Method of estimating microbial risk of development of bacterial intestinal infections transmitted by water way in case of direct release of causative agent of acute intestinal infections from water intended for different purposes

FIELD: medicine.

SUBSTANCE: bacteriological analysis of water by normalised indicators is performed with determination of pathogenic bacteria, additionally during water analysis determined are potentially pathogenic bacteria and their pathogenic and virulent properties, obtained data are used to estimate probability of infectious process development in people by formula: Hpatogen=(C•(100-Pt)•V•v/r)•T. After that, calculated is integral index of probability of development of bacterial intestinal infections transmitted by water way with direct release of causative agents isolated and identified during microbiological analysis of water by formula: After that, risk of development of bacterial intestinal infections transmitted by water way is carried out, it is considered to be acceptable if its value does not exceed 1x10-5, and microbial risk of development of bacterial intestinal infections transmitted by water way is considered to be low. If its value is from 1x10-5 and lower, microbial risk of development of bacterial intestinal infections transmitted by water way is considered to be high. If its value constitutes more than 1x10-5, risk of water contamination with pathogenic and potentially pathogenic microflora is estimated at population level by formula: Rp=Rv•100000.

EFFECT: application of claimed method makes it possible to reduce or prevent development of intestinal diseases and makes it possible to predict probability of BII development with direct release of bacterial causative agents from water for various purposes, taking into account their species composition and biological properties.

1 ex, 2 tbl

 

The present invention relates to medicine, more specifically to work on the epidemiological assessment of water for various purposes in order to prevent intestinal infections, waterborne, and allows on the basis of the determination and identification of microorganisms isolated from water for various purposes, conducting risk estimation and forecasting the incidence of intestinal infections of the population.

Morbidity of acute intestinal infections is beyond the scope of issues to be addressed by health care, and is directly related to the protection of the environment, improvement of environmental conditions and, in particular, supplied drinking water. One of the most important factors in the spread of infectious diseases is a water transmission, the probability of which in modern conditions is considerably expanding and represents a serious epidemiological problem (Rachmaninov Y.A., 2006; GP Craun and other, 2002 and others). According to UNESCO, more than 80% of human diseases are associated with water quality. The economic damage from the use of poor quality drinking water is hundreds of billions of dollars (Onishchenko GG, 2001).

Evaluation of epidemic risk associated with changes in species composition and biological properties of microbiocenosis under the influence of anthropogenous the CSO pollution, is one of the urgent problems. A number of studies revealed that in areas with higher levels of environmental pollution are often infectious disease with atypical signs of biochemical and genetic properties (Ginsburg A.L., 2006, Bondarenko V.M., 2004; Talaia YG 1973-2009; bayazitova LT, 2009 and others). This etiological significance can purchase a variety of "opportunistic" pathogens (Emelyanov I.G., 1994). The list of "legitimate" and potential pathogens of humans continuously replenished by yesterday's saprophytes (V.A. Pokrovsky, 2004; Prokopyeva M.V., 2004; Palkina S.V., 2004; Nilov LU, 2009), which often are pathogenic, virulent and antibiotic-resistant properties.

Development of a method of assessing the microbial risk associated with the spread of the causative pathogenic and potentially pathogenic taking into account the characteristics of the pathogens, as well as the infective dose and the time of development of infectious process, is one of the urgent problems in both scientific and practical terms.

The closest analogue of the prior art is not revealed.

The technical purpose of this invention is to reduce or prevent the incidence of intestinal infections associated with microbial contamination of water with p is izlagaemogo way through the many qualitative features with reliable probability forecast.

The technical result is achieved in that the method of assessing the level of microbial risk of bacterial intestinal infections transmitted by water with the direct allocation of the pathogen, includes bacteriological analysis of water by standardized indicators with the definition of pathogenic bacteria and additionally for the analysis of water to determine potentially pathogenic bacteria and pathogenic and virulent properties, the data and assess the likelihood of human infection by the formula:

Hpatogen=(C·100-Pt)·V·ν/r)·T,

where

Hpatogen- the likelihood of human infection; V is the volume consumed by the individual fluid contaminated with foodborne bacterial gastrointestinal infections (conditionally on who is considered to be the 1 liter); Pt- purification of water from a specific pathogen to establish an acceptable risk; ν - generation bacterial growth; r - infective dose for a specific pathogen intestinal infections; T - time development of infectious process with regard to manifestations of bacteria pathogenic and virulent properties, then carry out the calculation of the integral indicator of the probability of occurrence of bacterial intestinal infections transmitted by water with the direct allocation of pathogens isolated and identifier the bathrooms when conducting microbiological analysis of water according to the formula:

,

where

Rν- the integral indicator of the probability of occurrence of bacterial intestinal infections transmitted by water with the direct allocation of pathogens isolated and identified when conducting microbiological analysis of water, M is the number of intestinal agents used in the assessment of sanitary conditions affecting the quality of drinking water; i - ordinal indicator; Xi- share index; Hpatogenis an indicator of the likelihood of bacterial intestinal infections in contamination of the water of pathogenic and potentially pathogenic microflora; W is the sum of the weights Xi, Rν- the integral indicator of the probability of occurrence of acute intestinal infections in contamination of water by pathogens of water-related infections, then assess the risk of water contamination by pathogenic and potentially pathogenic microflora at the population level by the formula:

Rp=Rν·100000

where

Rνwith the direct selection pathogens were isolated and identified when conducting microbiological analysis of water; Rp- population risk, 100000 - calculation of population risk is 100,000 thousand people.

Method of assessment microbial risk including the AET such qualitative characteristics of microorganisms, as their pathogenic and virulent properties, i.e. the ability of microorganisms present in the water at a certain infective dose, initiate the infectious process in humans, especially with a weakened immune status.

The proposed method is implemented as follows.

Water quality assessment is performed on the normalized indicators under current law for the particular type of water taking into account not only pathogenic microorganisms (Salmonella, Shigella), but also potentially pathogenic micro-organisms (Klebsiella, and Pseudomonas), as well as identifying their pathogenic and virulent properties.

Currently, in accordance with the regulations determined by such factors as OKB (gram-negative, oxidatively that do not form spores, bacilli, able to grow on differentiated lactose environments, fermenting lactose to acid, aldehyde and gas at a temperature of 37°C)TKB (growth at 44°C) and coliphages. Use only ectoparasiticide representatives of the family Enterobacteriaceae exclude from consideration many species of bacteria, particularly Salmonella and Klebsiella, as shown by our research, most of which have the properties of pathogenicity and virulence, i.e. the ability to represent the risk of bacterial intestinal infections (BCI) in contact to identify Alannah doses in the human body. A false-positive result bacteriological analysis does not allow accurate prediction of the occurrence of the KJV. The hypothesis confirms that bacterial quality analysis of various types of water you need to consider and identify potentially pathogenic bacteria (Klebsiella, pseudomonad and other potentially pathogenic bacteria) as risk factors.

The results of experimental studies have paved the way to a fundamentally new solution to the question of the dependence between the level of bacterial contamination of water and the degree of risk of intestinal infections in the population, spreading through water.

Conducted research to identify the species composition of pathogenic and potentially pathogenic bacteria, as well as their biological activity has allowed us to develop a method for assessing the microbial risk of bacterial intestinal infections transmitted by water under the direct isolation of causative agent of acute intestinal infections of the water for various purposes, and to predict the likelihood of bacterial intestinal infections in the use of poor quality water for drinking, household and recreational purposes.

For the mathematical representation of the occurrence of infectious p is ocess, which initiate the microorganisms present in water sources and considered independently from each other, the most frequently used methods for the Poisson distribution (Meynell et all. 1968) or logarithmic normal distribution (Mechalas, 1972). The emergence of infectious process is characterized by a single parameter p, which plays the likelihood of BCI caused by each organism.

In the Handbook on drinking water (Geneva, volume 3, section 7) section to assess the biological risk presents a model for calculating the risk of infection on the content in the river water of some microorganisms (cryptosporidia, Campylobacter and rotavirus). In the present work on the basis of experimental data, the model who improved.

Example: the Proposed method is tested on the material collected data (table 1).

When conducting microbiological analysis of water was isolated and identified 2 colonies of Klebsiella related to potentially pathogenic bacteria Hpatogen=(2·(100-99,999)·1·0,15):100·24=7,7×10-5where 100-99,999=10-3(water purification for the establishment of acceptable risk); ν generation of bacterial growth 0.15; 100 - infectious dose by Klebsiella, resulted from studies in volunteers, the 24 h time once the development of infectious process with regard to manifestations of bacteria pathogenic and virulent properties and one colony found H patogen=(1·(100-99,999)·1·0,62):100·24=1,5×10-4where 100-99,999=10-3(water purification for the establishment of acceptable risk); ν generation of bacterial growth is equal to 0.62; 100 - infectious dose for Pseudomonas established by calculating the Poisson, 24 h - time development of infectious process with regard to manifestations of bacteria pathogenic and virulent properties. Rν- the integral indicator of the probability of occurrence of acute intestinal infections in the water: 2 colonies of Klebsiella and 1 colony pseudology equal to Rp=Rν·100000=6,1 per 100 thousand population (see table 1).

In the experimental studies were calculated constants generation of bacterial growth of some microorganisms (table 2). The use of the constant generation of bacterial growth gave an opportunity with greater reliability to calculate the likelihood of human infection with consideration of the properties of the pathogen (BCI).

In accordance with the guidelines for drinking-water quality [Recommendations, who, Geneva, 2004] recommended value acceptable level of microbial risk of bacterial intestinal infections that spread through water, is 1×10-5all risk values below this level is a low level of microbial risk value is of above this level is a high level of microbial risk of bacterial intestinal infections, propagating through water.

The data obtained show prospects for the use of the developed method to assess the level of microbial risk, to predict the likelihood of bacterial intestinal infections with the direct allocation of bacterial pathogens from water of different types of water use, taking into account changes in their species composition (pathogenic and potentially pathogenic bacteria) and biological properties.

Table 1
The calculation of the risk assessment of microbial contamination of water with the direct selection potential pathogen from water of different water
no water sampleMicrobial contamination by KlebsiellaThe likelihood of BCIMicrobial contamination by PseudomonasThe likelihood of BCIThe total risk of the KJVPopulation risk per 100 thousand population (1/year)
1. Moscow region, Bolshevo (drinking well)21of 1.5×10-4of 6.1×10-56,1
2. The river Pakhra, Moscow region, Podolsk district, the village of Krasnaya Pakhra river (below the town, 300 m from the discharge of wastewater)4of 1.5×10-423×10-4of 2.6×10-426
3. Pond water (the convent)3of 1.1×10-446×10-44,8×10-448
4. Waste water after disinfection (Kurianovskaya WWTP)197,3×10-411of 1.64×10-3of 1.4×10-3141,25
5. Voskresensk, Moscow region (a well on the outskirts of the village)5of 1.9×10-400 the 5.7×10-5the 5.7

Table 2
Constant generation of bacterial growth of some microorganisms, obtained experimentally and their weights
Pathogens OKAEscherichiaKlebsiellaFoundStaphylococcusSalmonella, Shigella
Constant generation of bacterial growth0,180,150,620,190,28
The weighting factor Xi0,10,511,52

Method of assessment microbial risk of bacterial intestinal infections transmitted by water with the direct allocation of the pathogen, including bacteriological analysis of water by standardized indicators with the definition of pathogenic bacteria and additionally for the analysis of water to determine potenziale pathogenic bacteria and pathogenic and virulent properties, according to the data, assess the likelihood of human infection by the formula:
Hpatogen=(C·(100·Pt)·V·ν/r)·T,
where Hpatogen- the likelihood of human infection; V is the volume consumed by the individual fluid contaminated with foodborne bacterial gastrointestinal infections (conditionally on who is considered 1 l); Pt- purification of water from a specific pathogen to establish an acceptable risk; ν - generation bacterial growth; r - infective dose for a specific pathogen intestinal infections; T - time development of infectious process with regard to manifestations of bacteria pathogenic and virulent properties, then carry out the calculation of the integral indicator of the probability of occurrence of bacterial intestinal infections transmitted by water with the direct allocation of pathogens isolated and identified when conducting microbiological analysis of water according to the formula:
,
where Rν- the integral indicator of the probability of occurrence of bacterial intestinal infections transmitted by water with the direct allocation of pathogens isolated and identified when conducting microbiological analysis of water; M - the number of intestinal agents used in the assessment with the nitarno hygienic conditions, affecting the quality of drinking water; i - ordinal indicator; Xi- share index; Hpatogenis an indicator of the likelihood of bacterial intestinal infections in contamination of the water of pathogenic and potentially pathogenic microflora; W is the sum of the weights Xi, Rνwith the direct selection agents, selected and identifitsirovannykh when conducting microbiological analysis of water, then assess the risk of bacterial intestinal infections that spread through water, the microbial risk of bacterial intestinal infections that spread through water, is considered acceptable if its value does not exceed 1·10-5the microbial risk of bacterial intestinal infections that spread through water, is considered low, if its value is 1·10-5and below, the microbial risk of bacterial intestinal infections that spread through water, is considered high if its value is greater than 1·10-5then assess the risk of water contamination by pathogenic and potentially pathogenic microflora at the population level by the formula:
Rp=Rν·100000,
where Rν- the integral indicator of the probability of occurrence of acute intestinal infections in Contamines is the water pathogens of water-related infections; Rp- population risk, 100000 - calculation of population risk is 100,000 thousand population.



 

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