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Chronic Inflammatory Bowel Diseases in Tajikistan

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Microbiological Aspects and Antibiotic Resistance in the Pathogenesis Chronic Inflammatory Bowel Diseases in Tajikistan

Tech Area / Field

  • MED-DIS/Disease Surveillance/Medicine
  • MED-DID/Diagnostics & Devices/Medicine

Status
3 Approved without Funding

Registration date
24.02.2010

Leading Institute
Institute of Gastroenterology, Academy of Sciences, Republic of Tajikistan, Tajikistan, Dushanbe

Collaborators

  • Universita' Politecnica delle Marche, Italy, Ancona\nUniversity of Dundee, UK, Dundee\nUniversity of Birmingham / School of Immunity and Infection, UK, Birmingham

Project summary

Infections are known as the world's largest killer of children and young adults. They account for more than 13 million deaths a year. Most of these deaths occur in developing countries - one in two deaths - since they have the least financial resources to spend on health care. All this becomes worsened by the huge increase in migration of larger part of population over the past decade caused by war, difficult economical situation, famine and natural tragedies. It should be mentioned, that the rate of current human migration increased worldwide and, particularly, in the developed countries. Tajikistan is also highly involved in the process of this migration.

The common term "infectious diseases" includes the following kind of diseases: bacterial intestinal diseases and intestinal diseases of uncertain bacterial etiology. It is well known that the intestinal bacterial diseases are frequently characterized by a complex presentation, which is a major factor for their frequent misdiagnosis and/or lack of identification.

It should be also especially noted, that infections in immunosuppressed patients are characterized by a change of their classical clinical appearance and epidemiology. Spread investigation of Campylobacter, E-coli and etc in Tajikistan was not done and it has a number of reasons: first of all with difficulties and high cost of laboratory diagnostics, connected with cultivation particularities of Campylobacter and E-coli, as well as with persity of clinical manifestations of intestinal diseases and variety of the ways and factors of causative agents (Campylobacter, E-coli). The study of the spread and drug resistance of Campylobacter and other intestinal pathogenic microorganisms shows, that they are now an emerging and expanding public health problem for Tajikistan. It becomes clear, that many diseases once thought unrelated- i.e. cancer- are now know to be related to chronic infection processes. The need for the study of spread and morphologic appearance of infections in Tajikistan is stipulated by the heightened migration of human beings, poor sanitation condition and also by presence of densely populated cities in the country. Due to these reason infectious diseases are considered by the Ministry of Health of Tajikistan to be among the problems of the highest priority.

Crohn’s diseases (CD) and ulcerative colitis (UC), also known as inflammatory bowel diseases (IBD), are characterized by chronic inflammation of the gastrointestinal tract. It is know that IBD meets frequently in Tajikistan. Many patients taking antibiotics complain of general gastrointestinal upset. The literature data on abundance of medicinal resistance of the patients having chronic intestinal diseases are not sufficient. We should own information and data about biological properties of microorganism, including the structure and leading resistant and the development of the rational etiotropic therapy of disbiotic state.

The project proposal concerns with the use of efficient clinical bacteriological methods for differentiation of several strains of intestinal microorganism and characterization of intestinal microflora of patients with some series of diseases of digestive tract and development of methods for the regulation of some changes concerning the human health. It is known that state of host’s bacterial ecology plays an important and decisive role in formation of defined kinds of human malignant diseases. E. coli is an important representative of aerobic bacteria in human intestinal microflora. Besides the bad effects of none-pathogenic E.coli is an important representative of aerobic bacteria in human intestinal microflora. Besides the bad effects of none-pathogenic E.coli several strain on physicochemical integrity of intestine, the clinical bacteriological analyses include the determination of E.coli’s summary quantities, the quantities of E.coli strains with lack of enzymatic activities, etc, and don’t include the determination of unfavorable for human health of none-pathogenic E.coli strain in E.coli total quantities. The analysis of literature data on the investigations of aerobic and anaerobic bacteria from human intestinal microflora has shown that till now there is no integrated approach for the regulation of intestinal microflora during the various CDDT.

The emergence of pathogenic bacteria resistant to most currently available antimicrobial agents represents one of the most critical problems in modern medicine. The problem is of particular concern in the newly independent Republic of Tajikistan, where the uncontrolled use of antibiotics, combined with a deteriorating public heath infrastructure accompanying the disintegration of the former Soviet Union, has resulted in the extensive emergence of antibiotic-resistant strains of pathogenic bacteria.

This proposal is designed to address several critical aspects of the problem of antimicrobial resistance in Tajikistan, with the ultimate goal of limiting the development of bacterial resistance in, and its spread from, this developing country. The proposal is based on a strong research component and involves close collaboration between Tajik researchers and foreign investigators. More specifically, four major tasks will be jointly addressed:

  1. Antibiotic-resistance patterns of the strains of interest will be determined using modern antimicrobial susceptibility-testing techniques (conventional and genetic-based), with appropriate quality control.
  2. Molecular subtyping of the strains of interest will be performed by pulsed field gel electrophoresis (PFGE) and randomly amplified polymorphic DNA (RAPD) techniques, and in addition, a novel typing methodology based on the multilocus sequence typing (MLST) technique will be developed for enterococci, and the enterococcal strains isolated in Tajikistan will be comprehensively analyzed for the first time by this novel approach.

Institute of Gastroenterology of the Academy of Sciences of The Republic of Tajikistan for many years together with special organizations is actively engaged in the investigations on disbacteriosis and different disease, especially the Irritable bowel syndrome, Cron disease and series of cancer neoplasm. In particularly the important role of E.coli and Campylobacter spp strains from intestinal microflora in the formation of organism's normal state has been shown. However till now there are no data on the mechanisms of their actions, which exactly can be useful not only for regulation of bacterial activities, but also for the regulation of intestines physiological state during number of diseases. In this context, the main objective of the Project will be use of methods for differentiation of several strains of intestinal microorganisms, the investigation and establishment of correlation between the state of intestinal microflora and different diseases (chronic inflammation of bowel disease, Crone's disease, and irritable bowel syndrome) for the purpose to regulate the state of intestinal microflora during these diseases.

The purpose of the research

The purpose of the research is the investigation of the molecular and epidemiological state and sensivity to antimicrobial drug by the bacteria of the types E-coli, Campylobacter spp., detection of the leading pathogenic factors in chronic inflammatory bowel diseases.

Objectives

  1. Molecular and epidemiological investigation of the bacterial of E-coli, and Campylobacter spp., among the children and adult population of various Tajikistan districts. Detection of the species composition of the isolated presumably pathogenic enteric bacteria and evaluation of the clinical value of colonization of the bowels by Enterococci and Campylobacter spp.
  2. Detection of the pathogenic factor of the enteric microorganism (E-coli and Campylobacter spp.) isolated from the patients having Crohn's disease (CD) and Ulcerative colitis (US) and irritable bowel syndrome know as chronic inflammatory bowel diseases (IBD).
  3. Determination of the problem of antimicrobial resistance in Tajikistan, with the ultimate goal of limiting the development of bacterial resistance in, and its spread in various regions of this country


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