of:
straight or curved rod-shaped
mobility
negative Gram stain
ability to form spores
ability to decompose glucose and hydrogen peroxide
114. What morphological characteristics are characteristic of Vibrio cholerae:
A. has an ovoid shape
B. has the shape of a curved stick
B. monotrich
G. does not form a dispute
D. forms a capsule
115. By what characteristics should representatives of Vibrionaceae and Enterobacteriaceae be differentiated:
A. according to morphological
B. by the nature of the breakdown of glucose in sugar media
B. by the presence of oxidase
D. by the presence of amino acid decarboxylases
D. by mobility
E. all of the above are true
116. Vibrio cholerae has the following antigens:
A. somatic O-antigen
B. surface K-antigen
B. flagellar H-antigen
D. cross-reacting antigen
D. all of the above are true
117. By what signs are Vibrio cholerae distinguished from cholera-like ones:
A. by agglutinability of O1 or O139 serum
B. by the presence of oxidase
G. by belonging to the Heiberg biochemical group
D. for resistance to novobiocin
E. all of the above are true
118. Where is Vibrio cholerae localized in the patient’s body:
1. inside the mucus covering the stomach lining
2. in regional lymph nodes
3. in the mononuclear phagocyte system
4. on the surface of the colon epithelium
5. on the surface of the epithelium of the small intestine
119. What characteristics are used to determine whether an isolated Vibrio cholerae culture belongs to a biovar:
A. by antigenic properties
B. by lysis by specific phages
V. according to the Voges-Proskauer reaction
G. by growth on medium with polymyxin
D. according to the ability to grow on alkaline MPA
E. all of the above are true
120. What material from a patient is used for accelerated detection of the cholera pathogen using the immunofluorescent method:
B. feces
B. sputum
D. blood serum
121. Which of the following pathogenicity factors does Vibrio cholera have:
1. protein (TOX T)
2. colonization factor (ACF)
3. Pili Adhesion (TSP)
4. exotoxin (cholerogen-ST)
5. endotoxin
6. all of the above are true
122. What role does Vibrio cholerae 0139 play in human pathology:
1. causes mild diarrhea
2. causes foodborne illnesses
3. causes typical cholera
4. none
5. opportunistic microorganism
123. What role do specific secretory antibodies play in the body of a cholera patient:
A. block the attachment of Vibrio cholerae to the epithelium of the small intestine
B. provide intestinal cleansing from Vibrio cholerae
V. prevent the penetration of Vibrio cholerae into the blood
G. kill Vibrio cholerae in the bloodstream
D. kill Vibrio cholerae in the intestinal lumen
124. Which class of immunoglobulins play the greatest role in the recovery process in cholera:
125. What is the main cause of death in patients with cholera:
A. action of endotoxin
B. disturbance of blood electrolyte composition
B. liver failure
D. severe dehydration
D. jaundice
E. all of the above are true
126. How are patients with cholera treated:
A. antibiotic therapy
B. restoration of blood electrolyte composition
B. blood transfusion
D. pain relief
D. rehydration
127. What is the mechanism of action of cholerogens:
A. The A-subunit penetrates into the enterocyte
B. inside the cell, the A-subunit of the toxin activates adenylate cyclase
B. The B-subunit penetrates into the enterocyte
G., with the help of A-subunits, attaches to enterocyte receptors
D., with the help of B-subunits, attaches to enterocyte receptors
128. What ions are lost in the feces and vomit of a cholera patient:
1. bicarbonate ions
2. potassium ions
3. sodium ions
4.chlorine ions
5. all of the above are true
129. What effect does cholerogen have on enterocytes:
1. blocks protein synthesis
2. mutagenic
3. disrupts energy metabolism
4. cytotoxic
5. cytotonic
130. Name the natural reservoir of the causative agent of cholera:
a person who is sick or a bacteria carrier
fish, shellfish, crustaceans
domestic and wild animals
all of the above
131. Indicate the possible routes of transmission of cholera:
contact-household
all of the above are true
132. Name the serovars of V.cholerae 01:
Gikoshima
All of the above are true
133. What clinical material is used for bacteriological diagnosis of cholera:
A. feces
B. vomit
D. liquor
E. all of the above are true
134. When examining material from a patient with suspected cholera, on the 1st day it is necessary to perform:
A. sowing in accumulation medium (1% peptone water)
B. sowing on an alkaline agar plate
B. sowing on a plate of elective medium (TCBS or Mansuro medium)
D. rapid detection of Vibrio cholerae in immunoserological reactions or PCR
D. all of the above are true
135. What nutrient media are used for primary inoculation of material when diagnosing cholera:
A. 1% peptone water (accumulation medium)
B. selenite broth
B. alkaline agar plate
D. bismuth sulfite agar
E. TSVS or Mansuro medium
136. Indicate the growth pattern of cholera vibrios on an alkaline agar plate:
1) medium-sized colonies, dull white, with wavy edges and a raised center
2) colonies are small (1 - 2 mm), transparent, shiny, with smooth edges, have a bluish tint
3) colonies are small, opaque, with a grayish-yellow tint, scalloped edges
4) black colonies with raised centers and smooth edges
137. Specify the minimum time after which the growth of V.cholerae colonies on alkaline agar is detected:
138. Indicate the growth pattern of V.cholerae on 1% peptone water:
diffuse opacification
bottom-wall sediment
delicate surface film on the surface of the medium
in the form of “lumps of cotton wool”
in the form of “lentils”
139. To study the saccharolytic activity of V.cholerae, you can use any of the following polycarbohydrate media, except:
lactose-sucrose
mannose sugar
Kitt-Tarotsi
Kligler
140. The belonging of vibrios to the species V.cholerae is determined by:
decomposition of sugars
agglutinability with O1 or O139 antisera
sensitivity to cholera monophages
all of the above are true
141. The main signs identifying the causative agent of cholera are:
enzymatic activity
antigenic structure
antibiotic sensitivity
all of the above are true
142. Based on the decomposition of which substrates, microorganisms of the genus Vibrio are classified into Heiberg groups:
A. glucose
B. mannose
B. sucrose
G. lactose
D. arabinose
143. Name the tests by which the biovars V.cholerae cholerae and eltor are differentiated. This is all except:
sensitivity to polymyxin
sensitivity to classical monophage or eltor
aglutination with antisera Ogawa, Inaba
agglutination of chicken erythrocytes
Voges–Proskauer reactions
hemolysis of sheep red blood cells
144. The main feature of differentiation of biovars of the causative agent of cholera is:
growth pattern on nutrient medium
antigenic structure
sensitivity to specific bacteriophages
enzymatic activity
145. Name the pathogenicity factors of V.cholerae. This is all except:
protein (TOX T)
colonization factor (ACF)
endotoxin
Cholerogen (CT)
pili adhesion (TSP)
146. An accelerated method for diagnosing cholera is not:
Bioassay on laboratory animals
Immobilization of motility with specific antiserum
147. For specific prevention of cholera, the following immunobiological drugs are used, except:
killed vaccine
Cholerogen toxoid
polyvalent cholera bacteriophage
cholera monophages
148. Basic properties of the causative agent of cholera serovar 0139:
a) sensitivity to polymyxin
b) hemolytic activity
c) sensitivity to El-Tor bacteriophages
d) agglutination 0139 – serum
d) all of the above are true
149. For emergency nonspecific prevention of cholera you can use:
a) cholerogens-anatoxin
b) cholera bacteriophage
c) TABte vaccine
d) antibiotics
d) all of the above are true
150. If cholera is suspected, the initial culture of the test material is carried out on:
c) blood agar
d) Endo medium
d) alkaline water
e) alkaline agar
Test answer standards
according to the cycle “Intestinal infections”
Indicate the main routes of transmission for acute intestinal infections (AI). Standards of answers to tests on the cycle “Intestinal infections”
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1. Typhoid fever is classified as:
1. Airborne infections.
2. Quarantine infections.
3. Anthroponosis.
4. Anthropozoonoses.
5. Particularly dangerous infections.
2. Antibodies to the causative agent of typhoid fever appear in the blood on:
1. 1 week.
2. 2 weeks.
3. 3 weeks.
4. 4 weeks.
5. 5 weeks.
3. Specify changes in the mucous membrane of the small intestine during typhoid fever:
1. Diphtheritic enteritis.
2. Phlegmonous enteritis.
3. Ulcerative enteritis.
4. Catarrhal enteritis.
5. Purulent enteritis.
4. Describe the characteristics of ulcers in the small intestine during typhoid fever:
1. Located across the intestinal tube.
2. Located along the length of the intestine.
3. The edges and shape are uneven.
4. They arise at the site of group follicles.
5. The edges are smooth and rounded.
5. Indicate the most typical outcome of healing of intestinal ulcers in typhoid fever:
1. Small scars.
2. Rough scars.
3. Complete restoration of lymphoid tissue.
4. Lymphoid tissue is not restored.
5. Pigmentation in the area of healed ulcers.
6. Intestinal bleeding, as a complication of typhoid fever, can develop due to:
1. 1 week.
2. 2 weeks.
3. 3 weeks.
4. 4 weeks.
5. 5 weeks.
7. Name the extraintestinal complications of typhoid fever:
1. Pneumonia.
2. Purulent perichondritis of the larynx.
3. Amyloidosis.
4. Waxy necrosis of the rectus abdominis muscles.
5. Osteomyelitis.
8. Salmonellosis is classified as:
1. Anthropozoonoses.
2. Anthroponosis.
3. Airborne infections.
4. Quarantine infections.
5. Parenteral infections.
9. Name the morphological forms of salmonellosis:
1. Primary.
2. Intestinal.
3. Septic.
4. With damage to the mesenteric lymph nodes.
5. Typhoid.
10. Name the most characteristic complication of typhoid fever:
1. Cicatricial stenosis of the intestine.
2. Amyloidosis.
3. Pyelonephritis.
4. Perforation of the intestine.
5. Cachexia.
11. Specify the types of intestinal inflammation in the second stage of dysentery:
1. Phlegmonous.
2. Ulcerative.
3. Croupous.
4. Diphtheritic.
5. Catarrhal.
12. Indicate the most common localization of pathological changes in dysentery:
1. Jejunum.
3. Sigmoid colon.
4. Ileum.
5. Descending colon.
13. Characterize vascular disorders in the intestinal wall during dysentery:
1. Vascular rupture.
2. Full blood.
4. Diapedetic hemorrhages.
5. Thromboembolism.
14. Name the changes in the colon in the third stage of dysentery:
1. Catarrhal colitis.
2. Fibrinous colitis.
3. Ulcerative colitis.
4. Purulent colitis.
5. Serous colitis.
15. List the intestinal complications that may occur with dysentery:
1. Perforation of the intestine.
3. Amyloidosis.
4. Intestinal phlegmon.
5. Intestinal bleeding.
16. Name the extraintestinal complications of acute dysentery:
1. Bronchopneumonia.
2. Pyelonephritis.
3. Meningitis.
4. Liver abscess.
5. Arthritis.
17. Name the extraintestinal complications of chronic dysentery:
1. Obesity.
2. Cachexia.
3. Pneumonia.
4. Amyloidosis.
5. Myxedema.
18. Characterize the changes in the mesenteric lymph nodes in the second stage of typhoid fever:
1. Lymphoid tissue is displaced.
2. The size of the lymph nodes is increased.
3. Typhoid granulomas may occur.
4. Hyperplasia of B-dependent zones.
19. Name the nonspecific complications of cholera:
1. Anemia.
2. Venous congestion.
3. Typhoid.
4. Sepsis.
20. Name the stages of changes in the small intestine during typhoid fever:
1. Brain swelling.
2. Fibrinous enteritis.
3. Purulent enteritis.
4. Stage of necrosis.
5. Stage of clean ulcers.
21. List the intestinal complications that occur with typhoid fever:
1. Cicatricial stenosis.
2. Peritonitis.
3. Perforation.
4. Bleeding.
5. Hypermelanosis.
22. Indicate the route of infection with typhoid fever:
1. Fecal-oral.
2. Contact.
3. Parenteral.
4. Airborne.
5. Transmissive.
23. Indicate the route of penetration of the pathogen into the intestinal wall during typhoid fever:
1. Intraepithelial.
2. Thixotropy.
3. The pathogen is located in the intestinal lumen.
4. Interepithelial.
5. Lymphogenic.
24. Indicate the biological environment in which the causative agent of typhoid fever can be detected in the first week of the disease:
25. List the forms of typhoid fever depending on the location of local changes:
1. Pneumotif.
2. Ileotif.
3. Ileocolotyphus.
4. Meningotif.
5. Cholangiotyphoid.
26. Indicate the structures of the intestinal wall in which changes develop during typhoid fever:
1. Serous membrane.
2. Muscle layer.
3. Group lymphoid follicles.
4. Nerve plexuses.
5. Solitary follicles.
27. Give the name of the second stage of cholera:
1. Gastroenteritis.
2. Pyelonephritis.
3. Dehydration.
4. Anasarca.
5. Fibrinous colitis.
28. Indicate the changes that are characteristic of the algic period of cholera:
1. Gastroenteritis.
3. Anasarca.
4. Dehydration.
5. Pulmonary edema.
29. Name the clinical and morphological types of dysenteric colitis in children:
1. Phlegmonous.
2. Ulcerative.
3. Follicular.
4. Follicular-ulcerative.
5. Granulomatous.
30. Morphological changes in the small intestine in the algic period of cholera:
2. Enteritis.
3. Polyps of the mucous membrane.
4. Necrosis of the mucous membrane.
5. Pigmentation of the mucous membrane.
31. Specify changes in the lymph nodes and spleen during typhoid fever:
1. Amyloidosis.
2. Atrophy.
3. Anemia.
4. Formation of granulomas.
5. Hemosiderosis.
32. Name the causative agent of cholera:
1. Salmonella.
2. Shigella.
3. Vibrio El Tor.
4. Vibrio Koch.
5. Mycobacterium.
33. Indicate the route of infection with cholera:
1. Airborne.
2. Parenteral.
3. Nutritional.
4. Transmissive.
5. Contact.
34. The source of cholera infection is:
1. Sick animal.
2. Sick person.
3. Transfused blood.
4. Vibration carrier.
5. Household items.
35. Indicate the reservoir (habitat) of the El Tor vibrio:
1. Sick person.
2. Sick animal.
4. Vibration carrier.
36. List the periods of cholera:
1. Enteritis.
3. Fibrinous colitis.
4. Ulcerative colitis.
5. Gastroenteritis.
37. Name the parts of the intestine in which the main changes in cholera are localized:
1. Jejunum.
2. Ileum.
3. Sigmoid colon.
4. Transverse colon.
38. Name the changes in internal organs during cholera during the algic period:
1. Atrophy of the lymphoid tissue of the spleen.
2. Necrosis of the epithelium of the kidney tubules.
3. Amyloidosis.
4. Myocardial dystrophy.
5. Purulent meningitis.
39. Name the specific complications of cholera:
1. Amyloidosis.
2. Hyalinosis.
3. Typhoid.
4. Intestinal gangrene.
5. Uremia.
40. Name a possible complication of alterative changes in the lymph nodes during typhoid fever:
1. Gangrene of the intestine.
3. Peritonitis.
4. Myocardial infarction.
5. Amyloidosis.
41. Give the name of the changes in group follicles of the small intestine in the first stage of typhoid fever:
2. Fibrinous enteritis.
3. Brain swelling.
4. Intestinal gangrene.
5. Formation of clean ulcers.
42. Name the type of inflammation in the intestinal lymphoid tissue during typhoid fever:
1. Exudative.
2. Fibrinous.
3. Chronic productive.
4. Acute productive.
5. Purulent.
43. Name the cells that predominate in group follicles of the small intestine in the first and second stages of typhoid fever:
1. Macrophages.
2. Lymphocytes.
3. Leukocytes.
4. Eosinophils.
5. Giant cells of foreign bodies.
44. The accumulation of macrophages in the lymphoid tissue of the intestine during typhoid fever is called:
1. Abscess.
2. Heart attack.
3. Empyema.
4. Granuloma.
5. Phlegmon.
45. Specify the changes in enterocytes characteristic of cholera:
1. Displacement of cell organelles to the apical part.
2. Vacuolization and loss of microvilli.
3. Hyaline droplet dystrophy.
4. Fatty degeneration.
5. Cell proliferation.
46. The pathogenesis of local changes in cholera is:
1. Increased secretion of isotonic fluid.
2. Damage to cell membranes.
3. Lymphostasis.
4. Venous congestion.
5. Violation of fluid reabsorption.
47. List the nonspecific complications of cholera:
1. Pneumonia.
2. Abscesses.
3. Erysipelas.
4. Amyloidosis.
5. Sepsis.
48. Indicate the most common outcome of healing of dysentery ulcers:
1. Complete regeneration.
2. Substitution.
3. Formation of rough scars.
4. Malignancy.
5. Epithelial hyperplasia.
49. Specify the changes in the small intestine characteristic of the 3rd week of typhoid fever:
1. Venous congestion.
2. Brain swelling.
3. Dirty sores.
4. Gangrene.
5. Scarring.
50. The most common complication of typhoid fever is:
1. Hepatitis.
2. Meningitis.
3. Intestinal bleeding.
5. Exhaustion.
51. Indicate the stage of dysentery at which the development of paraproctitis and peritonitis is possible:
1. First.
2. Second.
3. Third.
4. Fourth.
52. Name the causative agent of dysentery:
1. Salmonella.
2. Mycobacterium.
3. Shigella.
4. Cryptococcus.
5. Streptococcus.
53. Indicate the route of penetration of the pathogen into the intestinal wall during dysentery:
1. Interepithelial.
2. Transepithelial.
3. Intraepithelial.
4. Thixotropy.
5. Chemotaxis.
54. Indicate the main pathogenetic mechanisms of action of the causative agent of dysentery:
1. Cytolytic.
2. Chemotactic.
3. Vazoneuroparalytic.
4. Hypoxic.
5. Lymphotropic.
55. Indicate the changes in the intestines that occur during the course of dysentery:
1. Catarrhal colitis.
2. Croupous colitis.
3. Diphtheritic colitis.
4. Stage of healing of ulcers.
5. Purulent colitis.
56. Indicate possible intestinal complications that may develop in connection with the regeneration of ulcers in dysentery:
1. Bleeding.
2. Perforation.
3. Peritonitis.
4. Stenosis of the intestinal lumen.
5. Diverticulosis.
57. Name the general changes in dysentery:
1. Hyperplasia of the spleen.
2. Fatty liver degeneration.
3. Necrosis of the epithelium of the kidney tubules.
4. Metastatic calcification.
5. Fibrosing alveolitis.
58. With dysentery, a disorder may develop:
1. Fat metabolism.
2. Protein metabolism.
3. Carbohydrate metabolism.
4. Mineral metabolism.
59. Macroscopic changes in the spleen in typhoid cholera:
1. Pulp hyperplasia.
2. Greasy appearance on the cut.
3. Pulp atrophy.
4. Heart attacks.
5. Hyalinosis of the capsule.
60. Indicate the changes in the colon in typhoid cholera:
1. Atrophy of the mucous membrane.
2. Swelling of the mucous membrane.
3. Purulent colitis.
4. Diphtheritic colitis.
5. Croupous colitis.
61. List the possible changes in internal organs during typhoid cholera:
1. Splenic infarctions.
2. Foci of liver necrosis.
3. Subacute extracapillary glomerulonephritis.
4. Hyperplasia of the spleen.
5. Amyloidosis of the spleen.
62. List the biological fluids in which the causative agent of typhoid fever is found in the second week of the disease:
1. In the blood.
3. In bile.
5. In the lymph.
63. List the stages of changes in the intestine during typhoid fever:
1. Brain swelling.
2. Necrosis.
3. Formation of ulcers.
4. Stage of dystrophy.
5. Healing.
64. List the general changes in the body that are typical for typhoid fever:
1. Exanthema.
2. Hyperplasia of the spleen.
3. Dystrophy of parenchymal organs.
4. Hyalinosis of arterioles.
5. Glomerulonephritis.
65. Macroscopic characteristics of the spleen during the algic period of cholera:
1. Reduced in size.
2. Increased in size.
3. The pulp does not allow scraping.
4. The pulp produces abundant scraping.
66. List the pathogenic effect of the exotoxin secreted by Shigella:
1. Vasoparalytic.
2. Chemotactic.
3. Lymphotropic.
4. Damages the intramural ganglia.
5. Causes the formation of granulomas.
67. Give macroscopic characteristics of changes in the intestinal wall in diphtheritic colitis:
1. The wall is thinned.
2. The wall is thickened.
3. The mucous membrane is necrotic.
4. Increased blood supply to blood vessels.
5. Anemia.
68. List the possible changes that occur in the lungs with abdominal type:
1. Bronchitis.
2. Emphysema.
3. Focal pneumonia.
4. Abscess.
5. Lobar pneumonia.
69. List the names of extraintestinal forms of typhoid fever:
1. Meningotif.
2. Pneumotif.
3. Cholangiotyphoid.
4. Sepsis.
5. Cholera typhoid.
70. The accumulation of cells in the lymph nodes, characteristic of typhoid fever, is called:
1. Follicle.
2. Abscess.
3. Granuloma.
4. Sinus histiocytosis.
5. Infiltration.
71. Specify the morphological manifestation of alteration in the lymph nodes during typhoid fever:
1. Granuloma.
2. Abscess.
3. Necrosis.
4. Amyloidosis.
5. Hyalinosis.
72. Indicate the possible nature of colitis in dysentery in adults:
1. Gangrenous.
2. Ulcerative.
3. Catarrhal.
4. Follicular.
5. Follicular-ulcerative.
73. List the changes in the small intestine in cholera enteritis:
1. Dystrophic changes in the epithelium.
2. Congestion of blood vessels and hemorrhages.
3. Brown atrophy.
4. Swelling of the intestinal wall.
5. Lymphomacrophage infiltration of the stroma.
74. Indicate the topographic localization of changes in typhoid cholera:
1. Small intestine.
2. Sigmoid colon.
3. Transverse colon.
4. Cecum.
5. Ileum.
75. Indicate the nature of inflammation in the small intestine during cholera:
1. Productive.
2. Fibrinous.
3. Purulent.
4. Catarrhal.
76. Give the name of the fourth stage of changes in group follicles during typhoid fever:
1. Dirty sores.
2. Clean ulcers.
3. Brain swelling.
4. Ulceration.
5. Scarring.
77. Quarantine infections include:
1. Smallpox.
2. Tuberculosis.
4. Yellow fever.
5. Malaria.
78. Specify the duration of the incubation period for cholera:
1. Several hours.
2. 3-5 days.
3. 1-2 months.
4. 1-4 weeks.
5. 1-2 weeks.
79. List the mechanisms of action of Vibrio cholerae exotoxin and mucinase enzyme:
1. Secretion of isotonic fluid.
2. Spasm of intestinal smooth muscles.
3. Blockade of the “sodium pump” of cells.
4. Violation of fluid reabsorption.
5. Damage to cellular and vascular membranes.
80. Give a general description of the algic period of cholera:
1. Metabolic acidosis.
2. Hyperergy.
3. Blood thickening.
4. Oliguria.
5. Increased body temperature.
81. List the main reasons for the development of cholera coma:
1. Hypoproteinemia.
2. Progressive exicosis.
3. Hyperlipidemia.
4. Oliguria.
5. Electrolyte imbalance.
82. List the macroscopic changes in the small intestine in cholera enteritis:
1. The intestinal wall is thinned.
2. The mucous membrane is necrotic.
3. The mucous membrane is swollen.
4. Multiple hemorrhages on the mucous membrane.
5. Ulcerations.
83. Specify the features of rigor mortis in cholera:
1. Weakly expressed.
2. Disappears quickly.
3. Significantly expressed.
4. It lasts a long time.
5. Developing quickly.
84. Microscopic changes in the kidneys during postcholera uremia:
1. Subacute extracapillary glomerulonephritis.
2. Mesangioproliferative glomerulonephritis.
3. Amyloidosis.
4. Infarct-like necrosis of the cortex.
5. Acute pyelonephritis.
85. List the main causes of death of patients during the algic period of cholera:
1. Acute cardiovascular failure.
2. Acute liver failure.
4. Uremia.
5. Intoxication.
86. Specify the duration of the incubation period of typhoid fever:
1. 1-3 months.
2. 2-6 weeks.
3. 10-14 days.
4. 1-2 days.
5. 1-5 hours.
87. Characterize typhoid cells:
1. They belong to macrophages.
2. They belong to lymphocytes.
3. Giant multinucleated cells.
4. Cells with light cytoplasm.
5. The cytoplasm contains an infectious agent.
88. List the organs in which the formation of typhoid granulomas is possible:
1. Lungs.
2. Heart.
3. Lymph nodes.
4. Bone marrow.
89. List the causes of death of patients with typhoid fever:
1. Intestinal bleeding.
2. Peritonitis.
3. Pneumonia.
4. Sepsis.
5. Amyloidosis.
90. Describe the septic form of salmonellosis:
1. Changes in the intestines are significant.
2. Changes in the intestines are weakly expressed.
3. Abscesses in many internal organs.
4. Diphtheritic colitis.
5. Catarrhal gastroenterocolitis.
Collection output:
EPIDEMIOLOGICAL ASSESSMENT OF POSSIBLE RISK FACTORS FOR INTESTINAL INFECTIONS
Isakova Zhainagul Turganbaevna
Lecturer at the Department of General and Clinical Epidemiology of KSMA named after. I.K. Akhunbaeva, Republic of Kyrgyzstan, Bishkek
Toygombaeva Vera Sadvakasovna
Dr. med. Sciences, Professor of the Department of General and Clinical Epidemiology of KSMA named after. I.K. Akhunbaeva Republic of Kyrgyzstan, Bishkek
Alymkulova Venera Alymkulovna
Lecturer at the Department of General and Clinical Epidemiology Republic of Kyrgyzstan, Bishkek
ANNOTATION
The article presents data from a sociological survey of students about the presence of bad habits, the nature of water consumption, compliance with personal hygiene rules and knowledge about the factors of transmission of intestinal infections.
Keywords: morbidity, intestinal infections, bad habits, risk factors.
Infectious diseases at the beginning of the 21st century still remain one of the most important health problems worldwide. According to WHO, more than 2 billion people suffer from infectious diseases every year, of which 17 million people die. Every day, 50 thousand deaths worldwide are caused by infectious diseases, which continue to be the leading cause of death and the first cause of premature mortality.
Among infectious the most common diseases (after ARVI) are spicyintestinalinfections(OKI).
Disease frequency intestinalinfections, estimated in extensive prospective studies over the past 50 years in the United States is 1.2 to 1.9 cases per person per year, the number of deaths associated with infectiousd jarea, ranges from 500 per year atchildren up to over 10,000 in the adult population. The highest incidence is recorded in children early age: 2.46 cases of disease per year per 1 child under 3 years of age.
According to WHO, more than 5 million people die from acute intestinal infections and their complications every year worldwide. children. Despite the successes of medical science and practical healthcare, acute intestinal infections (AI) remain one of the pressing problems of our time. According to the World Health Organization, up to 1-1.2 billion diarrheal diseases are registered annually in the world, from which about 4 million people die, and 60-70% of the sick are children under the age of 14 years. They pose the greatest threat to young children, due to the high level of morbidity and mortality among them. According to Russian authors, intestinal infections occupy 3-4 place among all infectious diseases in children. In addition to damaging public health, they cause serious economic damage. In the USA, economic losses from OKZ amounted to about 1.5 billion dollars, in Russia - 253.45 billion rubles. .
The problem of acute intestinal infections has fully retained its relevance for the Kyrgyz Republic due to the prevailing adverse socio-economic consequences - the disintegration of the former Union, a noticeable decrease in living standards, unemployment, migration of the rural population from villages to cities and deterioration of sanitary and living conditions. In the structure of infectious pathology without influenza and ARVI in the Kyrgyz Republic, the share of intestinal infections is 49%. High levels of incidence of intestinal infections determine the importance of conducting epidemiological studies for the development of preventive measures, reducing socio-economic damage, and protecting the health of the child population.
Purpose of the study: epidemiological assessment of behavioral risk factors for intestinal infections of students.
Materials and methods of research. The material for the study was survey data conducted among metropolitan university students aged 17-22 years (500 pcs.).
Methods: statistical, search, sociological.
Discussion results. To assess knowledge about the influence of behavioral risk factors on the spread of intestinal infections, we conducted a survey of students at capital universities. The questionnaire contained 20 questions, from the answers to which information was obtained about knowledge of the prevention of intestinal infections, type of water supply, issues of personal hygiene, place of residence and the presence of bad habits.
The respondents were 500 students, of whom 54.1±2.2% were female and 45.9±2.2% were male. Age ranged from 17 to 22 years (Figs. 1 and 2).
Figure 1. Share by age
Figure 2. Specific gravity by gender
To the question “Do you know how intestinal infections are transmitted?” the majority of respondents (76±2.0%) answered positively. But among the students, there were also those who did not know about this - 23.7±2.0% (Fig. 3).
Figure 3. Share of answers to the question “Do you know how intestinal infections are transmitted?”
When asked what kind of water they use, respondents indicated that they use water from a central water source, and only 5.6±1.0% of students noted that they use water from an open source (Fig. 4).
Figure 4. Type of water supply
One of the factors of possible infection with intestinal infections is vegetables and fruits, which can be contaminated with soil. Therefore, our questionnaire contained a question about the rules for washing vegetables and fruits before eating them. As the answers showed, most students wash them under running water. However, there were those who did not wash them at all - 2%, and 6.4±1.1% of students scalded them with boiling water before using them (Fig. 5).
Figure 5. Share of answers to the question “How do you wash vegetables and fruits?”
Behavioral risk factors for contracting intestinal infections include bad habits. It turned out that about 30% of respondents have the following bad habits: biting and biting their nails - 58%, putting a pen or pencil in their mouth - 35.8% and 7% - putting their fingers in their mouth.
Passing chewing gum to each other can also be considered bad habits; 2% of students were like that.
To comply with the rules of personal hygiene, appropriate conditions are required at the place of study and residence. To the question “Are there conditions for hand washing in the educational institution?” 13% of respondents gave a negative answer, which indicates that they do not have the opportunity to wash their hands during the day.
To the question “When do you wash your hands?” It turned out that 43.4±1.5% of students washed before eating, 17.4±1.2% after eating, and 39.2±1.5% of students after visiting the toilet.
To identify students' knowledge about possible routes of infection, we included a question about factors of transmission of intestinal infections. 38±1.5% of respondents believe that the transmission factor is dirty hands, 25.4±1.4% - vegetables and fruits, 15.8±1.1% of cases can be infected in public transport, 14.3±1 .1% - maybe money, 6.2±0.7% of respondents - when working on a computer (Fig. 6).
Figure 6. Share of transmission factors (%)
At the same time, it should be noted that the stereotypes of water consumption have now changed. From these questionnaires it turned out that 39% of students drink boiled water, which raises doubts. Filtered, raw and bottled water is consumed by 21.6±1.6%, 20.0±1.6% and 16.9±1.5%, respectively (Fig. 7).
Figure 7. Specific gravity of water consumption patterns (%)
Conclusions:
1. The problem of acute intestinal infections has fully retained its relevance for the Kyrgyz Republic due to the prevailing adverse socio-economic consequences. In the structure of infectious pathology in the Kyrgyz Republic, the share of intestinal infections without influenza and ARVI is 49%.
2. Among the respondents, women made up 54.1±2.2%, men - 45.9±2.2%.
3. 80% of students are well informed about the routes and factors of transmission of intestinal infections.
4. Bad habits are one of the reasons for the spread of intestinal infections, which affect 30% of respondents.
5. According to our research, possible factors for the transmission of intestinal infections are 38±1.5% - dirty hands, 25.4±1.4% - vegetables and fruits, 15.8±1.1% - public transport, 14. 3±1.1% - money, 6.2±0.7% - computer.
Bibliography:
1. Aidaraliev A.A. Scientific basis for optimizing the system of training management personnel in healthcare of the Kyrgyz Republic at the present stage: Diss. for the academic degree of Doctor of Medical Sciences: 14.00.33. Bishkek. 2002. - 33 p.
2. Briko N.I., Pokrovsky V.I. Globalization and the epidemic process. / N.I. Briko, V.I. Pokrovsky //Epidemiology and infectious diseases. - 2010. - No. 4. - p. 4-10.
3. Kasymbekova K.T. Epidemiology of enteric viral infections in the Kyrgyz Republic: Dissertation for the scientific degree of Doctor of Medical Sciences: 14.0030. M. 2004. - 35 p.
4. Onishchenko G.G. the fight against infectious diseases is a priority topic of the Russian Federation's chairmanship of the Group of Eight in 2006 //Healthcare of the Russian Federation. - 2007. - No. 1. - P. 3-6.
5. Shakhanina I.L. Economic damage caused by infectious diseases in the Russian Federation as of December 2000 / I.L. Shakhanina, L.A. Osipova, O.I. Raduto // Epidemiology and infectious diseases. - 2001 - No. 6. - P. 58.
What intestinal infection can take a chronic course: a) dysentery; b) typhoid fever; c) yersiniosis; d) salmonellosis?
What acute intestinal infections can be complicated by perforation of the intestinal wall? a) salmonellosis; b) cholera; c) typhoid fever; d) yersiniosis; d) dysentery.
What type of inflammatory reaction is characteristic of damage to the lymphoid elements of the intestinal wall during typhoid fever? A) purulent; b) acute productive; c) fibrinous; d) hemorrhagic.
In which form of intestinal infection is exicosis most pronounced? – a) typhoid fever; b) dysentery; c) cholera; d) yersiniosis.
Which part of the intestine is affected by typhoid cholera? – a) jejunum; b) duodenum; c) blind; d) thick.
Which intestinal infections are pure anthroponoses? a) dysentery; b) cholera; c) salmonellosis; d) typhoid fever.
Indicate the possible localization of typhoid granulomas in the patient’s body at the height of the disease? – a) skin; b) brain; c) gallbladder; d) spleen; e) bone marrow; e) lung; g) kidneys; h) lymph nodes; i) adrenal glands.
Topic: Bacterial intestinal infections. Level II tests. Option 1.
List the types of coexistence of macro and microorganisms: 1…2…3…
2. List the stages of morphological changes in the intestines during typhoid fever: 1…2…3…4…5…
3. What are the main extraintestinal complications of dysentery: 1…2…3…4…5…6…
4. Name the stages (periods) in the development of cholera: 1…2…3…
List the clinical and anatomical forms of salmonellosis: 1…2…3…
Typical task.
The patient became acutely ill with high fever and intoxication. On the 10th day of illness, a roseola rash appeared on the skin of the body. On the 17th day of illness, signs of an acute abdomen were revealed and peritonitis was diagnosed. The patient died. At autopsy, deep ulcers were found in the ileum in the area of necrotic group follicles. One of the ulcers is perforated. There is fibrinous-purulent exudate in the abdominal cavity.
What disease are we talking about?
What stage of the disease was diagnosed?
What type of mesenteric lymph nodes were?
The detection of what formations in group follicles and lymph nodes of the mesentery during histological examination has diagnostic significance?
What microscopic structure do these formations have?
Topic: Bacterial intestinal infections. Level II tests. Option 4.
Name the variants of typhoid fever depending on the localization of changes in different parts of the intestine: 1...2...3...
Specify the form of exanthema in typhoid fever (localization, elements).
Specify the ways of transmission of salmonellosis: 1...2...
Name the clinical and morphological variants of salmonellosis: 1...2...
List the possible causes of death of patients with dysentery: 1…2…3…4…5…
Specify the mechanism of action of Vibrio cholerae toxin.
List the stages of cholera: 1…2…3…
Describe typhoid cholera (localization, nature of inflammation).
List the clinical and morphological variants of yersiniosis.
A 3-year-old child was diagnosed with dysentery. The diagnosis was confirmed bacteriologically. Upon admission, the patient’s condition was serious, the clinical picture of acute renal failure was increasing, which was the cause of death.
Name the strains of the causative agent of dysentery that are most common at present.
Indicate the possible localization of the process in the intestine.
Determine the nature of the pathogen’s impact on the intestinal wall.
Name the variants of the inflammatory reaction in the intestines in children.
Determine the pathogenesis of acute renal failure.
