JOURNAL OF HEPATO-GASTROENTEROLOGY RESEARCH | ЖУРНАЛ ГЕПАТО-ГАСТРОЭНТЕРОЛОГИЧЕСКИХ ИССЛЕДОВАНИЙ
№1 | 2020
91
Эргашева Муниса Якубовна,
PhD, врач ординатор Кашкадарьинской
областной инфекционной больницы.
Карши, Узбекистан
Ярмухамедова Махбуба Кудратовна
к.м.н., доцент курса инфекционных болезней
факультета последипломного образования.
Самаркандский государственный медицинский институт.
Самарканд. Узбекистан.
Локтева Любовь Михайловна
Врач вирусолог, референс лаборатория
Научно-исследовательского института вирусологии.
Ташкент, Узбекистан.
Гарифулина Лиля Маратовна
к.м.н., доцент, заведующая кафедрой
педиатрии лечебного факультета
Самаркандского государственного
медицинского института, Самарканд, Узбекистан
РОЛЬ ПОЛИМЕРАЗНОЙ ЦЕПНОЙ РЕАКЦИИ В ДИАГНОСТИКЕ ЭНТЕРОВИРУСНОЙ ИНФЕКЦИИ У
БОЛЬНЫХ С ПРОЯВЛЕНИЯМИ ОСТРОЙ КИШЕЧНОЙ ИНФЕКЦИИ
For citation:
Ergasheva Munisa Yakubovna, Yarmukhamedova Makhbuba Kudratovna, Lokteva Lyubov Mikhailovna,
Garifulina Lilya Maratovna. The role of polymerase chain reaction in the diagnosis of enterovirus infection in patients with
manifestations of acute intestinal infection. Journal of hepato-gastroenterology research. 2020, vol. 1, issue 1, pp.91-93
http://dx.doi.org/10.26739/
2181-1008-2020-1-19
АННОТАЦИЯ
В статье представлены результаты лабораторного исследования 170 пациентов с острой кишечной инфекцией
на предмет выявления энтеровирусов. Было выявлено, что значительная часть острых кишечных инфекций
представлена острой кишечной инфекцией энтеровирусной этиологии. Были определены особенности эпидемиологии
и клинической картины заболевания.
Ключевые слова:
энтеровирусная инфекция, острая кишечная инфекция, полимеразная цепная реакция
Ergasheva Munisa Yakubovna,
PhD, physician resident of Kashkadarya
regional infectious diseases hospital.
Karshi, Uzbekistan
Yarmukhamedova Makhbuba Kudratovna
Candidate of Medical Sciences, Associate Professor
of the Course of Infectious Diseases
Faculty of Postgraduate Education.
Samarkand State Medical Institute.
Samarkand. Uzbekistan
Lokteva Lyubov Mikhailovna
Doctor virologist, reference laboratory
Research Institute of Virology.
Tashkent, Uzbekistan.
JOURNAL OF HEPATO-GASTROENTEROLOGY RESEARCH | ЖУРНАЛ ГЕПАТО-ГАСТРОЭНТЕРОЛОГИЧЕСКИХ ИССЛЕДОВАНИЙ
№1 | 2020
92
Garifulina Lilya Maratovna
Candidate of Medical Sciences, Associate Professor,
Head of the Department
Pediatrics Faculty of General Medicine
Samarkand StateMedical Institute,
Samarkand, Uzbekistan
THE ROLE OF POLYMERASE CHAIN REACTION IN THE DIAGNOSIS OF ENTEROVIRUS INFECTION IN
PATIENTS WITH MANIFESTATIONS OF ACUTE INTESTINAL INFECTION
ABSTRACT
Results of a laboratory research of 170 patients with acute intestinal infection regarding identification of enteroviruses
are presented in article. It was taped that an appreciable part of acute intestinal infection is presented AII to an enteroviral
etiology. Features epidemiological features and a clinical picture of a disease were defined.
Keywords:
enteroviral infection, acute intestinal infection, polymerase chain reaction.
Introduction.
In recent years activation of an
enteroviral infection (EVI) in all regions of the world,
irrespective of their social and economic development
becomes perceptible. Often EVI is difficult to make the
diagnosis that is bound to a variety of clinical forms of illness,
which similar under traditional respiratory infections or
intestinal infections in this connection early diagnostics of
enteroviral infections and well-timed delivery of health care is
complicated. A variety of various forms of acute intestinal
infection doesn't allow us to establish the final diagnosis in this
connection laboratory confirmation of the diagnosis surely is
required. In such cases diagnostics of EVI in structure of acute
intestinal infections requires use of the polymerase chain
reaction (PCR). The most important advantage of the PCR
before other methods, is its high sensitivity allowing to define
single molecules of infectious pathogens. So, the PCR allows
to define a contagium, to carry out monitoring of geographical
distribution of options of EVI. Due to above listed by us the
work object was set: to define EVI contribution in
development of symptoms of acute intestinal infection (AII) in
patients of the Kashkadarya region of Uzbekistan.
Material and methods
: The clinical laboratory
research of 170 patients from AII on the basis of the Regional
infectious diseases hospital of Qarshi is conducted. At all
patients from AII for identification of RNA of enteroviruses
the PCR method was carried out. Excrements which got for 1-
3 days are investigated. PCR was conducted (3) at the
Reference laboratory of the Research Institute of Virology of
the Ministry of Health of the Republic of Uzbekistan by means
of the Ampli-sens Enterovirus test system (TsNIIE of Ministry
of Health of the Russian Federation, Moscow).
The results of the research and their discussion.
Results of a research showed that in fecal samples of 170
patients from AII the 73rd on identification of an EV had a
positive result that made 43%, Thus, almost each 3 and 4
patient from AII at the heart of an etiological factor of a disease
had an enteroviral infection. Among patients from aII and the
confirmed enteroviral infection children from the birth up to
18 years - 50 children (68,4%) prevailed, at the same time the
largest frequency was made by children of early age till 1 year
– 21 children (28,7%), children of 1 year to 3 years made 18
people (24,6%), there were only 4 children from 4 to 7 years
(5,4% of cases), from 8 to 14 years - 3 children (4,1% of cases),
from 15 to 18 years of 5 children (6,8% of cases) and the
remained contingent adults made, so sick from 19 to 30 years
made 11 people (15,5% of cases) and 30 years of 10 patients
(13,6%) are more senior. Thus, our data coincide with data of
literature which speak about the largest frequency of
distribution of the EVI intestinal form at children of early age.
This fact is bound to the reduced local immunity of children of
early age, especially if children don't receive or receive not
enough breast feeding, the gastro intestinal tract GIT forming
local immunity. At the same time prevalence of boys/men 43
(59%), against girls/women – 30 became perceptible (41%).
At the collecting of the epidemiological anamnesis
first of all prevailed giving not boiled raw water from open
reservoirs, even to children till 1 year of life: 32 patients
(43,8%), at other contingent were taped meal in public dining
rooms - 9 patients (12,3%), 15 mothers (20,5%) claimed that
the diarrhea at their children developed after contact to patients
with an ARD and AII.
At other sick causal factors of development of AII it
wasn't succeeded to tap (17 patients – 23,2%). When
determining the residence of patients it was taped that most of
all patients with the EVI intestinal form arrived from rural
areas. Prevalence of larger number of patients with EVI from
the rural area - 56 patients (76,7% of cases) tells about a
possible water factor of transfer of an EV .
In diagnostics of EVI detection of seasonal features
was important, it was so taped that at observation in spring and
summer – the autumn period, the greatest number of patients
with the taped EV by means of the PCR was observed in May
– 54 cases (73,9%) when comparing with patients at which the
negative result on an EV was observed, it was taped that at this
contingent of patients the greatest case rate was distributed
almost evenly in April and May months - 46,3% and 42,1% of
cases.
The disease at patients of an enteroviral etiology
generally began with All sharply 56(76,7%). Patients arrived
for 1-2 days of a disease of 29 (39,7) %, at the same time 27
(36,9%) patients 2(2,7%) for 7-8 days, 2 (2,7%) for the 10th
day were hospitalized for 3-4 days from the beginning of a
disease, 10 (13,5%) for 5-6 days, and more than put from the
beginning of a disease and 3 (4,1%) patients considered
themselves patients during the long time. The acute beginning
of a disease at the main contingent of patients will completely
be compounded with literature data (1-2).
It is necessary to notice that at patients with the EVI
intestinal form the general state was in most cases regarded as
moderately severe 50 (68,4%), but in the comparative analysis
it was taped that the number of cases with a serious current of
this form prevailed in group with a positive PCR result on an
EV (19 (25,7%) at EVI and 20 (21,05%) at patients with
negative result).
JOURNAL OF HEPATO-GASTROENTEROLOGY RESEARCH | ЖУРНАЛ ГЕПАТО-ГАСТРОЭНТЕРОЛОГИЧЕСКИХ ИССЛЕДОВАНИЙ
№1 | 2020
93
The intoxication syndrome became perceptible at all
patients from the first day of illness and lasted on average
3,72±0,46 days. High temperature of febrile character was
observed at 11 (15,06%) patients whereas the subfebrile
condition occurred at the majority 49 (67,1%) patients from
AII, normal div temperature was diagnosed at only 13
(17,8%) patients. It is compounded with data of literature (1-
2) where it is indicated the relative mild current of the EVI
intestinal form, with moderate intoxication.
The specific gastrointestinal tract disease at patients
with the EVI intestinal form in 100% of cases was
characterized by a loss of appetite, at a part of patients 7 (9,5%)
the anorexia was observed. At 17 patients (23,2%) abdominal
pains were observed. Often the diarrhea was followed by
nausea – at 18 (24,6%), vomiting – at 14 (19,1%). Almost at
all patients the liquid chair without pathological impurity from
5-6 at 32 (43,8%) patients, and till 10-12 once a day - at 13
was observed (17,8%). At only 2 patients (2,7%) of the studied
selection it was observed impurity of slime, pus and a blood in
a chair. At the same time at 12 (16,4%) patients the condition
of a serious dehydration of which the main part was made by
children of early age of 10 children (83,3%) developed.
It is necessary to notice that at 16 of 21 (76,1%) sick
adult age with EVI the accompanying pathology in the form of
chronic cholecystitis, chronic pyelonephritis, chronic gastritis,
chronic hepatitis and a helminthic invasion became
perceptible. We consider that this chronic pathology in a GIT
promotes dysfunction mucous an intestine and as a result to a
larger susceptibility of an organism as to EVI and other
intestinal infections. In group of comparison with negative
result of the PCR at 11 of 31 (35,4%) adults the accompanying
chronic pathology of a GIT was observed.
From background diseases the larger frequency of
anemia of serious degree at patients with the EVI intestinal
form attracts attention. Perhaps, this fact is one of EVI
provoking for more mild perception as anemia promotes
depression of immunobiological properties of an organism. So
anemia frequency degrees 3 made a half of cases of
observations 37 (50,6%), at the same time there were 24
patients with the 2nd degree of anemia (32,8%), only 11 (15%)
cases patients with mild degree of anemia made and at only 1
(1,3%) the patient a hemoglobin within norm was observed.
When comparing with group with negative result of the PCR
it was taped that the number of patients with serious anemia
made in this selection 35 (36,8%), moderately severe anemias
of 42(44,2%), mild degree 15 (15,7%) and at 3 (3,1%) a
hemoglobin was within norm.
Conclusions:
In structure of patients from AII at 43%
positive takes of the PCR on existence of an EV were taped, at
the same time children till 1 year prevailed. The major causal
factor of distribution of EVI were giving raw unboiled water
from open reservoirs in rural areas that speaks about a possible
water factor of transfer of an EV. The disease was
characterized by an acute current and moderate severity
against the background of anemia of serious degree.
Список литературы/References
1. Lukashev A. N., Ivanova O. E., Khudyakova L. V. The social and economic importance of an enteroviral infection and its
role in structure of infectious pathology in the world //Journal of microbiology, epidemiology and immunobiology — 2010. —
No 5 — Page 113-120. (In Rus.).
2. Musabayev E. I., Nazarova R.P., Bayzhanov A. K., Kasimova R. I. Enteroviral infections etiology, clinic, diagnostics,
treatment. Methodical Recommendations Tashkent.-2010. – (In Rus.).
3. Poklonskaya N. V. et al. Use of various modifications of a method of a polymerase chain reaction at diagnostics of enteroviral
infections//Medical news, 2004. - No. 1, P. 13-16. (In Rus.).
