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Epidemiology and Vaccinal Prevention

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Vol 20, No 5 (2021)
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PROBLEM-SOLVING ARTICLE

4-20 1204
Abstract

Relevance. Currently, the national calendar of preventive vaccinations does not provide for revaccination against whooping cough in children over the age of 18 months. At the same time, the epidemiological and economic feasibility of revaccination against whooping cough in children aged 6–7 years, as well as adolescents, has been demonstrated in world practice. Aim. Based on a mathematical model, develop a forecast of pertussis morbidity dynamics and assess the potential socio-economic damage under the current and expanded vaccine prophylaxis algorithms.

Methods. Mathematical modeling of the potential effect of revaccination against whooping cough in children aged 6–7 years (scenario 1) and at 6–7 years and 14 years (scenario 2) was carried out within the framework of the national calendar of preventive vaccinations. A simulation dynamic mathematical model is constructed that allows predicting the development of the epidemiological process of whooping cough on the basis of the dynamics of the main indicators of its prevalence in the population that developed in previous years. The model took into account dynamic changes in the preventive effectiveness of vaccinations and the potential level of underestimation of morbidity. The obtained arrays of indicators served as the basis for extrapolating trends in morbidity and mortality until 2034.The calculation of epidemiological benefits was carried out in the metrics of prevented loss of years of life under the two scenarios under consideration in comparison with the current vaccination algorithm. The calculation of the economic effect was carried out on the basis of the obtained indicators of epidemiological benefits in the metrics of the monetary equivalent of the average cost of a year of life, taking into account the projected inflation coefficients until 2034.

Results. The projected decrease in the number of years of life lived in a state of illness, in comparison with the current situation, will total 44.5 thousand years for the period 2019–2034 under scenario 1 and 66.7 thousand years under scenario 2. The socio-economic damage from prevented cases of the disease, expressed in the monetary equivalent of the average cost of living, will decrease by 28.6% (scenario 1) or 42.0% (scenario 2).

Conclusions. A comparison of the received public benefits with the costs of vaccination shows that the expansion of the NCPP with additional revaccinations against whooping cough (at 6–7 years or at 6–7 and at 14 years) is advisable both in epidemiological and economic aspects.

ORIGINAL ARTICLES

21-31 1016
Abstract

Relevance. The success of the global community in the fight against measles through vaccination at the beginning of the twentyfirst century allowed WHO to declare the goal of eliminating this infection by 2010. However, ten years later, the problem of the growing incidence of measles has become relevant again for all countries of the world. The pandemic of the new coronavirus infection (COVID-19) has affected all spheres of human life and has exacerbated the situation in the fight against other infections, including those managed with the help of specific prophylaxis. Since the measles contagiosity index and mortality rate are significantly higher than similar characteristics of COVID-19, the risk of increasing the incidence of this infection in the coming years is difficult to overestimate.

Aim of the study: to assess the epidemic situation of measles in the context of the COVID-19 pandemic, as well as the prospects for its development; to propose preventive measures.

Materials and methods. The article analyzes the statistical materials available on the official websites of the WHO (WHO). https://www.who.int/data/), the CDC US (https://www. cdc.gov) and the Federal Service of Rospotrebnadzor (https://www.rospotrebnadzor.ru/) on vaccination coverage and measles incidence in 13 countries in the WHO European Region and the United States. The epidemic situation on measles, as well as the level of population coverage with vaccination against its pathogen in the Russian Federation, were assessed according to the Federal State Statistical Observation forms 2010 – 2020: Form 2 «Information on infectious and parasitic diseases» and Form 6 «Information on the populations of children and adults vaccinated against infectious diseases».

Results. It has been established that the increase in the measles incidence occurred in 2017–2019 worldwide, including European countries with a population coverage of two vaccine doses at the 97% level between 2010 and 2019. The prevalence of measles cases in children under the age of 10 is shown, as well as the wide range (from 56.9% to 10.9%) in the proportion of vaccinated persons among them. The results obtained indicate the existence of problems in the organization of modern vaccine prevention. The introduction of widespread restrictive and quarantine measures against the COVID-19 pandemic, on the one hand, has reduced the incidence of measles and, on the other hand, has exacerbated the difficulties in implementing measles prevention. Thus, the results indicate a possible increase in measles incidence in the population after the end of the COVID-19 pandemic.

Conclusion. It is necessary to immediately develop an action plan to catch up on the coverage and increase the rate of routine vaccination, to improve the statistical record of persons subject to the introduction of the vaccine and vaccinated, as well as to overcome anti-vaccination attitude among the population.

32-38 999
Abstract

Relevance. The novel coronavirus pandemic is a major burden on public health and healthcare professionals. The study of the prevalence of antibodies among medical workers provides an understanding of the potential risk of transmission of the infectious agent, the level of herd immunity, the introduction of specific immunization and risk stratification in various areas of professional activities.

The purpose of this study was to assess the level of specific antibodies to SARS-CoV-2 in the personnel of the medical and sanitary unit, providing the population with outpatient and inpatient medical care.

Materials and methods. A study to assess seroprevalence to the SARS-CoV-2 virus was carried out in the Omsk region from September 2020 to December 2020. The study included 2 groups of employees of continuously operating organizations – the main group – employees of the medical and sanitary unit of the city of Omsk (n = 631), the control group consisted of employees of two industrial enterprises in the city of Omsk (n = 1696). The level of class G immunoglobulins to the SARS-CoV-2 virus was determined by enzyme-linked immunosorbent assay.

Results. Among medical workers, the proportion of people with a positive reaction to IgG was 73.1% (n = 461; 95% CI 69.5–76.4%). In the control group, the proportion of those who were seropositive was 3.9 times less than that – 18.6% (n = 315; 95% CI 16.8–20.5). Significant differences in seroprevalence in men and women were revealed in medical workers (χ2 = 4.164; p = 0.0413). The highest proportion of seroconversion was found in nursing staff – 85,4% (95% CI 71.6 – 93.1), in doctors – 63.3% (95% CI 55.0–70.9). The highest rate of seroprevalence was found among hospital medical workers – 81.9%, the lowest among employees of the administrative and economic service – 51,8%.

Conclusions. The level of specific antibodies to SARS-CoV-2 among medical workers significantly exceeded that of other professional groups, and there was a high proportion of seroconversion among junior medical personnel and in-patient medical unit workers.

39-51 807
Abstract

Background. The COVID-19 pandemic has become a serious challenge for all of humanity due to the rapid global spread, high frequency of severe forms, increased mortality and required the development of new approaches to managing epidemiological processes. Serological studies are the most important tool for monitoring the infectious process, identifying risk groups, assessing the effect of vaccines used and epidemiological projections.

Purpose. Conducting serological monitoring in relation to the modern transferred new coronavirus infection determining the level and structure of population immunity to SARS-CoV-2 in the population of the Republic of Tatarstan; maintaining the period of spread of COVID-19 from August to December 2020.

Materials and methods. The study involved 41 444 residents of the Republic of Tatarstan, who filled out questionnaires that included clinical, anamnestic data and an epidemiological history in relation to COVID-19, who were tested for the presence of common antibodies (IgG, IgA and IgM) to the SARS coronavirus. CoV-2 by the method of enhanced chemiluminescence on the VITROS 3600 analyzer using the VITROS Anti-SARS-CoV-2 Total Reagent Pack test systems.

Statistical processing was carried out by methods of variation statistics and correlation analysis according to the Pearson method using MS Excel and WinPepi.

Results. Seropositivity to SARSCoV-2 in the population of the Republic of Tatarstan averaged 35.8 ± 0.235%. An increase in the level of seropositive persons was noted from 29.95 ± 0.674% in August to 68 ± 9.33% in December. The highest proportion of seropositive individuals was found in was found in the group of the able-bodied population aged 18–59 years. The average geometric titer of antibodies was 4.2 (4.09–4.31), among seropositive – 89.29 (88.13–90.46). In the social and professional structure of the population, the largest proportion of seropositive individuals was found in was found among production workers 40.35 ± 2.177, creative professions – 40 ± 9.798; health care 35.24 ± 0.389; 34.26 ± 1.218 unemployed and 33.06 ± 2.479 civil servants. Among the residents of the Republic of Tatarstan, seropositive to the SARS-CoV-2 virus, the proportion of asymptomatic forms of infection was 82.59 ± 0.446%.

Сonclusions. There is a positive dynamics of seropositivity among the population of the Republic of Tatarstan. The results of sero-epidemiological monitoring can be used to predict the epidemiological situation, plan measures for specific and non-specific prophylaxis of COVID19.

52-60 1807
Abstract

Background. The vaccine is the best available instrument to prevent influenza and reduce the risks of major disease complications and mortality. The vaccine effectiveness during the influenza season depends on a number of factors: (1) a person vaccinated (their age and health status); (2) the vaccine formulation; (3) types and subtypes of the circulating viruses; (4) vaccination timeline, as the immune response fades over time. An influenza vaccine can yield different effectiveness in people who have been infected or vaccinated previously and in those who have not been yet exposed to the circulating viruses. At present, trivalent and quadrivalent influenza vaccines are registered and produced in Russia. It allows for vaccination of all social groups, including high-risk populations, and for increasing the number of vaccinated individuals yearly. Russian Federation constantly improves the production of influenza vaccines, introducing new variants of vaccine formulations into national clinical usage. It is thus essential to monitor and analyze the changes in the effectiveness of influenza vaccines every season.

Aim of the study. To evaluate of the effectiveness of Russian domestic influenza vaccines during the epidemic season 2019–2020 in St. Petersburg compared to the season 2018–2019.

Materials and Methods. 3315 female and male adult participants aged 18 years and older were monitored from October 2019 to March 2020. The group included university students and tutors, researchers, and production and office workers of industrial enterprises. Sovigripp, Grippol Plus, Ultrix, and Ultrix Quadri influenza vaccines were used for immunization.

Results and Discussion. In the context of incomplete correspondence between the viruses circulating in Russia and the strains used in the vaccines, the vaccination of the St. Petersburg population during the epidemic season 2019-2020 with Sovigripp, Grippol Plus, Ultrix, and Ultrix Quadri influenza vaccines cumulatively reduced influenza and ARI incidences by half; the total vaccine effectiveness against influenza and ARI amounted to 50.0%. The strongest preventive effect was identified for Grippol Plus, Ultrix, and Ultrix Quadri which demonstrated the total vaccine effectiveness from 70.6% to 75.0%, and their effectiveness against influenza A and B viruses reached from 65.5% to 83.5%.

Conclusion. In the context of incomplete correspondence between the viral strains used in the vaccines and the strains circulating in Russia and St. Petersburg during the epidemic season 2019- 2020 and considering the active circulation of non-influenza viruses such as rhinoviruses and adenoviruses, we found a moderate preventive effectiveness of the influenza vaccines during the seasonal epidemic increase in ARI cases. Russian domestic influenza vaccines were shown to have good acceptability, be safe, and non-reactogenic.

61-68 655
Abstract

Relevance. The risk of developing complications of an epidemiological nature for especially dangerous infections is determined by the possibility of importing an infection from disadvantaged countries, which depends on many factors, including the migration activity.

Aim. To analyze the external risks of cholera importation into Primorsky Krai by various modes of transport.

Materials and methods. Data of the Federal Service for Surveillance on Consumer Rights Protection and Far Eastern territorial department Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing by railway transport was used. The analysis of the incidence of cholera in the world was carried out according to the WHO, the Reference Center for Monitoring Cholera in the Russian Federation, the Internet resource ProMED-mail.

Results and discussion. During the analyzed period (2015–2018), 311,435 vehicles (automobile transport – 87.4%, sea transport – 7.7%, air transport – 4.3%, railway transport – 0.6%) and more than 5 million people arrived in Primorsky Krai from abroad. Analysis of passenger flows by all modes of transport showed that Asian destinations dominate.

Conclusion. Evaluation of the epidemiological situation of cholera in the Southeast Asian countries does not rule out the risk of cholera importation into Primorsky Krai, given the high intensity of migratory activity. No conflict of interest to declare.

69-78 1283
Abstract

Relevance. In the Russian Federation, in recent decades, there has been a decrease in the incidence of hepatitis A (HA), at the same time, not only sporadic morbidity is registered, but also an outbreak. A decrease in the circulation of the HA virus affected the increase in the number of people without antibodies to the virus, which led to a shift in the incidence to older age groups and an increase in more severe forms of the disease. Hepatitis E (HE) is quite widespread in the world, and its specific weight in the structure of acute viral hepatitis in some countries reaches 50.0%. HE has been registered in the Russian Federation only since 2013. only in certain territories, and the incidence rates are very low. In all likelihood, this indicates a hidden circulation of the HE virus in the Russian Federation. To understand the current epidemiological situation in the incidence of HA and HE, it is necessary to understand the current trends in the epidemic process of these infections. The purpose of this work was to compile an epidemiological characteristic of the incidence of hepatitis A and E in the population of the Russian Federation at the present stage for the formation of proposals for improving the system of preventive and anti-epidemic measures.

Materials and methods. To achieve this goal, a retrospective epidemiological analysis of the incidence of viral hepatitis A and E in the territory of the Russian Federation, including in federal districts, was carried out. The materials for the study were the forms of official statistical observation No. 2, 5, 6 and 23, as well as state reports «On the state of sanitary and epidemiological well-being» in the Russian Federation region for 2011–2020.

Results. The conducted research allows us to compare the epidemic process of hepatitis A and E in the Russian Federation with other regions of the world. The intensity of the epidemic process of HA has significantly decreased, at the same time, there is an uneven distribution of morbidity in various federal districts. In the age structure of patients with HA, the highest incidence rates are observed among the child population and adolescents. The frequency of HA infection and a decrease in the specific weight in the structure of acute viral hepatitis were revealed. Although the territory of the Russian Federation is not endemic for hepatitis E, this disease has taken root completely. The incidence of hepatitis E in the Russian Federation is at a sporadic level. The highest incidence of HE in the Russian Federation was observed among the adult population aged 18 years and older. The issue of carrying out preventive measures, including vaccination, remains relevant.

Conclusion. On the territory of the Russian Federation, there is currently a steady trend of reducing the incidence of hepatitis A. However, children under the age of 14, adolescents, as well as nonimmune adults, among whom cases of diseases are registered, are still at risk. This requires adjusting the methods of preventing this infection, which is possible not only by improving sanitary and communal improvements, but also by vaccination within the national vaccination calendar, and not only for epidemic indications. The true incidence of HE today is obviously much higher than that recorded in official statistical forms, and this requires the introduction into clinical practice (especially at the polyclinic level) of modern available tests for detecting markers of the hepatitis E virus when examining patients with symptoms of liver damage, as well as the development of effective prevention methods.

79-88 808
Abstract

Relevance. Monitoring the genotypic diversity of the hepatitis C virus as well as its prevalence in the population, including in certain population groups, is an important public health task.

Aim. To analyze main epidemiological indices (incidence and prevalence) among people living with HIV and evaluate abundance of chronic hepatitis C among them, reveal molecular-genetic distribution of hepatitis C virus (HCV) isolated from HIV-positive people living in the Far Eastern Federal district (FEFD) of the Russian Federation.

Materials and methods: a retrospective epidemiological analysis including estimation of HIV-infection incidence and prevalence as well as percent of HIV-positive people suffering from chronic viral hepatitis C was conducted for nine constituent entities of the FEFD. Molecular genetic analysis included evaluation of 120 samples of serum positive for HCV RNA that was obtained from people diagnosed with HIV-infection. A type-specific commercial PCR test-kit as well as partial sequencing by Sanger of HCV NS5B gene (241 bp and 350 bp) were utilized in order to specify HCV genotypes.

Results and discussion: in total 26.26% of people living with HIV were registered for regular medical examination due to chronic hepatitis C in the FEFD in year 2019. Their percentage has grown over a 5-year period. Dominant HCV subtype among surveyed HIV-positive people was subtype 3a followed by HCV subtype 1b. HCV genotype 2 and subtype 1a were detected less frequently and were identified as minor genotypes. Genotype distribution among people aged under 35 years was more significant in comparison with older citizens. Some regional particularities were discovered. For example, HCV genotype 2 was registered more frequently in the Khabarovsk krai compared to mean estimated value of the sampling collection. Subtype 1b was dominant in Republic Sakha (Yakutia).

Conclusion: an increase in percent of HIVinfected people suffering from chronic hepatitis C has been noted during a 5-year period. Should be noted that the value varies in different constituent entities ofthe FEFD. Molecular-genetic analysis showed general prevalence of HCV 3a subtype while 1b HCV subtype is dominant in the Russian Federation in patients suffering from HCV-monoinfection as well as in those infected with HIV and HCV.

PRACTICAL ASPECTS OF EPIDEMIOLOGY AND VACCINE PREVENTION

89-97 953
Abstract

Relevance. Prevention of the outbreak of a new coronavirus infection in medical organizations (MO) is one of the tasks facing the Rospotrebnadzor service and practical health care. Analysis of the causes and conditions of the spread of SARS-CoV-2 in the MO allows us to determine the most effective measures to contain the infection and prevent the occurrence of subsequent diseases in the focus.

The aim is to characterize the epidemiological features of a new coronavirus infection during its nosocomial spread in medical organizations based on the analysis of outbreak incidence.

Materials and methods. The data of the reporting forms «General information on patients with positive COVID-19», «General information on patients with community-acquired pneumonia with positive COVID-19» (138 pieces of information), copies of «Acts of epidemiological investigation of foci of infectious (parasitic) diseases with the establishment of a causal relationship» (57 pieces of information), copies of extraordinary reports on an emergency of a sanitary and epidemiological nature (57 pieces of information) were analyzed. The work uses epidemiological and statistical methods of research.

Results. When analyzing 57 COVID-19 outbreaks in 30 medical organizations, it was found that the outbreak incidence was more often registered in multidisciplinary hospitals – 70.2% compared to 12.3% in specialized organizations of noninfectious profile, 10.5% of outbreaks were in polyclinics, 1.8% at emergency medical stations. The total number of people affected by the spread of the infection was 961, with a small proportion of children (15 people or 1.7%). Among those who fell ill with the spread of infection in the foci, the share of employees of medical organizations was 62.6%, including doctors – 16.6%, middle and junior medical workers-50.6% and 11.3%, respectively, and other categories – 21.5%. In nosocomial outbreaks of COVID-19, the focality index corresponded to 16.9, and the average duration of the focus was 32.4 days. The construction of the so-called «combined» outbreak diagram in the course of the epidanalysis allowed us to establish its total duration, which was 71 days, with the peaks of morbidity within the outbreak at intervals of 3–7 days, the greatest number of cases in the 1st and 8th days, and the gradual «extinction» of its activity in dynamics.

Conclusions. The outbreak of COVID-19 in medical organizations usually occurred when there was an epidemic problem with COVID-19 in the territory. The peculiarity of nosocomial outbreaks was a significant proportion of adults (98.3%), mainly employees of medical organizations, who were often active sources of infection, as well as the involvement of structural units and hospitals for adults in the epidemic process, a high frequency of etiological interpretation of outbreaks (95.9%), a significant proportion of asymptomatic forms of infection and carrier, and the complexity of differential diagnosis of cases of out – of-hospital and nosocomial infection. The patterns of occurrence and spread of morbidity in medical organizations can be used in practical anti-epidemic work.

98-106 734
Abstract

Relevance. The geographical spread of HIV infection among the population of various administrative territories is very heterogeneous. The Tyumen region, due to its vast territory and the significant remoteness of some areas from the regional center, is of particular interest in the framework of considering the territorial features of the spread of HIV.

Aims. To consider peculiarities of the spread of hiv infection among urban and rural residents of the Tyumen region in 1993–2019.

Materials & Methods. Statistical data of the «Center for the Prevention and Control of AIDS» in the period from 1993 to 2019, annual form No. 61 «Information on the contingents of HIV patients» for 2006–2019, materials of the state report «On the sanitary and epidemiological situation in the Tyumen region» for 2013–2019. Methods of epidemiological observation were used in the work: analytical and descriptive-evaluative with the use of methods of retrospective and operational analysis and statistical methods.

Results and Discussions. A specific feature of the spread of HIV infection among urban and rural residents is the tendency to exceed the regional incidence rate in a number of territories. Analysis of epidemiological data for the period under review showed that all territories of the region are involved in the epidemiological process of HIV infection, and in a number of territories the prevalence rate exceeds the average Russian level. HIV prevalence as of December 31, 2019 was 728.2 per 100 thousand people in Russia. In 17 administrative territories of the Tyumen region the infection rate is higher than the national average level and is per 100 thousand population in the city of Tobolsk – 1903.3, in the districts of Uvat – 1486.2, Tobolsk – 1440.5, Nizhnetavda – 1354.9, Tyumen – 1344.1, Yalutorovsk – 1327.6), in the city. Tyumen – 1249.3, in the districts: Vagay – 1195.2, Zavodoukovsky – 1119.2, in Ishim – 951.8, in the districts: Yarkovsky – 889.6, Vikulovsky – 881.3, Yurginsky – 846.9, Ishimsky district – 842.1, Aromashevsky – 851.6, Isetovsky – 754.4, Uporovsky district – 734.7.

Conclusions. The HIV epidemic in the Tyumen region is determined by its economic and geographic location and by the presence of exceptional epidemiologically significant prerequisites for the intensive spread of HIV, in particular, by the routes through which large quantities of drugs are illegally transported (drug trafficking from the northeast).

107-114 739
Abstract

Relevance. Miscarriage is one of the most common obstetric pathologies that determine the spontaneous death of the fetus. The role of changes in the microbiome of various biotopes is considered as a risk factor of this disease.

Aim of the research is to assess the microbiocenoses structure of the reproductive system and the intestine associated with the development of spontaneous miscarriages in early pregnancy.

Materials and methods. A case-control study was conducted and organized. The group of «cases» included 23 women with spontaneous miscarriage at 5–14 weeks of pregnancy and the control group included 23 women with normal pregnancies Based on the data of metagenomic sequencing of V3–V4 regions of the 16S rRNA gene, a comparative assessment of the structure of the vaginal and intestinal microbiome in these groups was carried out.

Results. As a result of the study, a number of taxonomic groups of microorganisms in the vagina and intestines associated with miscarriage. It was found that the decrease in the proportion of Lactobacillus spp. in the structure of the vaginal microbiome, less than 90% of the total number of identified taxa is associated with this pathology (OR = 5.28 (95% CI = 1.2-23.2)). The gut microbiocenoses of women with spontaneous miscarriage are characterized by less taxonomic diversity than the gut microbiome of women with advanced pregnancy. At the same time, some representatives of the intestinal microbiome (Akkermansia sp., Faecalibacterium sp., Bifidobacterium sp., Methanobrevibacter sp., Lactococcus sp.) predominate in women with a normal pregnancy.

Conclusion. The study demonstrated a significant role of changes in microbiocinosis of the reproductive tract and intestines in miscarriage. There is a potentially protective function of lactobacilli. The obtained data substantiates the need for active use of molecular genetic methods focused on the assessing the structure of the vaginal and intestinal microbiota in assessing the risks of reproductive failures.

115-122 674
Abstract

Relevance. The presence of pyrogenic impurities in finished dosage forms of concentrated cultural anti-rabies vaccines produced in the Russian Federation is determined using pyrogenicity tests on rabbits (in vivo). In accordance with the decision of the Board of the Eurasian Economic Commission dated September 7, 2018 N 151 «On the approval of guidelines for drawing up a regulatory document on the quality of a medicinal product», one of the requirements for parenteral drugs is the determination of bacterial endotoxins. This document indicates that the regulatory documentation should include a test and an admissibility criterion for bacterial endotoxins (BE) using the horseshoe crab amoebocyte lysate technique.

Aims. Experimental evaluation of the possibility of using the LAL-test to determine bacterial endotoxins in national vaccines for the prevention of rabies.

Materials and methods. The research of the drug «Cultural antirabies vaccine concentrated inactivated purified» of national production was carried out in accordance with the National Pharmacopoeia of the Russian Federation, General Pharmacopoeia Monograph OFS.1.2.4.0006.15 in three modifications: gel-clot test: methods A, B; turbidimetric kinetic test: method C; chromogenic kinetic test: method D.

Results. Was investigated 6 series of the national vaccines for the prevention of rabies from two national manufacturers (using three pharmacopoeial methods). LAL reagent produced by two companies (Charles River Endosafe® and Lonza). In order to confirm the reproducibility of the method, the gel-clot test was carried out at different time intervals by one or two operators. During the research was determined the possibility of using photometric methods (method C and D).

Conclusions. The research proved the possibility of determining bacterial endotoxins by methods: gel-clot test (method A), turbidimetric kinetic test (method C) and chromogenic kinetic test (method D). Method B is recommended for quantitative analysis of vaccine without instrumental methods. During the research all national vaccines for the prevention of rabies was free from bacterial endotoxins (no more 25 EU/ml).

OVERVIEW

123-128 557
Abstract

Relevance. Whooping cough remains a pressing public health problem worldwide, including in countries with high vaccination rates. One of the probable causes of the ongoing epidemic process of pertussis infection is B. pertussis biofilms, which differ from plankton cultures by an altered gene expression spectrum and are highly resistant to environmental conditions, antibiotics, and immune factors.

Aims. Analysis of literature data on the genetic and molecular - cellular mechanisms of biofilm formation by bacteria of the genus Bordetella, as well as approaches to the search for means aimed at suppressing the growth of biofilms and the destruction of formed biofilms in the macroorganism.

Conclusions. Biofilm formation by microbes of the genus Bordetella is a complex multistage process regulated by genetic signaling systems: the Bvg AS system and the 2-nucleotide (p) ppGrp system, as well as other regulatory proteins and the polysaccharide complex. The matrix of B. pertussis biofilms consists of extracellular DNA, proteins, and a polysaccharide polymer that play an important role in the formation of biofilms in the respiratory tract and on abiotic surfaces. The genetic and molecular-cellular processes of biofilm formation and maintenance, as well as the various components of the biofilm matrix, can serve as targets for new antimicrobial drugs and more effective pertussis vaccines that will better control the entire pertussis infection cycle, including colonization, persistence, and transmission of the causative agent. One of the approaches to the development of new-generation cell-free pertussis vaccines is the identification of new biofilm-associated antigens that can induce effective cellular and humoral responses. The search for drugs that can destroy biofilms, including substances that affect the matrix and facilitate the access of antibacterial drugs to microbial cells, is promising.



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ISSN 2073-3046 (Print)
ISSN 2619-0494 (Online)