Final OHRM 1 PDF

ONE HEALTH & VOL.
1, ISSUE 1
RISK MANAGEMENT JANUARY 2020
Biannual edition
Languages of publication: Romanian, English, French, Russian
Founder: Moldavian Biosafety and Biosecurity Association
EDITORIAL COUNCIL EDITORIAL STYLISTS
Editor-in-chief PANCIUC Liliana, stylist editor in English language
BURDUNIUC Olga, PhD, associate professor CAZAC Viorica, stylist editor in English language
Editorial Manager TUMURUC Olga, stylist editor in English language
CROITORU Catalina, PhD, associate professor NASTASIU Silvia, stylist editor of Romanian language
Executive editor COSTIN Viorica, stylist editor of Romanian language
CIOBANU Elena, PhD, associate professor COROBCEAN Doina, stylist editor of Romanian language
Specialty editor DAVID Ala, stylist editor in French language
BALAN Greta, PhD, associate professor SIMBOTEANU Tatiana, stylist editor in French language
BEHTA Emilia, stylist editor in Russian language
EDITORIAL BOARD
HONORARY MEMBERS INTERNATIONAL EDITORIAL BOARD
CEBAN Emil, PhD, university professor ALBU Adriana, PhD, associate professor, Iasi, Romania
FRIPTULEAC Grigorie, PhD, university professor BAKANIDZE Lela, PhD, Tbilisi, Georgia
RUDIC Valeriu, PhD, university professor, academician BALASOIU Maria, PhD, university professor, Craiova,
of ASM Romania
BINZ Thomas, PhD, Bern, Switzerland
NATIONAL EDITORIAL BOARD CODITA Irina, PhD, assistant professor, Bucharest,
BAHNAREL Ion, PhD, university professor
Romania
BUCOV Victoria, PhD, researcher professor
CATERINCIUC Natalia, PhD COSERI Sergiu, PhD, Iasi, Romania
CEPOI Liliana, PhD, associate professor DOMÍNGUEZ Jose, PhD, Barcelona, Spain
COJOCARU Radu, PhD, associate professor ELLIS Maureen, PhD, Ontario, Canada
COJOCARU Stela, PhD, associate professor FELSZEGHI Sara, PhD, university professor, Sopron,
CRUDU Valeriu, PhD, associate professor Hungary
CUROCICHIN Ghenadie, PhD, university professor FILALI-MALTOUF Abdelkarim, PhD, university
DUCA Maria, PhD, university professor, academician professor, Rabat, Morocco
of ASM GENITSARIS Savvas, PhD, university professor,
DUMITRAS Vasile, PhD, associate professor Thessaloniki, Greece
ERHAN Dumitru, PhD, research professor TAMBIC Arjana, PhD, Zagreb, Croatia
GHERGHITA Stela, PhD, associate professor HULMENICU Doina, PhD, university professor, Iasi,
GRAMMA Rodica, PhD, associate professor Romania
GROPPA Stanislav, PhD, university professor, IONESCU Gabriel, PhD, Bucharest, Romania
academician of ASM
JAVED Muhammad, PhD, assistant professor, Swabi,
GUDUMAC Valentin, PhD, university professor
GULEA Aurelian, PhD, university professor, Pakistan
academician of ASM LADNER Joel, PhD, university professor, Rouen, France
HOLBAN Tiberiu, PhD, university professor LASSNIG Caroline, PhD, Vienna, Austria
IAVORSCHI Constantin, PhD, university professor MACKELLAR Calum, PhD, visiting professor, Edinburg,
LOZAN Oleg, PhD, university professor Scotland
NISTREANU Victoria, PhD, associate professor MARES Mihai, PhD, university professor, Iasi, Romania
OPOPOL Nicolae, PhD, university professor, MATEI Florentina, associate professor, Bucharest,
academician of ASM Romania
POSTOLACHI Olga, PhD, associate professor MIKHEEVA Irina, PhD, Moscow, Russia
PRISACARI Viorel, PhD, university professor, NOVOSSIOLOVA Tatiana, PhD, Sofia, Bulgaria
academician of ASM RAFILA Alexandru, PhD, university professor,
RIMIS Constantin, PhD, associate professor Bucharest, Romania
ROJNOVEANU Gheorghe, PhD, university professor STOIAN Vlad, assistant professor, Cluj-Napoca,
SPANU Constantin, university professor, academician
Romania
of ASM
SPINEI Larisa, PhD, university professor STROOT Philippe, PhD, Namur, Belgium
STURZA Rodica, PhD, university professor TARCEA Monica, PhD, university professor, Targu
TAGADIUC Olga, PhD, university professor Mures, Romania
VISNEVSCHI Anatolie, PhD, university professor TRYFINOPOULOU Kyriaki, PhD, Athens, Greece
VYGOVSKA Liliia, PhD, Kiev, Ukraine
ISSN 2587-3458 (Print) e-ISSN 2587-3466 (Online) Tiraj: 500 ex.
Registered at the Ministry of Justice with no. 476676, 5th of July, 2017
1
ONE HEALTH & VOL. 1, ISSUE 1
CUPRINS – СОДЕРЖАНИЕ – CONTENTS – TABLE DES MATIÈRES

ARTICOLE DE CERCETARE – НАУЧНЫЕ СТАТЬИ –
RESEARCH ARTICLES – ARTICLES DE RECHERCHE
Irina Rusu, Liliana Hodorogea, Tiberiu Holban. The efficacy of direct-acting antiviral therapy 4
in patients with chronic hepatitis C
Наталия Афонина, Ирина Михеева. Современная эпидемиологическая характеристика 12
ветряной оспы в Pоссии
Liliia Vygovska, Vitliy Nedosekov, Valerii Ushkalov, Oksana Boyko, Oleksandra Kepple, Yuriy 22
Vishovan, Sergiy Tereshchenko, Liliana Davydovska, Sergiy Boianovskiy, Valentina Momot,
Tetyana Korchova. Study of antibiotic susceptibility of Salmonella spp. isolated from food and
biological material
Владислав Семериков, Елена Зубова, Вера Лошкарева, Людмила Софронова, Мария 27
Пермякова. К вопросу вакцинопрофилактики пневмококковой инфекции среди недоно-
шенных детей с бронхолегочной дисплазией
Stela Racovita, Mariana Sprincean, Dumitru Poneatenco, Eusebiu Vlad Gorduza, Veaceslav 36
Mosin. Development of semen quality in male partners of infertile couples in the Republic of
Moldova
Liuba Corețchi, Ion Bahnarel, Mariana Gîncu, Alexandra Cojocari, Marcus Hoffmann. Contro- 42
lul și evaluarea riscului expunerii populației la radon în Republica Moldova
Victoria Nistreanu, Dalia Paraschiv, Alina Larion. Comparative analysis of long-eared owl 50
(Asio otus) winter diet from two european cities – Chisinau (Republic of Moldova) and Bacau
(Romania)
Yuriy Vishovan, Valerii Ushkalov, Oleksandra Kepple, Andry Granate. Antimicrobial resistance 58
and biological properties of Staphylococcus spp. isolated from pigs
Liliana Cepoi, Ludmila Rudi, Tatiana Chiriac, Vera Miscu, Valeriu Rudic. Dialdehida malonică 64
– un potențial marcher al toxicității nanoparticulelor în mediul acvatic
ARTICOLE DE SINTEZĂ – ОБЗОРНЫЕ СТАТЬИ –

SYNTHESIS ARTICLE – ARTICLES DE SYNTHÈSE
Vasile Dumitras, Sergiu Cirlan, Andrei Marfin, Catalina Croitoru, Elena Ciobanu. Medical and 72
social aspects of floods and their medical risk management
OPINII ALE EXPERȚILOR – МНЕНИЯ ЭКСПЕРТОВ –

EXPERTS' OPINIONS – AVIS DES EXPERTS
Maureen Ellis. Strengthening Global Biosafety & Biosecurity 80
Cerinţe pentru autori 88

Требования для авторов 89
Requirements for authors 91
Exigences pour les auteurs 92
2
A great valuable start!
Maureen Ellis, Executive Director,

International Federation of Biosafety Associations
Ontario, Canada
Population health is the most valuable asset of a state, and maintaining public health is and
should be a priority for any country. Improving the health status of the population is the
main objective of reforms and improvement of health systems. National and international
strategies for health highlight the increasing role of promoting population and education
health.
The One Health concept recognizes that the health of people is connected to the health of
animals and of the environment. In order to disseminate the valuable results of scientific re-
search on the local, regional, national, and global levels – having as goal to achieve optimal
health outcomes by recognizing the interconnection between people, animals, plants and
their shared environment, in 2019 the Moldavian Biosafety and Biosecurity Association
(MDBBA) founded the „One Health & Risk Management” (OH&RM) Journal.
On this occasion, The International Federation of Biosafety Associations (IFBA) is pleased
to congratulate the members of the MDBBA for successfully launching the OH&RM Jour-
nal. This scientific journal provides a platform for exchanging the best practices and an
increased awareness of global risks in the handling of dangerous biological materials. For
the past two years MDBBA has been an active member of IFBA and a biosafety champion
in Moldova. The Association brings together a diverse community of individuals who share
their passion for biosafety issues.
Good luck!
3
ARTICOLE DE CERCETARE – НАУЧНЫЕ СТАТЬИ – RESEARCH ARTICLES –

ARTICLES DE RECHERCHE
THE EFFICACY OF DIRECT-ACTING ANTIVIRAL THERAPY IN PATIENTS

WITH CHRONIC HEPATITIS C
Irina RUSU1, Liliana HODOROGEA2, Tiberiu HOLBAN1
1
Department of Infectious Tropical Diseases and Medical Parasitology, Nicolae Testemitanu State University of
Medicine and Pharmacy, Chisinau, Republic of Moldova
2
Toma Ciorba Clinical Hospital of Infectious Diseases
Corresponding author: Irina Russu, e-mail: irina.rusu@usmf.md
DOI: 10.5281/zenodo.3700945 UDC: 616.36-002.2-085.281.8
Key words: chronic Introduction. Viral hepatitis C (HCV) is a significant global health problem. The risk of de-
HCV, treatment, so- veloping chronic HCV is up to 80% of patients, of whom 10-20% can develop liver cirrhosis
fosbuvir, ledipasvir, or hepatocellular carcinoma which can lead to death. Treatment with direct-acting antivi-
daclatasvir. ral agents (DAAs) contributes to a sustained virological response (SVR) in 97-99% of cases.
Material and methods. The study was conducted on 206 patients with chronic HCV who
underwent two generic antiviral agent therapies: group I (103) – Sofosbuvir 400 mg + Ledi-
pasvir 80 mg, whereas group II (103) – Sofosbuvir 400 mg + Daclatasvir 60 mg orally, once
a day, for 12 weeks. The assessment of hepatitis C virus RNA and genotype, as well as the
degree of hepatic fibrosis by Fibroscan, biochemical and complete blood count (CBC) indices
were carried out.
Results. The study results showed high efficacy of the generic DAAs treatment in patients
with chronic HCV over 12 weeks. The SVR rate made up 90.3% in Sofosbuvir + Ledipasvir
therapy and 86.4% – in Sofosbuvir + Daclatasvir. Similar treatment response was record-
ed in naive patients and those who previously underwent unsuccessful treatment with Pe-
gylated Interferon and Ribavirin. The DAAs treatment showed the following minor adverse
reactions: asthenia, headache, sleep disorder, and nausea, which did not require treatment
discontinuation.
Conclusions. The 12-week course of DAAs therapy exhibited high SVR rate in both chronic
HCV naive patients and those previously treated with Pegylated Interferon and Ribavirin.
Cuvinte cheie: HVC EFICACITATEA TRATAMENTULUI CU PREPARATE ANTIVIRALE CU ACȚIUNE DIRECTĂ
cronică, tratament, LA PACIENȚII CU HEPATITĂ VIRALĂ C CRONICĂ
sofosbuvir, ledipasvir, Introducere. Hepatita virală C (HVC) este o maladie cu un impact semnificativ la nivel
daclatasvir. mondial. Riscul de cronicizare a HVC este de până la 80% dintre pacienții diagnosticați cu
această maladie iar 10-20% dintre aceștea dezvoltă ciroza hepatică, carcinomul hepatoce-
lular sau poate surveni decesul. Tratamentul cu preparatele antivirale, cu acțiune directă
(PAAD) contribuie la obținerea răspunsului virusologic susținut (RVS) în 97-99% de cazuri
morbide.
Material și metode. Studiul științific a inclus 206 de pacienţi cu HVC cronică, care au primit
două scheme de preparate antivirale generice: I lot (103) – Sofosbuvir, 400 mg + Ledipasvir,
80 mg, însă cei din lotul II (103) – Sofosbuvir, 400 mg + Daclatasvir, 60 mg per os, o dată în
zi, timp de 12 săptămâni. Au fost evaluate ARN-VHC, genotipul virusului C, gradul de fibroză
hepatică prin Fibroscan, indicii biochimici și hemoleucograma.
Rezultate. Rezultatele studiului au demonstrat randamentul ridicat al tratamentului cu
PAAD, efectuat pe parcursul a 12 săptămâni pacienților cu HVC cronică. Rata RVS a fost de
90,3% – în cazul tratamentului cu Sofosbuvir + Ledipasvir și 86,4% – cu Sofosbuvir + Da-
clatasvir. Răspunsul la tratament a fost similar la pacienții naivi și la cei tratați anterior cu
Interferon pegilat și Ribavirină – fără succes. Tratamentul antiviral cu PAAD a î�nregistrat
reacț�ii adverse minore: astenie, cefalee, dereglarea somnului, grețuri, care nu au pretins
întreruperea tratamentului.
Concluzii. Tratamentul cu PAAD, administrat timp de 12 săptămâni, a atins RVS ridicat atât
la pacienții cu HVC cronică naivi, cât și cei tratați anterior cu PEG-INF și Ribavirină.
4
INTRODUCTION eliminate the virus and get negative RNA-HCV at

Viral hepatitis C is a significant global health pro- a 6-month interval after treatment completion by
blem. According to the World Health Organization obtaining a SVR. The literature data confirm that
data, 71 million people with hepatitis C virus are over 99% of patients who have obtained a SVR re-
estimated worldwide, accounting for 1.2% of the main HCV-negative over 4-5 years after the treat-
world population. Approximately 399 000 peo- ment was discontinued, with no signs of hepatitis.
ple die annually from HCV-related complications, The long-term SVR showed a 75% reduction of he-
which include cirrhosis, hepatocellular carcinoma patocellular carcinoma cases, decompensated and
and liver failure (1). Annually, 3-4 million new compensated cirrhosis and death over the next 15
cases of HCV occur, including 1300-1400 cases in years (11). It has recently been shown that pati-
the Republic of Moldova. The prevalence of HCV ents with SVR have a similar quality-of-life status
infection considerably ranges from a very low le- as the overall population (7), whereas those with
vel (0.05-0.1%) in the UK and Scandinavian coun- compensated and decompensated cirrhosis do not
tries, to the highest level in Asia and Egypt (˃5- require liver transplant (9, 12).
10%) (2, 3). The HCV incidence in the Republic of
Moldova was estimated at 4.5-5.0% in the overall MATERIAL AND METHODS
population with the prevalence of genotype 1b, The purpose of the research: to study the effective-
accounting for 98% (4, 5). People aged betwe- ness of Interferon-free treatment in patients with
en 30-49 are predominantly affected, men being chronic HCV infection.
more common than women. The risk of chronic
The research objectives: to assess the efficacy of
HCV infection is very high. Untreated acute hepati-
the DAAs therapy: Sofosbuvir + Ledipasvir and
tis C can develop into a chronic form in up to 80%
Sofosbuvir + Daclatasvir in patients with chronic
of people, of whom 10-20% develop liver cirrhosis
HCV infection. To study the evolution of clinical,
over 20 years, followed by decompensated liver
biochemical, virological and paraclinical indices
disease, hepatocellular carcinoma and even death
in patients with chronic HCV infection both at the
(6). Once the onset of chronic infection occurs,
beginning and end of treatment, as well as over 24
the rate of spontaneous recovery is significantly
weeks after treatment. To analyze the adverse re-
reduced. Chronic HCV in most patients develops
actions and complications that can occur after the
asymptomatically or nonspecifically, as long as
DAAs treatment.
no cirrhosis is present (7, 8, 9). As a result, HVC
is often diagnosed accidentally or remains undia- The research hypothesis: the emergence of new
gnosed. It has been estimated that only 30-50% of therapeutic opportunities allows each patient di-
HCV people are aware of their disease. Therefore, agnosed with chronic HCV infection to receive an-
the lack of an effective vaccine, that would con- tiviral treatment. DAAs have shown a higher effi-
tribute to a decrease in HCV morbidity rate and cacy and tolerability, as well as shorter treatment
subsequent consequences, requires the develop- duration compared to interferon therapy. A com-
ment of early diagnostic measures and treatment bination of at least two of the three major classes
in order to eradicate the infection. Once HCV is of drugs results in SVR≥95% in just 8-12 weeks of
identified, the assessment of the therapeutic suc- treatment. Patients who were treated for HCV in-
cess is possible by dosing the amount of RNA-HCV fection exhibited a better quality of life, as well as
and the sustained virologic response. Over time, a reduced risk of developing liver cirrhosis, hepa-
the SVR rate increased from 5-20% in interferon tocellular carcinoma and death related to liver and
monotherapy, to 40-50% in combined IFN + Riba- extrahepatic diseases.
virin treatment. Currently, the SVR rate accounts The study was conducted on 206 adult patients
for 95-100% in cases treated with DAAs (10). The with chronic HCV who initiated DAAs treatment
major advantage in the treatment of chronic HVC within the PHMI Toma Ciorba Clinical Hospital of
is the opportunity to administer DAAs – NS3/4A Infectious Diseases during 2017-2018.
protease inhibitors, NS5B polymerases and NS5A
replication complex. The inclusion criteria were as follows: patients
≥18 years of age, with chronic HCV confirmed
These drugs require oral short-term administrati- by anti-HCV, anti-HCV IgM, RNA-HCV>25 IU/mL,
on, having a high SVR rate and minimal side effects. with F0-F3 fibrosis of all genotypes, naive patients
The purpose of antiviral treatment is to definitely
5
or patients subjected to a previous unsuccessful extrahepatic manifestations. The results were si-
antiviral treatment. milar in both research groups. Most patients were
naive, whereas 14 (13.6%) patients from group I
The exclusion criteria were as follows: pregnant
and 11 (10.7%) patients from group II previously
and nursing patients, HIV-HBV-HVD co-infection,
administered antivirals with Interferon, Ribavirin,
liver cirrhosis, F4 fibrosis, hepatocellular carcino-
Boceprevir or Telaprevir, but unsuccessfully. Of
ma or other malignancies.
the total number of patients, 174 (84.4%) were
The patients included in the study were randomly infected with genotype 1. Of them, 170 cases were
divided into two groups of 103 patients each. The detected with 1b GT, 2 patients with GT 1a and mi-
study groups were comparable in terms of age and xed GT (1a+1b) each, 2 (1%) patients – genotype
gender. The degree of liver fibrosis was assessed 2, 10 (4.9%) patients – genotype 3, of whom 6 –
via Fibroscan. Patients with F0, F1, F2 and F3 fi- genotype 3a and 2 patients had mixed genotypes
brosis were selected. Chronic HCV patients were (3a+ 3b) and (3a+1b) each, one patient (0.5%) –
initially diagnosed by detecting anti-HCV via the genotype 4+1b. The only diagnostic tests available
immuno-enzymatic assay and confirmed by ARN- in the Republic of Moldova were for genotypes
HCV testing. Serum levels of ARN-HCV were de- 1-4. Genotypes 5, 6 and 7 have remained uniden-
termined by real-time polymerase chain reaction tified. Therefore, 19 (9.2%) patients with detecta-
(PCR) with a low detection limit <25 IU/mL. Prior ble quantitative HCV RNA have not been assessed
to treatment initiation, the HCV genotype was as- for genotype (tab. 1).
sessed (1a, 1b, 2, 3 and 4). Anamnestic, epidemio-
FibroScan elastometry assessment or elastogra-
logical, clinical, biochemical, serological and mole-
phy detected minor F0-F1 fibrosis in 70 (34%) pa-
cular biology data were collected in all patients at
tients, moderate fibrosis (F2) in 55 (26.7%) cases
the beginning, over 4 and 12 weeks of treatment,
and advanced fibrosis (F3) in 81 (39.3%) cases.
as well as over 24 weeks after the antiviral treat-
Patients of group I more frequently exhibited mi-
ment completion.
nor fibrosis – in 52 (50.5%) cases, and group II had
The 1st group included 103 patients treated with predominantly advanced fibrosis in 58 (56.3%)
Twinvir (Sofosbuvir 400 mg/Ledipasvir 90 mg), cases. At the beginning of antiviral treatment, the
(manufacturer: Incepta Pharmaceuticals, Bangla- level of HCV viremia ranged from 2 168 to 64 402
desh), one pill orally, once daily, for 12 weeks. 936 copies/mL (mean value – 6 413 266 ± 776
The 2nd group included 103 patients, undergo- 462 copies/mL) and did not differ significantly in
ing treatment with Nucleobuvir (Sofosbuvir 400 both groups (tab. 1).
mg) – one pill, and Daclavirdin (Daclatasvir 60 At least one gastrointestinal disease, such as chro-
mg) – one pill orally (manufacturer: EVʌPHʌRMA, nic pancreatitis, chronic cholecystitis or chronic
Egypt), for 12 weeks. gastroduodenopathy was found in 64 (62.1%)
All patients signed an informed consent. The study patients from group I and in 60 (58.2%) patients
protocol was positively endorsed by the Research from group II.
Ethics Committee of Nicolae Testemitanu SUMPh Concomitant chronic hepatitis C virus infection
(meeting no. 75 of 26.04.2017). with diabetes were found in 62 (30.1%) patients,
with hypertensive disease – in 63 (30.6%), ische-
RESULTS mic heart disease – in 27 (13.1%), autoimmune
Of the 206 patients with chronic HCV included in thyroiditis – 18 (8.7%), and vasculitis – 20 (9.7%),
the study, there were 104 (50.5%) men and 102 which could be extrahepatic manifestations of
(49.5%) women. There were patients aged betwe- HCV, due to unknown disease onset (tab. 2).
en 20-79 years old, mean age 50.13±1.28 years. Patients with extrahepatic manifestations were ol-
Patients aged 41-50 years – 55 (26.7%) were the der (55.86±0.97 years) than those without mani-
most affected, as well as patients aged 51-60 years festations (45.08±1.07 years) (p<0.001). Patients
– 63 (30.6%). There were 19 (9.2%) patients aged without extrahepatic manifestations exhibited
20-30, 33 (16%) patients aged 31-40 years, 30 a short-term disease from the time of detection
(14.5%) patients aged 61-70 years, and 6 (2.9%) (9.52±0.58 years), compared to those who had ex-
patients aged 71-80 years. More than half of the trahepatic manifestations (11.54±
patients had concomitant digestive diseases or
6
0.63 years), (p<0.05). There were no contraindi- 6 (5.82%) patients from group II, who exhibited
cations for DAAs, compared to Interferon treat- extrahepatic manifestations, as well as cancer re-
ment, in 9 (8.73%) patients from group I and in mission.
Table 1. General characteristics of chronic HCV patient groups at the initiation of antiviral treatment.
Lot SOF+LDV Lot SOF+DCV
Indices OR 95% CI, P
(n=103) (n=103)
Age, years 50.03±1.29 50.24±1.28 >0.05
Males, n/(%) 51 (49.5) 53 (51.4) 0.93 (0.54-1.60), >0.05
Females, n/(%) 52 (50.5) 50 (48.6) 0.78 (0.63-1.87), >0.05
Gastrointestinal comorbidities, n/(%) 64 (62.1) 60 (58.2) 1.18 (0.67-2.06), >0.05
Extrahepatic manifestations, n/(%) 56 (54.3) 60 (58.21) 0.85 (0.49-1.48), >0.05
Previous antiviral treatment, n/(%) 14 (13.6) 11 (10.7) 1.32(0.57-3.05), >0.05
Genotype, n/(%)
1b 98 (95.1) 72 (69.9) 8.43 (3.13-22.76), <0.001
2 1 (0.97) 1 (0.97)
3 0 10 (9.7)
4 0 1 (0.97)
Mixed 0 4 (3.88)
Unidentified 4 (3.88) 15 (14.5) 0.24 (0.08-0.74), <0.05
Fibrosis staging, n/(%)
F0-F1 52 (50.5) 18 (17.5) 4.81 (2.54-9.12), <0.001
F2 28 (27.2) 27 (26.2) 1.05 (0.57-1.94), >0.05
F3 23 (22.3) 58 (56.3) 0.22 (0.12-0.41), <0.001
ARN-VHC, copies /mL, mean value 6.231.148± 6.595.385± >0.05
745.259 1.450.617
Table 2. Comorbidities of patients with chronic HCV at the initiation of antiviral treatment.
Comorbidities OR 95% CI, P
(n=103) (n=103)
Chronic pancreatitis, n/(%) 23 (22.33) 26 (25.24) 1.17 (0.61-2.23), >0.05
Chronic cholecystitis, n/(%) 31 (30.09) 26 (25.24) 0.78 (0.42-1.44), >0.05
Chronic gastroduodenopathy, n/(%) 26 (25.24) 25 (24.27) 0.95 (0.50-1.78), >0.05
Diabetes mellitus, n/(%) 32 (31.06) 30 (29.12) 0.91 (0.50-1.65), >0.05
Hypertensive disease, n/(%) 22 (21.35) 41 (39.8) 2.43 (1.32-4.50), <0.01
Cardiomyopathy, n/(%) 17 (16.5) 10 (9.7) 0.54 (0.24-1.25), >0.05
Tumors, n/(%) 9 (8.73) 6 (5.82) 0.65 (0.22-1.88), >0.05
Obesity, n/(%) 11 (10.68) 13 (12.62) 1.21 (0.51-2.83), >0.05
Autoimmune thyroiditis, n/(%) 9 (8.73) 9 (8.73) 1.0 (0.38-2.63), >0.05
Vasculitis, n/(%) 9 (8.73) 11 (10.68) 1.25 (0.49-3.15), >0.05
The DAAs treatment showed a good biochemical RNA-HCV it was undetectable. Virologic failure at the
response even from the first month of treatment. end of treatment was recorded in 8 (7.8%) patients
There was a significant ALAT decrease in both from group I and in 13 (12.6%) from group II.
groups, thus over 4 weeks of treatment, the mean
ALAT values showed decreasing rate of 3.47 times Over 24 weeks after antiviral treatment comple-
in group I and 2.81 times in group II, which reached tion, undetectable RNA-HCV was maintained in
the normal indices and maintained during the tre- 93 (90.3%) patients in group I and 89 (86.4%) in
atment and after its completion (p<0.001) (fig. 1). group II. Although the SVR24 rate in patients who
administered SOF+LDV treatment was higher than
Virologic response over 12 weeks after the treatment in those with SOF+DCV, there was not any statisti-
was recorded in 95 (92.2%) patients treated with cally significant difference OR=0.68, 95% CI (0.20-
SOF+LDV; in 90 (87.4%) patients with SOF+DCV, 1.61), p=0.39 (fig. 2).
7
Table 3. Mean values of biochemical indices at the initiation of antiviral treatment.

Biochemical parameters P
(n=103) (n=103)
Thymol test, U 4.78±0.28 6.0±0.31 <0.01
Total bilirubin, µmol/L 16.54±0.93 15.98±0.73 >0.05
ALAT, IU/L 108.23±12.2 118.8±14.78 >0.05
ASAT, IU/L 81.8±8.44 90.38±7.49 >0.05
Alkaline phosphatase, IU/L 206.17±9.18 183.94±8.68 >0.05
GGT, UI/L 67.03±5.72 76.63±8.24 >0.05
Glucose, mmol/L 5.96±0.18 6.05±0.19 >0.05
Amylase, IU/L 89.44±4.83 99.14±5.25 >0.05
Prothrombin time index, % 88.56±0.65 86.27±0.65 <0.05
Figure 1. Dynamics of ALAT activity in patients with chronic HCV treated with DAAs.
Figure 2. Virologic response in chronic Hepatitis C patients.

* VR12 – virologic response at the end of treatment
** SVR24 – sustained virologic response over 24 weeks after treatment
8
The analysis of the SVR-related predictive fac- with SVR showed a higher initial level of ALAT
tors in DAAs treatment (tab. 4, tab. 5), revealed (117.75±10.69 IU/L), compared to those in whom
that SVR was mostly found in patients with high virologic failure was recorded (79.68±11.88 IU/L),
cytolytic activity compared to those who had se- (p<0.05). The obtained data help to conclude that
rum aminotransferase level within normal range. age, gender, level of viremia, liver fibrosis stage
Young patients showed a more frequent SVR than and genotype are not predictive factors of SVR in
those over 60, although the differences were not DAAs treatment.
statistically significant. At the same time, patients
Table 4. SVR-related predictive factors for Sofosbuvir+Ledipasvir treatment.

Factors SVR n=93 Total n=103 % 95% CI P
Age
≤40 years 22 24 91.6 1.0
41-60 years 51 56 91.1 0.93 (0.17-5.15) 0.93
≥60 years 20 23 86.9 0.61 (0.09-4.01) 0.60
Gender
Males 48 51 94.1 1.0
Females 45 52 86.5 0.40 (0.10-1.65) 0.21
ALAT
Normal range 18 22 81.8 1.0
> normal range 75 81 92.6 2.78 (0.71-10.89) 0.14
ARN-VHC
< 1 mln copies/mL 13 13 100 1.0
1-5 mln copies/mL 43 50 86.0 0.21 (0.01-4.01) 0.30
>5 mln copies/ mL 37 40 92.5 0.40 (0.02-8.20) 0.55
Fibrosis stage
0-1 49 52 94.2 1.0
2-3 44 51 86.3 0.38 (0.09-1.58) 0.19
Genotype
1 88 98 89.8 1.0
2,3,4 1 1 100 0.36 (0.01-9.31) 0.53
Unidentified 4 4 100 1.06 (0.05-21.25) 0.97
Table 5. SVR-related predictive factors for Sofosbuvir+Daclatasvir treatment.

Factors SVR n=89 Total n=103 % 95% CI P
Age
≤40 years 24 27 88.9 1.0
41-60 years 47 53 88.7 0.98 (0.23-4.26) 0.98
≥60 years 18 23 78.3 0.45 (0.09-2.13) 0.31
Gender
Males 46 53 86.8 1.0
Females 43 50 86 0.93 (0.30-2.88) 0.91
ALAT
Normal range 14 18 77.8 1.0
> normal range 75 85 88.2 2.14 (0.59-7.8) 0.25
ARN-VHC
< 1 mln copies/mL 22 24 91.7 1.0
1-5 mln copies/mL 33 39 84.6 0.50 (0.09-2.70) 0.42
>5 mln copies/ mL 34 40 85 0.52 (0.10-2.79) 0.44
Fibrosis Stage
0-1 15 18 83.3 1.0
2-3 74 85 87 1.35 (0.33-5.41) 0.68
Genotype
1 60 71 84.5 1,0
2, 3, 4 17 17 100 6.65 (0.37-118.64) 0.20
Unidentified 2 15 80 0.73 (0.17-3.03) 0.66
9
Treatment failure was established in 24 (11.6%) ated with antivirals, that was 160 (88.4%) and 22
patients. Of them, there were 14 women (58.3%) (88%) cases, respectively.
and 10 men (41.7%). There were 19 (79.2%) pati-
The DAAs therapy was well tolerated by patients
ents over 40 years and those with an average (F2)
from both groups, whereas 27 (13.1%) patients
and advanced (F3) fibrosis level 18 (75%) were
experienced minor adverse reactions like asthe-
more likely to fail the treatment. The ARN-HCV vi-
nia, headache, nausea, insomnia, hypertensive
remia level was similar in patients who had SVR
crisis, which were quickly compensated without
and those with virologic failure. The SVR rate was
suspending the treatment (tab. 6).
similar in naive patients and those previously tre-
Table 6. Adverse reactions to antiviral treatment in patients with chronic HCV.
SOF/LDV SOF/DCV
Indices I II OR 95% CI, P
N=103 N=103
Asthenia, n (%) 4 (3.9) 5 (4.9) 0.79 (0.21-3.04), p= 0.73
Headache, n (%) 4 (3.9) 3 (2.9) 1.35 (0.29-6.17), p= 0.70
Nausea, n (%) 2 (1.9) 4 (3.9) 0.49 (0.09-2.73), p=0.42
Insomnia, n (%) 3 (2.9) 2 (1.9) 1.51 (0.24-9.26), p=0.65
Hypertensive seizures, n (%) 0 1 (0.97) 0.33 (0.01-8.20), p=0.50
DISCUSSIONS
The implementation of the National Program of ARN-HCV after treatment, thus the progression of
combating viral hepatitis B, C and D over 2017 and liver cirrhosis and hepatocellular carcinoma be-
2021 has as an overall purpose to further reduce ing stopped (8, 9). Our study results have proved
the morbidity rate of acute and chronic hepatitis a high efficacy of generic antiviral agents admi-
B, C and D viral infections and cirrhosis, as well nistered over 12 weeks in patients with chronic
as minimize their socioeconomic consequences. HCV, thus a sustained virologic response was re-
Access to modern DAAs schemes leads to the disa- corded over 24 weeks after treatment in 90.3% of
ppearance of HCV RNA over four weeks after tre- patients undergoing Sofosbuvir + Ledipasvir and
atment initiation, as well as to virus elimination in 86.4% patients receiving Sofosbuvir+Daclatasvir.
about 90% of cases. Reactivation of HCV over 24 The treatment was effective in both naï�ve patients
weeks after DAAs treatment completion is rare, al- and those who underwent a previous unsuccess-
though reinfection should not be excluded. About ful treatment with PEG-INF, RBV, Boceprevir or
99% of patients who exhibited SVR had a negative Telaprevir.
CONCLUSIONS
1. The generic direct-acting antiviral agents showed a high efficacy, having a sustained virologic respon-
se in approximately 90% of patients treated with both treatment schemes.
2. The sustained virologic response was similar in both naï�ve patients and in those who underwent a
previous unsuccessful antiviral treatment.
3. Generic antiviral agents have been well tolerated by most patients, whereas minor side effects did not
require treatment discontinuation.
CONFLICT OF INTERESTS REFERENCES

The authors do not declare any conflict of interest. 1. World Health Organization. Global Hepatitis Report
2017. Available from: http://apps.who.int/iris/bit-
stream/handle/10665/255016/9789241565455-
eng.pdf?sequence=1 [Accessed 10th January 2019].
10
2. Pântea V. Hepatitele virale acute și cronice (etiologie, 7. American Association for the Study of Liver Disea-
epidemiologie, patogenie, tablou clinic, diagnostic și ses and the Infectious Diseases Society of America.
profilaxie). Chiș� inău: 2014. Recommendations for Testing, Managing, and Trea-
3. World Health Organization. Global Hepatitis Report ting Hepatitis C. 2016. Available from: https://www.
2016. Available from: https://www.who.int/hiv/ hcvguidelines.org/ [Accessed 10th January 2019].
pub/arv/ global-AIDS -update-2016_en.pdf [Acces- 8. Chhatwal J, Wang X, Ayer T, et al. Hepatitis C disease
sed 27th December 2018]. burden in the United States in the era of oral direct-ac-
4. Agenț�ia Naț�ională pentru Sănătate Publică. Notă ting antivirals. Hepatology. 2016; 64:1442-1450.
informativă cu privire la realizarea Programului 9. Asselah T, Boyer N, Saadoun D, et all. Direct-acting
Național de combatere a hepatitelor virale B, C și D antivirals for the treatment of hepatitis C virus in-
pentru anii 2017-2021. 2017. p.5-6. Available from: fection: optimizing current IFN-free treatment and
https://msmps.gov.md/ro/content/nota-infor- future perspectives. Liver Int. 2016; 36:47-57.
mativa-cu-privire-la-realizarea-programului-nati- 10. Ahmed OA, Kaisar HH, Badawi R, et al. Efficacy and
onal-de-combatere-hepatitelor [Accessed 10th Ja- safety of sofosbuvir-ledipasvir for treatment of a
nuary 2019]. cohort of Egyptian patients with chronic hepatitis
5. European Association for the Study of the Liver. Re- C genotype 4 infection. Infect Drug Resist. 2018;
commendations on Treatment of Hepatitis C 2018. 11:295-298.
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HEPC-2018/Full-report.pdf [Accessed 10th January H. Hepatology – A clinical textbook. 7th Edition 2016.
2019].
12. Săndulescu O, Streinu-Cercel A, Stoica A, et al. Re-
6. Lok AS, Seeff LB, Morgan TR, et al. Incidence of he- gression of liver fibrosis following sustained virolo-
patocellular carcinoma and associated risk factors gical response in patients with chronic HCV infec-
in hepatitis C-related advanced liver disease. Gas- tion and cirrhosis. BMC Infectious Diseases. 2016;
troenterology. 2009; 136:138-148. 16(602):46-47.
Date of receipt of the manuscript: 03/02/2020

Date of acceptance for publication: 29/02/2020
Irina RUSU, ORCID 0000-0002-2759-3171

Liliana HODOROGEA, ORCID 0000-0003-4795-9852
Tiberiu HOLBAN, ORCID 0000-0003-0923-3129
11
СОВРЕМЕННАЯ ЭПИДЕМИОЛОГИЧЕСКАЯ
ХАРАКТЕРИСТИКА ВЕТРЯНОЙ ОСПЫ В РОССИИ
Наталия АФОНИНА, Ирина МИХЕЕВА
«Центральный� научно-исследовательский� институт эпидемиологии» Роспотребнадзора, Москва,
Россий� ская Федерация
Контактная информация: Наталия Афонина, e-mail: afonina_nat2009@mail.ru
DOI: 10.5281/zenodo.3700955 УДК: 616.914-036.22(470+571)
Key words: chicken- CURRENT EPIDEMIOLOGICAL CHARACTERISTIC OF CHICKENPOX IN RUSSIA

pox, vaccination, pre- Introduction. The varicella vaccine introduction in the National immunization schedule
vention. is planned in Russia by 2020. Since 2013, vaccination against chicken-pox has been carried
out according to epidemiological indications and as part of regional immunization pro-
gram in some regions.
Material and methods. A descriptive epidemiological study has been carried out to assess
the current epidemiological features of chicken-pox in Russia. A retrospective analysis of
the incidence distribution in the time, age and territorial aspects was carried out, as well as
taking into consideration the number of doses administered to certain population groups.
Materials for a research include the official data on incidence of chicken-pox and quantity
of varicella vaccine doses administered in 2006-2018 in the country in general, and in two
megalopolises – Moscow and St. Petersburg.
Results. It is established that long-term and seasonal recurrence, the age structure and the
epidemic nature of chicken-pox incidence did not change in comparison with the prevacci-
nal period due to low vaccination coverage of the children in country scales. On the example
of the immunization program in Moscow it is shown that vaccination before attendance at
childcare allowed to reduce incidence of children at the age of 3-6 years. However, a long-
term epidemiological effect was not achieved due to incomplete vaccination coverage of the
entire cohort of children.
Conclusions. When introducing vaccination, it is necessary to strengthen the epidemiolog-
ical surveillance of chicken-pox and its vaccine prophylaxis in order to timely respond to
unfavorable trends of shift in the age of chicken-pox occurrence.
Cuvinte cheie: CARACTERISTICA EPIDEMIOLOGICĂ ACTUALĂ A VARICELEI ÎN RUSIA

varicela, vaccinare, Introducere. În Rusia introducerea vaccinului împotriva varicelei este planificată în con-
prevenire. formitate cu Programul național de imunizare până în 2020. Din anul 2013, vaccinarea
contra varicelei se efectuează corespunzător indicațiilor epidemiologice, iar în unele regi-
uni – în baza prevederilor Programului regional de imunizare.
Material şi metode. A fost realizat un studiu descriptiv epidemiologic pentru a evalua par-
ticularitățile epidemiologice actuale ale varicelei în Rusia. A fost efectuată o analiză retro-
spectivă a distribuției incidenței în timp, după vârstă și aspecte teritoriale, luând în consid-
erație și factorii sociali, precum și după numărul de doze administrate anumitor grupuri de
populație. Materialele pentru cercetare includ datele oficiale privind incidența varicelei și
cantitatea de doze de vaccin administrate în perioada 2006-2018 în țară, în general, și în
două orașe mari – Moscova și Sankt Petersburg.
Rezultate. S-a stabilit că recurența pe termen lung și ciclicitatea sezonieră, structura de
vârstă și caracterul epidemic al incidenței varicelei nu s-au modificat în comparație cu peri-
oada prevaccinală, din cauza nivelului scăzut de vaccinare a copiilor pe întreg teritoriul
țării. Luând ca exemplu Programul de imunizare din orașul Moscova observăm că vaccin-
area înainte de încadrarea copilului în instituțiile preșcolare a permis reducerea incidenței
bolii la copiii de 3-6 ani. Însă, nu a fost obținut un efect epidemiologic pe termen lung din
cauza acoperirii incomplete a vaccinării tuturor copiilor.
Concluzii. La inițierea vaccinării este necesar să se consolideze supravegherea epidemio-
logică a varicelei ași a profilaxiei acesteia pentru a răspunde în timp util tendințelor defa-
vorabile de schimbare a vârstei apariției varicelei.
12
ВВЕДЕНИЕ ся внедрить в Национальный� календарь про-

Успехи вакцинопрофилактики инфекций� с аэ- филактических прививок, возникла необходи-
розольным механизмом передачи возбудите- мость дать современную эпидемиологическую
ля привели к изменению социально-экономи- характеристику этой� инфекции и определить, в
ческой� значимости массовых инфекционных какой� степени на нее повлияла различная так-
болезней� и смене приоритетов в противоэ- тика проведения вакцинопрофилактики.
пидемической� и профилактической� работе.
Например, в течение последних лет в России МАТЕРИАЛЫ И МЕТОДЫ
по уровню экономического ущерба (без учета Материалами для исследования послужили
ВИЧ-инфекции и туберкулеза) третье место данные Федерального государственного ста-
после ОРВИ и кишечных инфекций� неустанов- тистического наблюдения о заболеваемости
ленной� этиологии занимает ветряная оспа (1). ветряной� оспой� (формы 2 и 23-17) и количе-
Несмотря на сравнительно легкое клиниче- стве проведенных прививок против этой� ин-
ское течение и относительно редкие случаи фекции (формы 5 и 6) в 2006-2018 годах как
осложнений� и летальных исходов бремя ве- в Россий� ской� Федерации в целом, так и в двух
тряной� оспы велико из-за ее широкой� распро- мегаполисах – Москве и Санкт-Петербурге.
страненности и высокой� заболеваемости. Не- Задачами исследования являлось выявление
обходимость снижения экономических потерь групп населения, наиболее подверженных
обусловило актуальность внедрения вакцина- риску заболевания ветряной� оспой� , периодов
ции против ветряной� оспы (2, 3). риска подъема заболеваемости, а также оцен-
ка влияния на заболеваемость вакцинации. В
В России лицензированы две живые моно-
рамках описательного эпидемиологического
вакцины против ветряной� оспы зарубежно-
исследования выполнен ретроспективный�
го производства. В соответствии с Приказом анализ распределения заболеваемости во
Минздрава России от 21.03.2014 г. №125н временном, возрастном и территориальном
прививки против ветряной� оспы внесены в аспектах, а также с учетом охвата вакцинацией�
Календарь профилактических прививок по отдельных групп населения.
эпидемическим показаниям. Вакцинация
проводится бесплатно для населения за счет Для проведения статистического анализа свя-
бюджета здравоохранения субъектов федера- зи между величинами (показатели заболе-ва-
ции. Прививкам подлежат дети и взрослые из емости, число привитых) был использован
групп риска, ранее не привитые и не болевшие метод корреляции с расчетом коэффициента
ветряной� оспой� (4). Иммунизация возможна линей� ной� корреляции Пирсона (r) и оценкой�
и на коммерческой� основе за счет средств на- его достоверности.
селения. В некоторых субъектах федерации за
счет средств бюджета региона реализуются РЕЗУЛЬТАТЫ
региональные программы иммунизации. Так На фоне снижения инфекционной� заболеваемо-
в Москве вакцинация против ветряной� оспы сти в России значимость ветряной� оспы остает-
введена в Региональный� календарь профилак- ся высокой� , поскольку удельный� вес случаев
тических прививок, утвержденный� Приказом ветряной� оспы от общего числа зарегистриро-
Департамента здравоохранения г. Москвы от ванных случаев инфекционных заболеваний�
04.07.2014 г. № 614, согласно которого вакци- (без учета гриппа и ОРВИ) за период наблюде-
нация проводится детям в возрасте 12 месяцев ния ежегодно составлял от 21,3 до 30,5%.
и старше перед поступлением в дошкольные
организации, детям домов ребенка, а также по В течение 2006-2018 годов каждый� год в Рос-
эпидпоказаниям контактным лицам из очагов сий� ской� Федерации регистрировали от 674
заболевания, не болевшим, не привитым и не 797 до 936 917 случаев ветряной� оспы. Мини-
имеющим сведений� о профилактических при- мальный� показатель заболеваемости за пери-
вивках против ветряной� оспы, призывникам и од наблюдения составил 475,5 (в 2010 году),
детям, выезжающим на отдых в летние оздо- максимальный� – 642,4 на 100 тыс. населения
ровительные лагеря (5). (в 2014 году). В многолетней� динамике забо-
леваемости (рис. 1) ветряной� оспой� населения
В связи с тем, что в Россий� ской� Федерации к 2020 России в 2006-2018 гг. отмечалась слабовыра-
году вакцину против ветряной� оспы планирует- женная тенденция роста показателей� .
13
Рисунок 1. Заболеваемость ветряной� оспой� населения Россий� ской� Федерации, Москвы

и Санкт-Петербурга в 2006-2018 годах (показатели на 100 000 населения).
Для ветряной� оспы характерна цикличность Ветряная оспа по-прежнему оставалась «дет-
эпидемического процесса: за период наблюде- ской� » инфекцией� : дети в возрасте до 18 лет
ния отмечено 4 многолетних эпидемических составляли 94,0-95,2% от общего числа забо-
цикла продолжительностью от 2-х до 4-х лет левших (рис. 2).
с «пиками» заболеваемости в 2008, 2012, 2014
и 2017 годах.
Рисунок 2. Возрастная структура заболевших ветряной� оспой� в России в 2006-2018 годах (%).
14
Установлено неравномерное распределение стрирован в 2007 году и составил 8400,5 на 100

заболеваемости по возрастным группам на- тысяч детей� данного возраста, наименьший�
селения (рис. 3). Наибольшая заболеваемость показатель зафиксирован в 2016 году – 6265,9
отмечена среди детей� в возрасте 3-6 лет, мак- на 100 тысяч детей� данного возраста.
симальный� показатель среди них был зареги-
Рисунок 3. Заболеваемость ветряной� оспой� детей� различных возрастных групп в России

в 2006-2018 годах (показатели на 100 000 детей� данного возраста).
Высокие показатели заболеваемости детей� шим (42 474 ребенка и 47 взрослых). Структу-
дошкольного (2-6 лет) и школьного (7-14 лет) ра учреждений� , в которых были зарегистри-
возраста обусловлены, в том числе, и вспы- рованы вспышки, представлена в Таблице
шечной� заболеваемостью, поскольку в дет- 1. Приведенные данные подтверждают, что
ских образовательных учреждениях и школах дети, посещающие дошкольные образователь-
создаются условия, когда группа детей� на- ные учреждения и учащиеся школ представля-
ходится в одном помещении, при этом легко ют собой� социальные группы риска заболева-
реализуется аэрозольный� механизм передачи ния ветряной� оспой� .
возбудителя ветряной� оспы, возникают и раз-
Внутригодовое распределение случаев за-
виваются эпидемические вспышки с большим
болевания ветряной� оспой� также обуслов-
количеством заболевших. Например, в 2017
лено заболеваемостью детей� дошкольного
и 2018 годах, соответственно, 6,35% и 5,07%
и школьного возраста. Сезонный� подъем за-
от общего числа случаев заболевания за год
болеваемости начинался в сентябре, что со-
зарегистрировано в крупных эпидемических
впадает с началом учебного года в образова-
очагах ветряной� оспы с числом больных 10 и
тельных учреждениях, а с марта наблюдалось
более.
снижение заболеваемости, которая достигала
По данным статистического наблюдения в минимума в июле. Таким образом, сезонное
2017 году в России имела место 3271 вспышка распределение показателей� заболеваемости
ветряной� оспы с общим числом заболевших 54 непосредственно связано с формированием
513 человек (54 399 детей� и 114 взрослых), в детских коллективов. Выявлена прямая силь-
2018 году – 2 851 вспышка с 42 521 заболев- ная корреляционная связь между показателя-
15
ми помесячной� заболеваемости всего населе- учреждения (r=0,83; p<0,05), а также школьни-

ния и детей� 3-6 лет, посещающих дошкольные ков (r=0,83; p<0,05).
Таблица 1. Удельный� вес учреждений� разного типа, в которых в 2017-2018 гг. были зареги-стрированы
эпидемические вспышки ветряной� оспы с числом случаев заболевания 10 и более.
Зарегистрировано эпидемических вспышек
Тип учреждения 2017 год 2018 год
aбс.ч. % aбс.ч. %
Детские дошкольные учреждения 2436 74,47 2158 75,69
Школы 811 24,79 662 23,22
Колледжи, ВУЗы 4 0,12 1 0,04
Лечебные учреждения 6 0,18 10 0,35
Социальные учреждения для детей� 11 0,34 16 0,56
Прочие 3 0,10 4 0,14
ВСЕГО 3271 100 2851 100
Несмотря на то, что удельный� вес взрослых до 56 114 случаев ветряной� оспы у лиц в воз-
среди заболевших ветряной� оспой� оставал- расте 18 лет и старше. Показатели заболевае-
ся небольшим (5-7%), за период наблюдения мости взрослых находились на уровне 29,0 –
ежегодно в России регистрировали от 33 293 47,4 на 100 тыс. взрослого населения (рис. 4)
Рисунок 4. Заболеваемость ветряной� оспой� взрослого населения в Россий� ской� Федерации и в г. Москве
в 2006-2018 годах (показатели на 100 000 населения в возрасте 18 лет и старше).
При этом в целом по стране наметилась тен- та гной� но-септических и внутриутробных

денция повышения показателя заболевае- инфекций� ) в Москве за период наблюдения
мости взрослого населения. Однако для под- ежегодно составлял 10-18%, что в абсолют-
тверждения данного вывода необходимы ных числах составило от 22 (в 2017 г.) до 101
дальней� шие наблюдения. (в 2011 году) случая в год. За анализируемый�
период зарегистрировано 5 случаев зараже-
Одной� из эпидемиологических особенностей�
ния ветряной� оспой� медицинских работников
ветряной� оспы является внутрибольничная
по месту работы. В многолетней� динамике от-
заболеваемость: удельный� вес ветряной� оспы
мечалась выраженная тенденция к снижению
в структуре госпитальных инфекций� (без уче-
16
числа внутрибольничных случаев ветряной� часть из них (около 40%) были осуществлены в
оспы в городе. столице – г. Москве (табл. 2). Ежегодно в Москве
были вакцинированы более 20 000 детей� . В ре-
В рамках проведенного исследования была дана
зультате в динамике заболеваемости ветряной�
оценка влиянию вакцинации на уровень забо-
оспой� в Москве, в отличие от страны в целом,
леваемости ветряной� оспой� в Москве, Санкт-Пе-
наблюдалась тенденция к снижению (рис. 1).
тербурге и Россий� ской� Федерации в целом.
В другом мегаполисе, Санкт-Петербурге, за
С 2013 г. по 2018 г. в России было проведено тот же период времени ежегодно прививали
368 973 прививок против ветряной� оспы, еже- от 876 до 3 567 детей� , что составило от 2,1 до
годно вакцинировали от 32 112 до 85 517 де- 4,8% от общего числа введенных доз вакцины
тей� . В 2016-2018 годах объемы вакцинации против ветряной� оспы в России. В этих услови-
уменьшились с 78 833 до 57 128 прививок в ях заболеваемость ветряной� оспой� в Санкт-Пе-
год, что было обусловлено отсутствием оте- тербурге не уменьшилась и даже приобрела
чественной� вакцины и трудностями органи- тенденцию к росту (рис. 1).
зации закупок импортного препарата. На этом
На Рисунке 5 отражена динамика заболева-е-
фоне заболеваемость ветряной� оспой� в стране
мости ветряной� оспой� населения г. Москвы и
не имела тенденции к снижению (рис. 1).
г. Санкт-Петербурга в сопоставлении с коли-
По регионам России проведенные прививки чеством проведенных детям прививок против
распределялись неравномерно: значительная этой� инфекции.
Рисунок 5. Заболеваемость ветряной� оспой� и количество проведенных прививок

против ветряной� оспы в г. Москве и в г. Санкт-Петербурге в 2006-2018 гг.
С введением вакцинации заболеваемость де- Результаты количественного анализа не вы-

тей� 3-6 лет в Россий� ской� Федерации снизилась явили достоверной� сильной� степени корре-
на 28%: с 7057,9 до 5105,5 на 100 тысяч детей� ляционной� связи заболеваемости от числа
данного возраста. В то же время уменьшилась прививок против ветряной� оспы. На примере
и заболеваемость детей� в возрасте 7-14 лет, населения страны в целом прослеживалась от-
причем в Москве, по сравнению с Россией� в це- рицательная слабой� степени зависимость по-
лом, тенденция снижения заболеваемости де- казателей� заболеваемости детей� , подростков
тей� дошкольного и школьного возраста была и взрослых от числа проведенных прививок.
более выражена (рис. 6, 7). По данным, полученным в Москве, установле-
на лишь слабой� степени отрицательная корре-
Для оценки зависимости показателей� забо- ляционная связь показателей� заболеваемости
ле-ваемости ветряной� оспой� от объемов имму- детей� 3-6 лет и количества прививок. Более
низации против этой� инфекции был проведен того, выявлена слабая прямая зависимость за-
расчет коэффициента корреляции Пирсона болеваемости взрослых и детей� в возрасте до
для попарно связанных параметров (табл. 2). 1 года от числа сделанных прививок.
17
В условиях начального этапа вакцинопро- демонстрировала тенденцию к росту, однако

филактики ветряной� оспы заболеваемость в Москве наблюдалось снижение показателей�
взрослого населения Россий� ской� Федерации заболеваемости взрослых (рис. 4).
Рисунок 6. Заболеваемость ветряной� оспой� детей� 3-6 лет в Россий� ской� Федерации и в г. Москве
(2006-2018 годы).
Рисунок 7. Заболеваемость ветряной� оспой� детей� 7-14 лет в Россий� ской� Федерации и в г. Москве
(2006-2018 годы).
Таблица 2. Зависимость между уровнями заболеваемости ветряной� оспой� (ВО) разных возрастных групп
населения и числом привитых против ветряной� оспы лиц (Россий� ская Федерация, г. Москва, 2006-2018 годы).
г. Москва РФ
коэфф. Характеристика коэфф. Характеристика
Связанные параметры
коррел. корреляционной� коррел. корреляционной�
Пирсона r связи Пирсона r связи
Уровень заболеваемости ВО детей� 3-6 лет/ -0,24 отрицательная, -0,36 отрицательная,
число привитых против ВО слабая слабая
Уровень заболеваемости ВО детей� 7-14 лет/ -0,04 отсутствует -0,33 отрицательная,
число привитых против ВО слабая
Уровень заболеваемости ВО подростков/ -0,04 отсутствует -0,39 отрицательная,
число привитых против ВО слабая
Уровень заболеваемости ВО взрослых/ +0,23 положительна, -0,41 отрицательная,
число привитых против ВО слабая слабая
Уровень заболеваемости ВО детей� до 1 +0,20 положительна, -0,11 отрицательная,
года/ число привитых против ВО слабая очень слабая
18
ДИСКУССИИ лицензирована в Канаде в 1998 г., а плановая

Результаты исследования показали, что тен- иммунизация началась в 2004 г. в Онтарио.
денция, многолетняя и внутригодовая циклич- Уровень госпитализаций� , обращений� за неот-
ность, возрастная структура и вспышечный� ложной� помощью и количество амбулаторных
характер заболеваемости ветряной� оспой� в визитов снизились, в среднем, на 53%, 43% и
России не изменились по сравнению с довак- 45%, соответственно, по сравнению с 9%, 23%
цинальным периодом (6, 7). Современные про- и 29% по тем же показателям при внедрении
явления эпидемического процесса ветряной� вакцинации только в частном секторе (14).
оспы в России аналогичны тем, которые на- Эксперты ВОЗ предупреждали, что при недо-
блюдались в США и странах Европы до начала статочном охвате прививками детей� может
вакцинации против этой� инфекции (8-12). наблюдаться «повзросление» инфекции и
Практически все авторы отмечали, что ветря- рост числа тяжелых случаев заболевания сре-
ная оспа относится к «детским» инфекциям ди подростков и взрослых (13). Подобное на-
вследствие легкости реализации аэрозольно- блюдалось, например, в США. До 1995 г. почти
го механизма передачи возбудителя, при ко- 73% случаев ветряной� оспы регистрировали у
тором большинство детей� инфицируются уже детей� в возрасте до 6 лет с «пиком» заболева-
в первые годы жизни. емости в группе детей� 3-6 лет. А уже в 2004 г.
дети в возрасте до 6 лет включительно соста-
В 1998 г. Всемирная Организация Здраво-ох- вили только 30% заболевших этой� инфекцией� .
ранения на основании опыта Японии и США Максимальные показатели заболеваемости
рекомендовала плановую («универсаль-ную») среди вакцинированных регистрировали у де-
иммунизацию детей� в странах, где ветряная тей� в возрасте 6-9 лет, а среди непривитых – у
оспа является значительной� проблемой� здра- детей� 9-12 лет. При этом абсолютное число за-
воохранения, экономики и общества в целом, болеваний� среди детей� старшего возраста не
где вакцина является доступной� и где дости- увеличилось по сравнению с довакцинальным
жим и может поддерживаться высокий� (85- периодом (15).
90%) охват вакцинацией� (13).
В условиях начального этапа вакцинопро-
В Россий� ской� Федерации вакцинопрофи-лак- фи-лактики ветряной� оспы заболеваемость
тика ветряной� оспы началась с исполь-зовани- взрослого населения России демонстриро-
ем двух тактик иммунизации: первая- проведе- ва-ла тенденцию к росту, однако в Москве на-
ние прививок по эпидемическим показаниям, блюдалось снижение показателей� заболе-ва-
что, по сути, является вариантом выборочной� емости населения в возрасте 18 лет и старше
вакцинации, вторая – плановая (когортная) (рис. 4). Выявленная в 2018 году слабая по-
вакцинация в некоторых регионах с охватом ложительная корреляция заболева-емости
вакцинацией� ниже 90% вследствие ограни- взрослых в Москве с количеством сделанных
ченного финансирования закупок импортной� прививок, возможно, является следствием
вакцины из средств бюджета здравоохране- «повзросления» ветряной� оспы, обусловлен-
ния субъекта федерации. ной� недостаточным уровнем охвата детей� пла-
Как было показано, применение данных так- новой� вакцинацией� .
тик не позволила существенно улучшить ситу- Следует подчеркнуть, что причиной� относи-
ацию с ветряной� оспой� в целом по стране. При тельного «сдвига» заболеваемости на старшие
этом результаты вакцинации против ветря- возрастные группы может являться также ис-
ной� оспы в Москве продемонстрировали пре- пользование однодозной� схемы вакцинации
имущество эффекта плановой� вакцинации по против ветряной� оспы, поскольку после одно-
сравнению с выборочной� . кратной� прививки остается значительное чис-
К аналогичному заключению в свое время при- ло неиммунных лиц (16-18).
шли исследователи из Канады, которые пока- Чтобы предупредить это последствие вакци-
зали, что плановая иммунизация эффектив- нации, необходимо предусмотреть повторную
нее выборочной� вакцинации, проводимой� на прививку для детей� , получивших первую дозу
коммерческой� основе частными врачами. Вак- вакцины. К подобному заключению приводит
цина для профилактики ветряной� оспы была опыт профилактики кори, краснухи и эпиде-
19
мического паротита. Развитие вакцинопрофи- двукратной� прививки и использованием ком-

лактики этих трех инфекций� в стране прохо- бинированных вакцин против кори, краснухи
дило через период однократной� вакцинации. и эпидемического паротита и ветряной� оспы.
При всех трех инфекциях для профилактики
В рекомендациях ВОЗ (20) подчеркивалось,
эпидемических вспышек в школах, снижения
что до того, как страны примут решение о
риска возникновения врожденных и тяже-
внедрении вакцины против ветряной� оспы в
лых клинических форм заболевания проводят
программы плановой� иммунизации детей� , они
повторную вакцинацию детей� перед посту-
должны создать адекватный� эпиднадзор за
плением в школу, а также дополнительную
болезнью для оценки бремени ветряной� оспы
иммунизацию взрослых. Общие эпидемиоло-
с проведением постоянного эпиднад-зора по-
гические закономерности указанных инфек-
сле внедрения вакцинации. В связи с этим на
ций� и ветряной� оспы позволяют использовать
этапе расширения вакцинации в России про-
единые подходы к управлению эпидпроцес-
должается совершенствование системы эпи-
сом при всех четырех нозологиях (19). Поэто-
демиологического надзора за ветряной� оспой�
му перспективы вакцинопрофилактики ве-
и ее вакцинопрофилактикой� .
тряной� оспы в России связаны с внедрением
ВЫВОДЫ
1. В России на начальном этапе вакцинопрофилактики эпидемиологическая характеристика ве-
тряной� оспы не изменилась по сравнению с довакцинальным периодом, что обусловлено недо-
статочным уровнем охвата иммунизацией� детского населения.
2. На примере организации иммунизации против ветряной� оспы в городе Москве продемонстри-
ровано, что однократная вакцинация детей� перед поступлением в дошкольные образователь-
ные учреждения позволила снизить заболеваемость детей� в возрасте 3-6 лет, однако вследствие
неполного охвата прививками всей� когорты детей� данного возраста стой� кого эпидемиологиче-
ского эффекта достичь не удалось.
3. При внедрении вакцинации необходимо усиление эпидемиологического надзора за ветряной�
оспой� и ее вакцинопрофилактикой� для своевременного реагирования на неблагоприятные тен-
денции в виде «повзросления» инфекции.
КОНФЛИКТ ИНТЕРЕСОВ 4. Приказ Минздрава России от 21.03.2014 г.

Авторы подтверждают отсутствие конфликта №125н «Об утверждении национального кален-
даря профилактических прививок и календаря
интересов.
прививок по эпидемическим показаниям».
5. Приказ Департамента здравоохранения г. Мо-
ЛИТЕРАТУРА сквы от 04.07.2014 г. №614 «Об утверждении ре-
1. О состоянии санитарно-эпидемиологического гионального календаря профилактических при-
благополучия населения в Российской Федерации в вивок и календаря прививок по эпидемическим
2018 году: Государственный доклад. – Москва: Фе- показаниям».
деральная служба по надзору в сфере защиты прав
6. Воронин Е.М, Ермоленко М.В, Чернова А.М, Лыт-
потребителей� и благополучия человека; 2019.
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13. Varicella vaccines. WHO position paper. мы управления эпидемическим процессом кори,
MMWR.1998; 73:241-248. эпидемического паротита и краснухи. Эпидемио-
14. Kwong J.C, Tanuseputro P, Zagorski B, et al. Impact логия и вакцинопрофилактика. 2011; 1(56):8-14.
of varicella vaccination on health care outcomes in 20. Meeting of the Strategic Advisory Group of Experts
Ontario, Canada: Effect of a publicly funded pro- on immunization, April 2014 – conclusions and re-
gram? Vaccine.2008; 26:6006-6012. commendations. Weekly epidemiological record.
15. Chaves S.S, Gargiullo P, Zhang JX. et al. Loss of vac- 2014, 2(89):221-236 Available from: http://www.
who.int/we.
Дата получения рукописи: 10/09/2019

Дата принятия к публикации: 20/02/2020
Наталия АФОНИНА, ORCID 0000-0002-3205-4025,

Ирина МИХЕЕВА, ORCID 0000-0001-8736-4007, SCOPUS Author ID S-4858-2016
21
STUDY OF ANTIBIOTIC SUSCEPTIBILITY OF SALMONELLA SPP.

ISOLATED FROM FOOD AND BIOLOGICAL MATERIAL
Liliia VYGOVSKA, Vitalii NEDOSEKOV, Valerii USHKALOV, Oksana BOYKO, Oleksandra KEPPLE,
Yuriy VISHOVAN, Sergiy TERESHCHENKO, Liliana DAVYDOVSKA, Sergiy BOIANOVSKIY,
Valentina MOMOT, Tatyana KORCHOVA
Ukrainian Laboratory of Quality and Safety of Agricultural Products,
National University of Life and Environmental Sciences of Ukraine
Corresponding author: Liliia Vygovska, е-mail: lnvygovska@gmail.com
DOI: 10.5281/zenodo.3700957 CZU: 579.842.14:615.33.015.8
Key words: Salmonella Introduction. Antimicrobial resistance is a global public health problem that the
spp., biological properties, world is facing today.
antibiotics, resistance, sus- Material and methods. Isolation and identification of Salmonella spp. were per-
ceptibility. formed according to DSTU EN 12824: 2004; DSTU ISO 18593: 2006 standards; Nutri-
ent media were manufactured in accordance with DSTU EN ISO 11133: 2014 standard.
The antibiotic susceptibility of cultures was determined by the disk diffusion method.
The research findings were both studied and interpreted in accordance with EUCAST
recommendations.
Results. Out of 10 samples (material was obtained from animals, humans and foods),
10 cultures of Salmonella spp. were isolated and analyzed. The cultures were mainly
susceptible to semisynthetic and inhibitor-protected penicillins, cephalosporins, car-
bapenems and more often to tetracyclines, macrolides, lincosamides. Most Salmonella
spp. strains were intermediate susceptibility to aminoglycosides, 30% of Salmonella
spp. strains were susceptible to pefloxacin (II) and only 10% were susceptible to cipro-
floxacin (II).
Conclusions. The obtained data indicate the screening feasibility of antibiotic suscep-
tibility of Salmonella spp. including a wide range of tested drugs, which may be impor-
tant in determining the antibiotic therapy.
Cuvinte cheie: Salmonella STUDIEREA SENSIBILITĂŢII LA ANTIBIOTICE A SPECIILOR DE SALMONELLA,

spp., proprietăţi biologice, IZOLATE DIN MATERIALE BIOLOGICE ȘI PRODUSE ALIMENTARE
antibiotice, rezistenţă, sen- Introducere. Actualmente, rezistența antimicrobiană este o problemă globală de
sibilitate. sănătate publică.
Material şi metode. Izolarea și identificarea Salmonella spp a fost efectuată conform
standardelor DSTU EN 12824:2004; DSTU ISO 18593:2006; mediile nutritive fiind
preparate în conformitate cu standardul DSTU EN ISO 11133:2014. Sensibilitatea
tulpinilor la antibiotice a fost determinată prin metoda disc-difuzimetrică, iar studiul
și interpretarea rezultatelor au fost realizate în conformitate cu recomandările EU-
CAST.
Rezultate. Din 10 probe (material prelevat de la animale, oameni și din alimente) au
fost izolate și studiate 10 tulpini de Salmonella spp. Preponderent, tulpinile sunt sensi-
bile la penicilinele de semisintetice şi cele protejate de inhibitori, cefalosporine, carbap-
eneme; mai frecvent prezentând rezistență la tetracicline, macrolide și lincosamide.
Pentru aminoglicozide însă majoritatea tulpinilor Salmonella spp. au prezentat sen-
sibilitate intermediară, astfel, din 30% tulpini Salmonella spp. sensibile la pefloxacină
(II), doar 10% au fost sensibile la ciprofloxacină (II).
Concluzii. Datele obținute indică fezabilitatea screening-ului sensibilității Salmonella
spp. la antibioticele din cea mai largă listă posibilă de preparate testate, impunându-se
drept acțiune oportună în determinarea antibioticoterapiei.
22
INTRODUCTION RESULTS
Over the XXI century, infectious diseases are sti- The microbial cultures were isolated during the
ll the main causes of death worldwide (1, 2). microbiological assessment of materials taken
Recently, the spread of antibiotic-resistant mi- from Kiev, Volyn region.
croorganisms has become a public concern. Anti-
The study confirmed 6 samples of biomaterial,
microbials have been used in the production of li-
obtained from birds and 6 Salmonella spp. strains
vestock products for therapeutic and prophylactic
were identified: S. Typhimurium (from geese), S.
purposes, which contributed to the development
Virchow (from ducks), S.Virchow (from chickens),
of adaptive mechanisms to the applied antibiotics.
S. Gallinarum, S. Pullorum (from chickens), S. Ente-
This, in turn, served as an impetus for the produc-
ritidis (from chickens) S. Dublin (from calf); two
tion of new antimicrobial agents.
cultures – from food samples (S. Enteritidis, which
The Ukrainian agriculture sector shows a con- are rare Salmonella species (F-67+) and two cultu-
siderable sample size among global production res (S. Enteritidis, S. Typhimurium) found in peo-
volumes (3, 4). An increase in both the demand ple with symptoms of food poisoning).
and production volume of agricultural products is
The bacterial cultures formed a uniform turbidity
accompanied by a free section of the continental
and a small amount of white amorphous sediment
boundaries of semi-finished or finished agri-fo-
in the Pepted Meat Broth, which was easily bro-
od products (5). Migration of people, birds and
ken-down while being shaken. The cultures of S.
terrestrial wild animals also has contributed to
Dublin, S. Gallinarum, S. Pullorum formed growth
the microbial long-distance transfer (5, 6, 7, 8). All
rings. The bacterial cultures formed transparent,
these factors have differently promoted the spread
tender, greyish and 3-4 mm S-colonies in Meat In-
of multi-resistant microbial strains to the existing
fusion Agar.
antibiotics both due to their transportation by li-
ving organisms over long distances, and due to the The laboratory animals (white mice weighing 16-
production of the agro-industrial complex. 18 g) which were subcutaneously administered
doses of 0.5×109 CFU/cm3 died in 100% of experi-
The purpose of this work is to study the biological
mental animals within 8 hours.
properties and assess the antibiotic resistance
among various groups Salmonella spp. cultures, The research findings showed that the studied cul-
isolated from biological samples taken from Kiev, tures in 100% of cases were susceptible to ampi-
Volyn region. cillin and ampicillin/sulbactam, whereas were re-
sistant to benzylpenicillin and methicillin; 90% of
MATERIAL AND METHODS strains were resistant to oxacillin; 50% of cultures
were susceptible to ticarcillin and 10% – resistant
Salmonella spp. strains were isolated and iden-
to ticarcillin/clavulanic acid; 30% of strains were
tified from the research materials according to:
susceptible and 60% were resistant to amoxicillin;
DSTU EN 12824:2004 Microbiology of food pro-
30% of cultures were susceptible 30% – resistant
ducts and animal nutrition. Horizontal method
to piperacillin; 20% of strains were susceptible
for detecting Salmonella spp.; DSTU 4769:2007
and 80% – resistant to carbenicillin.
Bacteriological study of pathological material
from animals. Methods of detecting salmonella; The structural similarity between cephalosporins
MU 4.2.2723-10 “Laboratory diagnostics of sal- and penicillins causes the same mechanism of an-
monella, detection of Salmonella in food products timicrobial action and cross-allergies in some pa-
and environmental objects”, 2010; DSTU ISO tients (10, 11). The studied Salmonella spp. strains
18593:2006 “Microbiology of food products and showed susceptibility to most of cephalosporins;
animal nutrition. The study of microbial finger- no direct dependence of levels of antimicrobial
printing and washings from the surface”. Antibio- susceptibility to various generation of drugs was
tic susceptibility testing by disc diffusion method, found: 80% of the studied strains showed suscep-
using HiMedia’s discs. The research findings were tibility and 10% showed resistance to cefazolin
studied and interpreted in accordance with EU- (I); 60% of cultures showed susceptibility and
CAST guidelines (9). 30% showed resistance to cephalexin (I); 90% of
the studied bacterial strains were susceptible and
10% of cultures were resistant to cefaclor (II).
23
20% of the studied cultures were susceptible and Depending on the mechanism of action, quinolo-
60% are resistant to cefuroxime (II); 90% of the nes differ completely from other AMP drugs. 50%
studied cultures were susceptible to cefamandole of Salmonella spp. were susceptible to nalidixic
(II), no resistant cultures were detected; 80% of acid (I), norfloxacin (II), levofloxacin (III), and
the studied cultures were susceptible and 20% are gatifloxacin (IV). The remaining drugs showed a
resistant to cefixim (III); 30% of the studied cul- susceptibility of 30% (pefloxacin (II) to 10% (ci-
tures were susceptible and 30% were resistant to profloxacin (II), оfloxacin (II), lomefloxacin (II)) of
cefoperazone (III); 80% of the cultures of the stu- the studied cultures of Salmonella spp.
died cultures showed susceptibility to cefotaxim
Pathogenic microorganisms rarely develop anti-
(III), no resistant cultures were detected; 50% of
biotic resistance to nitrofurans. (19, 20, 21). The
the studied bacterial strains showed susceptibility
study results showed that 40% of the studied cul-
and 20% were resistant to ceftazidime (III); 20%
tures were susceptibile to furazolidone.
of the studied strains were susceptible and 20%
were resistant to ceftriaxone (III); 100% of the All the studied Salmonella spp. strains were sus-
studied strains showed resistance to cefepim (IV). ceptibile to chloramphenicol
Due to the natural activity of carbapenems (imipe-
DISCUSSIONS
nem and meropenem) against enterobacteria, the
studied cultures were found susceptible to imipe- Ten Salmonella spp. strains were isolated from 10
nem (70%) and meropenem (80%). samples of food products and biological material
of various origin. Among the isolated cultures, 2
No Salmonella spp. resistant to carbapenems was isolates belong to S. Enteritidis, 2- to S. Typhimu-
detected. rium, 2- to S. Virchow, 1- to S. Dublin, S. Gallina-
The most studied cultures exhibited a moderate rum, S. Pullorum, S. Muenchen, Salmonella F-67+.
resistance to aminoglycosides: 20% of cultures Cultural-morphological, enzymatic and antigenic
were susceptible and 30% were resistant to strep- properties of the selected cultures correspond to
tomycin (I); 60% – susceptible and 10% – resis- species characteristics; all bacterial cultures pro-
tant to gentamicin (I); 20% – susceptible and 20% ved to be pathogenic in white mice.
– resistant to kanamycin (I); 20% of cultures are The cultures were predominantly susceptible to
susceptible and 80% – intermediate susceptible semisynthetic and inhibitor-protected penici-
to neomycin (I); 40% –and 10% – resistant to llins, cephalosporins and carbapenems; cultures
tobramycin (II); except for netilin (II), to which showed resistance to tetracyclines, macrolides,
100% of the cultures were susceptible, and ami- and lincosamides in most cases. As regarding the
kacin (III), which showed an inhibitory effect on aminoglycosides, most of Salmonella spp. strains
20% of the studied Salmonella spp. strains showed intermediate resistance; up to 50% of stu-
Salmonella spp. have natural resistance to macroli- died Salmonella spp. strains were susceptible to
des (12, 13). Our studies also proved that Salmone- some quinolones of different generations, howe-
lla spp. is resistant to macrolides. However, cultures ver, cultures showed resistance to an overwhel-
of S. Gallinarum, S. Pullorum, S. Dublin, S. Virchow ming number of cases; 30% of the selected Salmo-
(Q) were susceptible to azithromycin (15); S. Virc- nella spp. cultures were susceptible to amoxicillin,
how (Q) strain was susceptible to clarithromycin. whereas the cultures were non-susceptible to
ampicillin, a screening recommended by EUCAST
Most of the Salmonella spp. showed natural resis-
(version 8) on the enterobacteria sensitivity to
tance to tetracyclines. The culture of S. Gallinarum
amoxicillin. From 30% of Salmonella spp. strains
Pullorum was susceptible to tetracycline, doxycy-
susceptible to pefloxacin (II) (EUCAST screening
cline; S. Typhimurium (F) showed sensitivity to
recommendations on susceptibility of Salmonella
Tetracycline.
spp. to ciprofloxacin), 10% cultures showed sus-
High concentrations of linquamides may also ceptibility to ciprofloxacin (II).
exhibit bactericidal effects to relatively high sus-
The study analysis found that the studied cultu-
ceptible microorganisms (13, 14). The studies
res isolated from food products, sick and dead
conducted on microbial resistance to lincosami-
animals, and biomaterial obtained from people
des showed susceptibility to lincomycin and clin-
were characterized by natural susceptibility to
damycin, except for S. Virchow (Q) strain.
24
antibiotics; no cases of acquired resistance was the current rational use of antibiotic therapy may
found within this study. This may indicate that, be effective.
CONCLUSIONS
1. The data obtained may indicate the need for screening studies on the susceptibility of Salmonella spp.
strains to antibacterial drugs, while the list of studied drugs should be expanded as much as possible. It
might be important when choosing an appropriate antibiotic therapy.
CONFLICT OF INTERESTS Conference on International Participation. Kyiv;

All authors declare no competing interests. 2017.
9. EUCAST. The european committee on antimicrobial
susceptibility testing. 2018 Available from: http://
ACKNOWLEDGMENT
www.eucast.org/ [Accessed 10th September 2019].
This present research was financially supported by 10. Threlfall E, Fisher I, Berghold C, et al. Antimicrobi-
the Ministry of Education and Science of Ukraine. al drug resistance in isolates of Salmonella enterica
from cases of salmonellosis in humans in Europe in
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Liliia VYGOVSKA, ORCID 0000-0001-6745-5753

Vitliy NEDOSEKOV, ORCID 0000-0001-7581-7478, SCOPUS Author ID 5718580555
Valerii USHKALOV, ORCID0000-0001-5694-632X, SCOPUS Author ID 36130483300
Oksana BOYKO, ORCID 0000-0001-8113-9423
Oleksandra KEPPLE, ORCID 0000-0002-8123-3310, Web of Science Researcher ID B-2919-2018
Yuriy VISHOVAN, ORCID 0000-0003-1128-593X
Sergiy TERESHCHENKO, ORCID 0000-0002-5786-8711
Sergiy BOIANOVSKIY, ORCID 0000-0002-4621-5192
26
К ВОПРОСУ ВАКЦИНОПРОФИЛАКТИКИ ПНЕВМОКОККОВОЙ

ИНФЕКЦИИ СРЕДИ НЕДОНОШЕННЫХ ДЕТЕЙ
С БРОНХОЛЕГОЧНОЙ ДИСПЛАЗИЕЙ
Владислав СЕМЕРИКОВ1, Елена ЗУБОВА2, Вера ЛОШКАРЕВА2, Людмила СОФРОНОВА2,
Мария ПЕРМЯКОВА2
ФГБОУ ВО ПГФА Минздрава России, Пермь, Россия
1
ФГБОУ ВО ПГМУ им. академика Е. А. Вагнера Минздрава России, Пермь, Россия

2
Контактная информация: Елена Зубова, e-mail: zubovaes@mail.ru
DOI: 10.5281/zenodo.3700973 УДК: 053.32-022.7-007.17-24./614.47:616.233
Key words: PCV13 VACCINE PROPHYLAXIS OF PNEUMOCOCCAL INFECTION AMONG PREMATURE IN-
vaccine, pneumo- FANTS WITH BRONCHOPULMONARY DYSPLASIA
coccal infection, Introduction. Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease
bronchopulmonary among children of the first year of life, especially children born prematurely with extremely
dysplasia. low and very low body weight.
Material and methods. To estimate the number of children born alive in Perm Territory
between 2015 and 2017, official statistics data were used. Experimental epidemiological
studies were used to assess safety, reactogenicity, immunogenic activity and preventive effi-
cacy of the Prevnar 13 vaccine when immunizing preterm infants with bronchopulmonary
dysplasia under prospective controlled randomized clinical observation.
Results. There were 29 premature infants with bronchopulmonary dysplasia under ob-
servation, the control group comprised 29 unvaccinated premature infants with BPD and
30 full-term infants. The PCV 13 vaccination of preterm infants with BPD established good
tolerance, poor reactogenicity (17.2±0.57%) and vaccine tolerance like full-term infants
(16.5±0.55%), high safety profile, high immunogenic properties (seroconversion – 93.1%,
seroconversion factor – 5.5). Evaluation of immunogenic activity among children with BPD
vaccinated with the PCV 13 vaccine revealed high immunological efficacy compared to un-
vaccinated healthy children.
Conclusion. The need for vaccination of premature babies with BDL against pneumococcal
infection has been scientifically substantiated. The study has confirmed safety, poor reac-
togenicity, high immunogenic activity and preventive efficacy of the Prevenar 13 vaccine
among premature babies with BDL under the conditions of the catamnesis department of
the perinatal center within the follow-up monitoring of vaccinated infants over three years.
Cuvinte cheie: vaccin VACCINOPROFILAXIA INFECȚIEI PNEUMOCOCICE LA SUGARII NĂSCUȚI PREMATUR,
VPC13, infecție pneu- DIAGNOSTICAȚI CU DISPLAZIE BRONHOPULMONARĂ
mococică, displazie Introducere. Cea mai frecventă boală pulmonară cronică la copii în primul an de viață,
bronhopulmonară. în special la sugarii născuți prematur, cu o greutate corporală foarte mică, este displazia
bronhopulmonară (DBP).
Material și metode. Pentru a estima numărul copiilor născuți vii în perioada 2015-2017,
în regiunea Permi, Rusia au fost utilizate datele statistice oficiale. Au fost proiectate stu-
dii epidemiologice experimentale pentru evaluarea eficacității profilactice și a reactivității,
demonstrarea siguranței și activității imunogene a vaccinului pneumococic conjugat (VPC
13) la imunizarea sugarilor născuți prematur cu DBP.
Rezultate. Au fost investigați 29 de copii născuți prematur, diagnosticați cu DBP și pentru
comparație – 29 de copii născuți prematur, nevaccinați cu DBP și, respectiv, 30 de copii
născuți la termen. Vaccinul VPC 13 administrat la sugarii născuți prematur care suferă de
DBP a stabilit o toleranță bună, reactivitate scăzută (17,2±0,57%) și toleranță similară la
vaccin ca și la copiii născuți la termen (16,5±0,55%), siguranță înaltă, proprietăți imuno-
gene crescute (seroconversia – 93,1%, factorul seroconversiei – 5,5). Evaluarea activității
imunogene la copiii cu DBP, vaccinați cu VPC 13 a evidențiat o eficacitate imunologică ridi-
cată la copiii născuți prematur cu DBP, în comparație cu copii sănătoși vaccinați.
Concluzii. Astfel, a fost dovedită științific necesitatea vaccinării copiilor născuți prematur
cu DBP împotriva infecției pneumococice și a fost confirmată siguranța vaccinului, reactivi-
tatea scăzută, activitatea imunogenă ridicată și eficacitatea profilactică.
27
ВВЕДЕНИЕ Оценка количества детей� , родившихся живы-

В настоящее время достаточно велико гло- ми, на территории Пермского края в 2015-2017
бальное бремя пневмококковой� инфекции гг., проведена по официальным данным оказа-
среди детей� до 5 лет. Наиболее частой� хрони- ния медицинской� помощи беременным, роже-
ческой� патологией� легких среди детей� первого ницам и родильницам (форма №32) и данных
года жизни, особенно среди детей� , родивших- годовых отчетных форм отделения катам-
ся недоношенными с экстремально низкой� неза краевого перинатального центра ГБУЗ
массой� тела и очень низкой� массой� тела, явля- ПК «Ордена «Знак Почета» Пермская краевая
ется бронхолегочная дисплазия (БЛД)(1). клиническая больница». Экспериментальные
эпидемиологические исследования применя-
БЛД – это полиэтиологическое хроническое за- ли для оценки безопасности, реактогенности,
болевание морфологически незрелых легких, иммуногенной� активности и профилакти-
развивающееся у новорожденных, главным ческой� эффективности вакцины ПКВ 13 при
образом глубоко недоношенных детей� , в ре- иммунизации недоношенных детей� с бронхо-
зультате интенсивной� терапии респираторно- легочной� дисплазией� в условиях проспектив-
го дистресс-синдрома и (или) пневмонии (1). ного контролируемого рандомизированного
Бронхолегочная дисплазия выявляется прак- клинического наблюдения, проведенного в
тически у всех новорожденных, родившихся 2015-2017 гг. Для иммунизации недоношен-
со сроком гестации менее 28 недель, у 40% – с ных детей� с бронхолегочной� дисплазией� ис-
гестационным возрастом 28-30 недель, у 4% пользовалась вакцина ПКВ 13 с 2-х месячного
– более 30 недель (1). Доказано, что обостре- возраста по схеме «3+1». Критериями включе-
ние БЛД связано с присоединением вирусных ния детей� явились: гестационный� возраст ме-
и вирусно-бактериальных ассоциаций� . Нали- нее 32 недель; отсутствие противопоказаний� к
чие бронхолегочной� дисплазии обуславливает введению вакцины Превенар 13, содержащей�
наиболее высокую восприимчивость к пневмо- 13 серотипов пневмококка – 1, 3, 4, 5, 6А, 6В,
кокковой� инфекции (2, 3). Центральное место 7F, 9V, 14, 18C, 19A, 19F и 23F, по схеме «3+1»,
в патогенезе БЛД занимает незрелость легких предусмотренных инструкцией� по примене-
недоношенного ребенка, что предрасполагает нию; наличие письменного информированно-
к баротравме и токсическому дей� ствию кис- го согласия родителей� на профилактическую
лорода при искусственной� вентиляции легких прививку. Вакцину ПКВ 13 в дозе 0,5 мл вводи-
(ИВЛ), приводящие к системной� воспалитель- ли внутримышечно в область переднебоковой�
ной� реакции легких, нарушая процесс форми- поверхности бедра в соответствии с инструк-
рования альвеол. Наличие БЛД у ребенка не- цией� по применению препарата.
редко приводит к ремоделированию стенки
бронхов и развитию легочной� гипертензии (4, Безопасность вакцины оценивалась врачом
5). Среди детей� с БЛД вне обострения заболе- иммунологом-аллергологом в ходе клини-
вания при исследовании назофарингеальных че-ского наблюдения за недоношенными деть-
мазков с помощью полимеразной� цепной� реак- ми с БЛД, привитыми и не привитыми против
ции инфицирование пневмококком достигает пневмококковой� инфекции, на основании дан-
12,6% (6). При инфицировании пневмококком ных лабораторных исследований� привитых и
дети с БЛД развивают тяжелые обострений� ос- не привитых в динамике: до и после иммуни-
новного заболевания (7). зации (на 28-й� день) с оценкой� общего анализа
крови (общего гемоглобина, содержания эри-
МАТЕРИАЛЫ И МЕТОДЫ троцитов, лей� коцитов, лей� коцитарная форму-
ла), уровня общего содержания IgE в сыворот-
Целью настоящего исследования определить
ке крови, а также результатов биохимического
распространенность бронхолегочной� патоло-
анализа сыворотки крови с определением об-
гии среди недоношенных детей� и установить
щего билирубина, аспартатаминотрансфера-
влияние вакцинации недоношенных детей� ,
зы (АСТ), аланинаминотрансферазы (АЛТ),
страдающих бронхолегочной� дисплазией� , про-
общего белка и креатинина, общего анализа
тив пневмококковой� инфекции на состояние
мочи (реакция мочи, плотность, число пло-
их здоровья.
ского эпителия и лей� коцитов), выполненных
стандартными унифицированными методами.
28
Реактогенность вакцины оценивали по нали- зации недоношенных детей� с БЛД использова-

чию системных и местных поствакцинальных лась вакцина ПКВ13.
реакций� , степени их выраженности и продолжи-
тельности на основе активного клинического РЕЗУЛЬТАТЫ
наблюдения за привитыми детьми по специаль- Методом случай� ной� выборки (единица вы-
ной� программе – через 30 минут и на 28 сутки борки – один ребенок) были сформированы
после иммунизации, а также по результатам 2 группы наблюдения. Дети основной� группы
ежедневных записей� родителей� в дневниках са- (n=29) имели БЛД и привиты вакциной� против
монаблюдения. Системные реакции оценивали пневмококковой� инфекции (первая группа).
по степени повышения температуры тела (тем- Группу сравнения (n=29) составили неприви-
пературные реакции были дифференцированы тые недоношенные дети с БЛД (вторая груп-
на слабые – 37,1-37,5oС, средние – 37,6-38,5oС и па), находящиеся на диспансерном наблюде-
сильные – 38,6oС и выше) и местные – по вели- нии в краевом перинатальном центре ГБУЗ
чине гиперемии и отека (в мм) в месте введения ПК «Ордена «Знак Почета» Пермская краевая
препарата. Результаты наблюдения фиксирова- клиническая больница» с 2-х месячного воз-
лись в индивидуальных «Дневниках наблюде- раста. Группы наблюдения были равноценны
ния за привитым» и сертификатах профилакти- и однородны по возрасту, половому признаку,
ческих прививок Ф.157/у-93. срокам иммунизации и состоянию здоровья.
Иммуногенную активность вакцины оцени- Для сравнительной� оценки переносимости
вали на основании определения в парных вакцинации недоношенными детьми с БЛД с
сыворотках крови (до и через 28 дней� после 2-х месячного возраста была сформирована
вакцинации) общего уровня специфических вторая группа сравнения – здоровые доношен-
IgG – антител (IgG-АТ) к смеси полисахаридов ные дети (n=30).
(СП) Streptococcus pneumoniae, входящих в со- Первые результаты данного исследования
став вакцины методом иммуноферментно- были опубликованы авторами в журнале
го анализа (ИФА) на твердофазном носителе «Эпидемиология и Вакцинопрофилактика» в
с расчетом средней� геометрической� титров 2018, №17/2 (8).
(СГТ) специфических антител, уровня серо-
конверсии (процент лиц, у которых наблюдал- Количество детей� , родившихся живыми, на из-
ся 4-кратный� прирост специфических антител учаемой� территории в 2015-2017 гг. по офици-
после введения вакцины) и фактора серокон- альным данным оказания медицинской� помо-
версии (кратность прироста специфических щи беременным, роженицам и родильницам
антител после вакцинации). (форма №32) колеблется от 31 372 до 37 972
детей� . Доля недоношенных детей� составляла
Профилактическую эффективность вакцины 6,0±0,3%, удельный� вес детей� с экстремально
оценивали в группе привитых и не привитых низкой� массой� тела (ЭНМТ), родившихся с мас-
лиц по количеству случаев заболеваний� остры- сой� от 500 до 999 гр., и очень низкой� массой�
ми респираторными инфекциями, внебольнич- тела (ОНМТ), родившихся с массой� от 1 000 до
ной� пневмонии, синуситов, бронхитов на 1000 1 499 гр., составлял 6,7±2,0 и 34,1±1,7 %% соот-
детей� за 12 месяцев (6 месяцев до и 6 месяцев ветственно (табл. 1).
после вакцинации) и при проспективном на-
блюдении через 3 года после проведенной� вак- В структуре первичной� заболеваемости детей�
цинации с расчетом индекса эффективности. с ЭНМТ уровень бронхолегочной� дисплазии
среди недоношенных детей� с ЭНМТ (рожден-
Статистический� анализ результатов проведен ные с массой� до 1 000 гр.) был наибольшим
с использованием методов параметрической� (53,6±2,0%): среднемноголетний� показатель
и непараметрической� статистики с определе- составил 767,0±3,9 на 1000 при общем показа-
нием средней� арифметической� (М), стандарт- теле первичной� заболеваемости 1 429,3±4,1;
ной� ошибки (m) и среднего стандартного от- показатели заболеваемости ретинопатией�
клонения (δ). Достоверность различий� между (462,3±3,0 на 1 000), поражения ЦНС тяжелой�
явлениями оценивали с помощью t-критерия степени (158,5±2,6 на 1 000), ней� росенсорной�
Стьюдента. Разность результатов считали ста- тугоухости (32,2±2,3 на 1 000) – наименьшими
тистически значимой� при р<0,05. Для иммуни- (p<0,05) (табл. 2).
29
Таблица 1. Данные о численности новорожденных детей� , родившихся живыми и количество

недоношенных детей� в Пермском крае, в 2015-2017 гг. (абс. число, %, М±m).
Количество новоро- Количество недо- Количество детей Количество де-

Годы ношенных детей с ЭНМТ тей с ОНМТ
жденных детей, родив-
наблюдения
шихся живыми, абс. абс. ч. % абс. ч. % абс. ч. %
2015 37 972 2 351 6,2 161 6,8 783 33,3
2016 36 654 2 165 5,9 156 7,2 765 35,3
2017 31 372 1 916 6,1 116 6,1 646 33,7
М±m 35 333 2 144 6,0±0,3 144 6,7±2,0 731 34,1±1,7
Таблица 2. Структура первичной� заболеваемости недоношенных детей� , родившихся живыми с ЭНМТ,

в г. Перми в 2015-2017 гг. (абс. число, показатель на 1000 детей� , М±m, %).
2015 2016 2017
Нозологические
абс. абс. абс. М±m
формы на 1000 % на 1000 % на 1000 %
ч. ч. ч.
БЛД 67 752,8 52,3 67 779,1 53,2 30 769,2 55,6 767,0±3,9
Ретинопатия 34 382,0 26,5 44 511,6 34,9 19 487,2 35,2 462,3±3,0
Поражение ЦНС
21 235,9 16,4 14 162,8 11,1 3 76,9 5,6 158,5±2,6
тяжелой степени
Тугоухость 3 33,7 4,8 1 11,6 0,7 2 51,3 3,6 32,2±2,3
Итого: 128 1438,2 100 126 1465,1 100 54 1384,6 100 1429,3±4,1
В структуре первичной� заболеваемости детей� составил 157,3±2,3 при общем показателе

с ОНМТ уровень выявленной� бронхолегочной� первичной� заболеваемости 382,4±3,2 на 1000.
дисплазии среди недоношенных детей� с Показатель заболеваемости ретинопатией�
ОНМТ (дети, рожденные с массой� от 1001 (94,6±1,9 на 1000), поражения ЦНС тяжелой�
до 1500 г) аналогично был наибольшим степени (75,9±1,8 на 1000) и ней� росенсорной�
(41,1±1,8%): среднемноголетний� показатель тугоухостью – аналогично наименьшим –
21,1±1,6 на 1000 (p<0,05) (табл. 3).
Таблица 3. Структура первичной� заболеваемости детей� , родившихся живыми с ОНМТ, в г. Перми

в 2015-2017 гг. (абс. число, показатель на 1000 детей� , М±m, %).
2015 2016 2017
Нозологические
абс. абс. абс. М±m
формы на 1000 % на 1000 % на 1000 %
ч. ч. ч.
БЛД 30 180,7 41,6 25 174,8 54,3 21 216,5 55,3 157,3±2,3
Ретинопатия 15 90,4 20,8 10 69,9 21,7 12 123,7 31,5 94,6±1,9
Поражение ЦНС
24 144,6 33,3 6 41,9 13,0 4 41,2 10,5 75,9±1,8
тяжелой степени
Тугоухость 3 18,1 4,3 5 34,9 11,0 1 10,3 2,7 21,1±1,6
Итого: 72 433,7 100 46 321,7 100 38 391,8 100 382,4±3,2
Фоновая клиническая характеристика детей� до 1500 граммов). В группе сравнения детей� с

представлена в Таблице 4. Средний� возраст де- очень низкой� массой� тела при рождении было
тей� на момент вакцинации против пневмокок- 11, с экстремально низкой� массой� – 10 детей� . В
ковой� инфекции составил в основной� группе кислородной� поддержке не нуждался ни один
9,12±4,29 мес., в группе сравнения – 11,29±4,58 ребенок с БЛД. Дети в обеих группах имели
мес. Средний� гестационный� возраст – 28±1,46 последствия перинатального поражения цен-
и 31±1,59 недель соответственно. В основ- тральной� нервной� системы.
ной� группе 15 детей� родились с экстремаль-
Сопутствующее заболевание дыхательной� си-
но низкой� массой� тела (менее 1000 граммов),
стемы (внутриутробные пневмонии в анамне-
13 детей� с очень низкой� массой� тела (от 1000
30
зе) имели 21,0±1,02 детей� основной� группы и домизированного клинического наблюдения

10±0,9%% в группе сравнения. не выявила достоверных различий� в частоте
поствакцинальных реакций� . Общее суммарное
Сравнительная оценка реактогенности конью-
число поствакци нальных системных реакций�
гированной� пневмококковой� вакцины ПКВ13
в группе привитых недоношенных детей� с БЛД
в группе привитых недоношенных детей� с БЛД
в течение 28 дней� после первой� иммунизации
и в группе привитых доношенных детей� в ус-
составило 17,2±0,57 против 18,5±0,55% в груп-
ловиях проспективного контролируемого ран-
пе привитых доношенных детей� (p>0,05).
Таблица 4. Фоновая клиническая характеристика привитых и непривитых детей� , участвующих в
клиническом исследовании (абс. число, M±m, %).
Показатели Привитые дети, Группа сравнения,
(единицы измерения) n=29 n=29
Возраст детей,
9,12±1,09 11,29±1,01
M±m (мес.)
Количество мальчиков, n (%) 8 (28±0,85) 9 (31±0,82)
Масса тела при рождении, г, Ме 1172,5 1510
(мин; макс) (690; 1780) (860; 1910)
Гестационный возраст при рождении, М±m,
28±1,46 31±1,59
недель
Количество детей с экстремально низкой массой
15 10
тела при рождении, абс. число
Количество детей с очень низкой массой тела при
13 11
рождении, абс.
Количество детей, перенесших внутриутробную
6 (21±1,02) 3 (10±0,9)
пневмонию, n (%)
В группе привитых недоношенных детей� с БЛД купировались самостоятельно без назначе-

выявлены легкие общие реакции у 4 детей� ния лекарственных средств. У одного ребенка
(13,8±0,57%), которые купировались без на- (3,3±0,55%) отмечена сильная реакция с подъ-
значения лекарственных средств. У одного ре- емом температуры до 38,7°С, которому одно-
бенка (3,4±0,57%) отмечена сильная реакция кратно назначено жаропонижающее средство
в виде подъема температуры тела до 39,5°С, в возрастной� дозировке. Местная реакция (ги-
потребовавшее назначения жаропонижающих перемия в месте введения вакцины в размере
лекарственных средств в возрастной� дози- до 2,5 см) наблюдалась у 2 детей� (6,6±0,55%).
ровке. Местных реакций� зарегистрировано не Комбинированных реакций� зарегистрировано
было. В основном все поствакцинальные реак- не было. В структуре поствакцинальных реак-
ции были слабой� и средней� степени выражен- ций� (16,5±0,55%) преобладали реакции сла-
ности, быстропроходящими в течение 2 дней� и бой� и средней� степени интенсивности и все
не требовали медикаментозного лечения. клинические проявления были быстро про-
ходящими (в течение 3 дней� ) и не требовали
Наиболее часто первая иммунизация против
лекарственного лечения.
пневмококковой� инфекции совмещалась с вве-
дением вакцины против вирусного гепатита В Следовательно, сравнительная оценка реак-
(34,5±0,57%), реже с инактивированной� поли- тогенности вакцины среди недоношенных де-
омиелитной� вакциной� (3,5±0,57%) и тетракси- тей� , имеющих бронхолегочную дисплазию, и
мом (3,5%±0,57%). Поствакцинальных реакций� привитых доношенных детей� выявила слабую
и поствакцинальных осложнений� у детей� при си- реактогенность (17,2±0,57%), и схожую пере-
мультанной� иммунизации в условиях проспек- носимость вакцины с доношенными детьми
тивного контролируемого рандомизированного (16,5±0,55%). В группах привитых детей� как
клинического наблюдения не отмечалось. основной� , так и в группе сравнения измене-
ний� со стороны дыхательной� системы (апное,
В группе привитых здоровых доношенных
десатурация, бронхообструктивный� синдром)
детей� по схеме «2+1» отмечены легкие об-
не наблюдались.
щие реакции у 2 детей� (6,6±0,55%), которые
31
В ходе мониторинга за показателями общего и не привитых детей� в динамике представле-

анализа крови у привитых детей� в динами- ны в Таблице 5.
ке не отмечено существенных отклонений� от
Результаты исследований� биохимического
нормы (р>0,05). Лей� коцитарная формула со-
анализа крови у привитых и не привитых де-
ответствовала возрастной� норме. Результаты
тей� в динамике представлены в Таблице 6.
клинических исследований� крови у привитых
Таблица 5. Показатели общего анализа крови детей� привитых и непривитых – до вакцинации

и через 28 суток после вакцинации (M±m).
Привитые дети, Группа сравнения,
n=29 n=29
Показатели
(единицы измерения) 28 сутки после 28 сутки после
до вакцинации, до вакцинации,
вакцинации, вакцинации,
(M±m) (M±m)
(M±m) (M±m)
Гемоглобин (г/л) 117,78±1,83 119±2,25 126±7,0 118±0,6
Эритроциты (×1012/л) 4,13±0,37 4,05±0,21 4,46±0,28 4,25±0,11
Лейкоциты (×109/л) 6,53±1,03 9,5±1,22 8,11±1,1 7,13±0,48
Палочкоядерные (%) 2,75±1,02 2,33±1,01 1,0±0,48 1,0±0,51
Сегментоядерные (%) 31,5±3,37 38,5±3,5 32,0±2,00 32,0±2,33
Эозинофилы (%) 2,6 ±0,75 2,33±0,44 4,8±1,27 3,4±1,29
Лимфоциты (%) 57,63±3,37 51±9,5 53,16±3,18 62,6±2,44
Моноциты (%) 9,13±2,16 6,75±1,63 6,8±2,44 6,0±2,0
СОЭ (мм/ч) 4,86±2,41 5,33±3,11 4,2±1,04 4,0±1,41
Таблица 6. Показатели биохимического анализа крови у привитых и не привитых детей� – до вакцинации

и через 28 суток после вакцинации (M±m).

n=29 n=29
Показатели
(единицы измерения) 28 сутки после 28 сутки после
до вакцинации, до вакцинации,
вакцинации, вакцинации,
(M±m) (M±m)
(M±m) (M±m)
Билирубин общий
8,33±1,51 7,25±0,43 8,36±1,51 7,2±0,24
(мкмоль/л)
АЛТ (Ед/л) 27,03±1,63 25,73±2,45 27,2±1,63 31,5±5,16
АСТ (Ед/л) 42,13±2,95 44,4±2,34 40,8±2,95 45,33±4,0
Общий белок (г/л) 59,28±3,46 58,3±1,31 57,03±4,04 57,14±1,19
Креатинин (мкмоль/л) 45,89±1,9 38,4±3,52 41,3±1,9 35,5±2,75
Оценка показателей� биохимического анализа общего белка в сыворотке крови до вакцина-

сывороток крови привитых детей� не выявил ции (59,28±3,46%) и после (58,3±1,31%) свиде-
существенных изменений� . Основные пока- тельствовало об отсутствии влияния вакцины
затели биохимического анализа крови соот- на белоксинтезирующую функцию печени.
ветствовали норме в обеих группах, также не
было обнаружено статистически достоверных Динамика содержания общего иммуноглобу-
различий� между фоновыми показателями и лина класса E в сыворотках крови привитых и
показателями, полученными через 28 дней� по- не привитых детей� представлена в Таблице 7.
сле вакцинации (р>0,05). Содержание
32
Таблица 7. Содержание общего уровня IgE в сыворотках крови привитых и непривитых детей� –
до вакцинации и через 28 суток после вакцинации (M±m).
Привитые дети Группа сравнения
Показатели n=29 n=29
(норма) 28 сутки после 28 сутки после вак-
до вакцинации до вакцинации
вакцинации, цинации,
Общий уровень IgE
37,46±3,12 33,65±2,27 15,55±3,72 14,48±3,59
(до 130МЕ/мл)
В основной� группе детей� уровень общего IgЕ страдающих бронхолегочной� дисплазией� , вы-
изначально был выше, чем у детей� группы явило увеличение суммарных IgG в 5,5 раза, в
сравнения и на 28 сутки существенно не изме- сравнении с 29 ребенком группы сравнения.
нился (р>0,05) в обеих группах. Среднегеометрическое титров (СГТ) антител
в основной� группе детей� до вакцинации со-
Результаты общего анализа мочи у привитых
ставила 25,46 у.е. Через 28 дней� после вакци-
находились в пределах нормальных физиоло-
нации уровень суммарных антител IgG возрос
гических величин, что свидетельствовало об от-
и составил 142 у.е. (р<0,05). Во второй� группе
сутствии токсического воздей� ствия вакцины на
сравнения у детей� уровень IgG к полисахари-
мочевыделительные органы привитых детей� .
дам пневмококка через 28 дней� остался на
Оценка содержания специфических антител исходном уровне и не изменился (35,24 у. е. и
к полисахаридам пневмококка в сыворотке 35,39 у.е. соответственно, р>0,05) (рис. 1).
крови на 28 сутки после иммунизации детей� ,
Рисунок 1. Уровень специфических антител (IgG) к полисахаридам пневмококка у привитых

недоношенных детей� с бронхолегочной� дисплазией� (n=29), и непривитых (n=29) в динамике
(до вакцинации и через 28 дней� после вакцинации) в у. е.
Проспективное наблюдение в течение 3 лет за уровень заболеваемости внебольничными

привитыми недоношенными детьми с бронхо- пневмониями и отитами среди привитых и не
легочной� дисплазией� по схеме «3+1» и в группе привитых (табл. 8).
сравнения позволило выявить определенный�
Таблица 8. Уровень заболеваемости внебольничными пневмониями и отитами среди привитых и

непривитых (показатели на 1000 детей� ).
Нозологические формы
n=29 n=29
Заболеваемость внебольничными пневмониями 0 33,3
Заболеваемость отитами 66,7 241,4
33
В группе привитых недоношенных детей� с В группе сравнения уровень заболеваемости

БЛД показатель заболеваемости отитами (66,7 внебольничной� пневмонией� не изменился до
на 1000 детей� ) был ниже в 3,5 раза чем среди возраста 24 месяцев, в дальней� шем дети этой�
не привитых детей� (241,4 на 1000 детей� ), а группы были привиты против пневмококко-
заболевших внебольничной� пневмонией� сре- вой� инфекции путем проведения однократной�
ди привитых не зарегистрировано (р <0,05). вакцинации.
В группе сравнения у заболевшего ребенка
Полученные результаты высокого профиля
с внебольничной� пневмонией� (33,3 на 1000)
безопасности, умеренной� реактогенности, вы-
в посеве мокроты выделился Streptococcus
сокой� иммуногенной� активности и профилак-
pneumoniae.
тической� эффективности вакцины ПКВ 13 у де-
Проспективное наблюдение за привитыми не- тей� , родившихся недоношенными, и имеющих
доношенными детьми с бронхолегочной� дис- бронхолегочную дисплазию, позволили вне-
плазией� в течение трех лет позволило уста- дрить в медицинскую деятельность отделения
новить 4 случая заболевания внебольничной� катамнеза краевого перинатального центра
пневмонией� (показатель составил 137,9 на технологию вакцинации недоношенных детей�
1000 детей� ), вызванных респираторно-синци- с высоким риском (3-й� уровень оказания нео-
тиальным вирусом. Случаев внебольничной� натологической� медицинской� помощи). Охва-
пневмонии среди привитых детей� , вызванных ты вакцинацией� недоношенных детей� , имею-
Streptococcus pneumoniae, в ходе проспективно- щих бронхолегочную дисплазию, в г. Перми в
го наблюдения в течение 3 лет не отмечено. 2015-2017 гг. представлены в таблице 9.
Таблица 9. Охват вакцинацией� недоношенных детей� , имеющих бронхолегочную дисплазию,
в г. Перми в 2015-2017 гг. (абс. число, %).*
Количество недоношенных Количество привитых,
Годы %
детей с БЛД, абс. абс.
2015 107 80 74,7
2016 92 76 82,6
2017 51 49 96,0
*по данным реестра краевого перинатального центра ГБУЗ ПК «Ордена «Знак Почета» Пермская краевая
клиническая больница».
ДИСКУССИИ клинических проявлений� бронхообструк-

Выявленная высокая частота (53,6±2,0%) тивного синдрома и негативного влияния на
распространения бронхолегочной� диспла- дыхательную систему – не наблюдалось ап-
зии среди родившихся недоношенных детей� ное и десатурации среди привитых), слабую
с экстремально низкой� массой� тела – сред- реактогенность (17,2±0,57%) и схожую пере-
немноголетний� уровень первичной� заболева- носимость вакцины с доношенными детьми
емости составил 767,0±3,9 при общем показа- (16,5±0,55%), высокий� профиль безопасно-
теле 1429,3±4,1 на 1000 и среди детей� с очень сти (отсутствие каких-либо патологических
низкой� массой� тела (41,1±1,8%) среднемно- отклонений� в показателях общего анализа
голетний� уровень первичной� заболеваемости крови, биохимического анализа крови, обще-
– 157,3±2,3 при общем показателе 382,4±3,2 на го анализа мочи и содержания общего IgE в
1000 на фоне неснижаемого количества недо- динамике), высокие иммуногенные свой� ства
ношенных детей� (6,0±0,3%) диктует необхо- (сероконверсия – 93,1%, фактор сероконвер-
димость своевременной� вакцинопрофилакти- сии – 5,5) и ее высокую профилактическую
ки пневмококковой� инфекции среди наиболее эффективность (наблюдалось существенное
восприимчивых детей� , имеющих бронхолегоч- снижение уровня заболеваемости отитами и
ную патологию. не регистрировались случаи внебольничной�
пневмонии среди привитых).
Введение вакцины ПКВ 13 недоношенным де-
тям, страдающих бронхолегочной� дисплазией� , При совмещении иммунизации против пнев-
выявило хорошую переносимость (отсутствие мококковой� инфекции недоношенным детям
34
с бронхолегочной� патологией� при первом поствакцинальных реакций� у привитых, в ус-

введении вакцины Превенар 13 и вакцины ловиях проспективного контролируемого ран-
против вирусного гепатита В (34,5±0,57%), с домизированного клинического наблюдения,
инактивированной� полиомиелитной� вакци- ни в одном случае поствакцинальных реакций�
ной� (3,5±0,57%) и тетраксимом (3,5%±0,57%) не отмечено.
ВЫВОДЫ
1. Научно обоснована необходимость вакцинации недоношенных детей� с бронхолегочной� дис-
плазией� против пневмококковой� инфекции и подтвержден высокий� профиль безопасности и
высокая профилактическая эффективность применения вакцины ПКВ 13 позволяют внедрить
во всех регионах Россий� ской� Федерации новую медицинскую технологию – вакцинацию недо-
ношенных детей� с бронхолегочной� дисплазией� против пневмококковой� инфекции на третьем
уровне оказания неонаталогической� медицинской� помощи детям в условиях отделения катам-
неза перинатальных центров в рамках реализации Национального календаря профилактиче-
ских прививок.
КОНФЛИКТ ИНТЕРЕСОВ 8. Owolabi AT, Fasubaa OB, Ogunniyi SO. Semen qu-
ality of male partners of infertile couples in Ile-Ife,
Нет конфликта интересов.
Nigeria. Niger J Clin Pract. 2013; 16(1):37-40.
9. Basnet P, Hansen SA, Olaussen IK, Hentemann MA,
ЛИТЕРАТУРА Acharya G. Changes in the semen quality among
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2. Esteves SC, Zini A, Aziz N, Alvarez JG, Sabanegh ES, 10. Geoffroy-Siraudin C, Dieudonné Loundou A, Romain
Agarwal A. Critical appraisal of world health orga- F, Achard V, Courbière B, Perrard MH, et al. Decline
nization’s new reference values for human semen of semen quality among 10 932 males consulting for
characteristics and effect on diagnosis and treat- couple infertility over a 20-year period in Marseille,
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3. Huyghe E, Izard V, Rigot JM, Pariente JL, Tostain J. 11. Louis JF, Thoma ME, Sorensen DN, Mclain AC, King
É� valuation de l’homme infertile: recommandations RB, Sundaram R, et al. The prevalence of couple in-
AFU 2007. Prog en Urol. 2008; 18(2):95-101. fertility in the United States from a male perspecti-
4. Gill K, Jakubik J, Rosiak-Gill A, Kups M, Lukaszuk ve: Evidence from a nationally representative sam-
M, Kurpisz M, et al. Utility and predictive value of ple. Andrology. 2013; 1(5):741-8.
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dispersion for fertility potential. Int J Environ Res cio-psycho-behavioral factors and male semen qu-
Public Health. 2019; 16(11). ality: Systematic review and meta-analyses. Fertil
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ductive Health and Research. WHO Laboratory Ma- 13. Gupta Sanjay, Swapnil S. Singhai. Management of
nual for the Examination and Processing of Human oligoasthenozoospermia: an observational clinical
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2010; 1:287. dical Research, 2016; 3(6):387-90.
6. Cooper TG, Noonan E, von Eckardstein S, Auger J, 14. Punab M, Poolamets O, Paju P, et al. Causes of male
Baker HWG, Behre HM, et al. World Health Organi- infertility: a 9 – year prospective monocentre study
zation reference values for human semen characte- on 1737 patients with reduced total sperm counts.
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7. Niang L, Ndoye M, Labou I, Jalloh M, Kane R, Diaw 15. Lee JY, Dada R, Sabanegh E, Carpi A, Agarwal A.
JJ, et al. Profil épidémiologique et clinique de l’in- Role of genetics in azoospermia. Urology. 2011;
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Дата получения рукописи: 27/12/2019
Дата принятия к публикации: 15/02/2020
Владислав СЕМЕРИРКОВ, ORCID 0000-0002-9755-8929
35
DEVELOPMENT OF SEMEN QUALITY IN MALE PARTNERS

OF INFERTILE COUPLES IN THE REPUBLIC OF MOLDOVA
Stela RACOVITA¹, Mariana SPRINCEAN¹, Dumitru PONEATENCO2, Eusebiu Vlad GORDUZA3,
Veaceslav MOSIN1,2
¹Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
2
Repromed Health Center, Chisinau, Republic of Moldova
3
University of Medicine and Pharmacy Grigore T. Popa Iasi, Romania
Corresponding author: Stela Racovita, e-mail: guzunstela@gmail.com
DOI: 10.5281/zenodo.3701047 UDC: 616.69-008.6(478)
Key words: human Introduction. It is estimated that over 15% of couples of reproductive age face infertility
semen, male infertility, worldwide. In about half of these cases the male factor is involved. To assess the potential of
diagnosis, reference male fertility the spermiogram analysis may not always be an optimal diagnostic tool, but
values. it remains the basic clinical tool.
Material and methods. The purpose of the study is to analyze the regional tendencies
of the semen quality in male partners of couples facing infertility. A retrospective study
of 4625 patients subject to semen analysis between 2012-2018 was conducted. All semen
samples were collected after a recommended period of sexual abstinence of three to five
days. The spermiogram analysis was performed by the computerized method according to
WHO guidelines for Human Semen analysis, 2010.
Results. Of the total number of 4625 men examined, 1861 (40.2%) presented normal values
of semen – normozoospermia, and 2764 (59.8%) showed abnormal semen parameters.
Asthenozoospermia was the most common abnormality profile recorded in 1394 (30.2%)
men, followed by oligoasthenozoospermia diagnosed in 973 men (21.0%). Azoospermia
was found in 200 men with an estimated prevalence of 4.3%. In 113 men examined,
oligozoospermia was found in 2.4%. Oligoasthenoteratozoospermia was diagnosed in 1.5%
and necrozoospermia in 0.3%.
Conclusion. The study provides the first evidence that semen quality in men in the Republic
of Moldova who are facing infertility in couples has deteriorated over the years.
Cuvinte cheie: EVOLUȚIA CALITĂȚII MATERIALULUI SEMINAL LA BĂRBAȚII PARTENERI DIN
material seminal, CUPLURILE INFERTILE ÎN REPUBLICA MOLDOVA
infertilitate masculină,
diagnostic, valori de Introducere. La nivel mondial se estimează că peste 15% dintre cuplurile de vârstă
referință. reproductivă se confruntă cu infertilitatea, iar în aproximativ jumătate din aceste cazuri
este implicat factorul masculin. Pentru evaluarea potențialului de fertilitate masculină
spermograma poate să nu fie întotdeauna un instrument de diagnostic optim, cu toate
acestea însă rămâne în continuare instrumentul clinic de bază.
Material și metode. Scopul: analiza tendințelor regionale ale calității materialului seminal
la bărbații din cadrul cuplurilor ce se confruntă cu infertilitatea. Studiu retrospectiv a fost
efectuat în perioada 2012-2018 pe un eșantion de 4625 bărbați care au făcut analize ale
materialului seminal. Recoltarea probelor a fost făcută după abstinență de la ejaculare timp
de 3-5 zile în condiții de laborator. Spermograma s-a realizat prin metoda computerizată
conform criteriilor și valorilor de referință stabilite de OMS în anul 2010.
Rezultate. Din numărul total de 4625 de bărbați investigați, 1861 (40,2%) au prezentat
valori normale ale materialului seminal normozoospermie și 2764 (59,8%) au prezentat
tulburări de spermatogeneză. Cea mai frecventă anomalie a spermatogenezei a fost
înregistrată astenozoospermia – la 1394 de bărbați cu o frecvență de 30,2%, urmată de
oligoastenozoospermia – la 973 de bărbați în 21,0% din cazuri. La 200 de bărbați a fost
înregistrată azoospermia, frecvența fiind de 4,3%, iar la 113 bărbați investigați a fost
depistată oligozoospermia cu frecvența de 2,4%, oligoastenoteratozoospermia – în 1,5% și
necrozoospermia – în 0,3%.
Concluzii. Studiul confirmă, că calitatea materialului seminal a bărbaților din Republica
Moldova, care se confruntă cu infertilitatea în cuplu, se deteriorează de-a lungul anilor.
36
INTRODUCTION
Infertility affects an estimated rate of 15% of cou- fore, it is essential that the human semen analysis
ples of reproductive age worldwide, and in about be performed according to the updated require-
half of these cases the male factor is involved (1). ments of the World Health Organization (WHO),
2010 (5). In recent years, the European Society for
The causes of infertility can be divided into four Human Reproduction and Embryo-logy (ESHRE),
broad categories: 1) female factor; 2) male fac- in collaboration with the WHO, have developed a
tor; 3) couple factor – due to cumulative female program to improve laboratory standardization in
and male infertility; 4) idiopathic infertility, une- terms of sperm sample diagnosis and assessment
xplained. The exact percentage for each of these criteria (6).
categories is difficult to determine; however, it
is generally reported that in about 40% of cases
MATERIAL AND METHODS
infertility is due to female cause, in 40% – male
cause, and in 20% – anomalies detected in both The purpose of the study is to analyze the regional
partners (1, 2). Thus, the examination of the male tendencies of semen quality in male partners of
partner is as important as the female one for the couples facing infertility.
assessment of couple’s fertility. Medical history The study presents a retrospective evaluation of
and physical examination are standard assess- 4 625 patients in the Republic of Moldova subject
ments for all men, including semen analysis. to semen analysis during 2012-2018. All semen
The spermiogram evaluation is relevant for the samples were collected in laboratory conditions
appreciation of the functional status of the semi- after a recommended period of sexual abstinence
niferous tubules, epididymis, and accessory sex of three to five days. Each sample was incubated
glands. The prognostic value of semen characte- at 37oC and analyzed within an hour. The spermi-
ristics, such as sperm concentration, percentage of ogram analysis was performed by the computeri-
motility, and morphology represents the first line zed method on the automated analyzer SQA IIC-P
of examination in the diagnosis of male infertility (Medical Electronic Systems, USA). Semen analy-
(3). Semen analysis may not always be an optimal sis was performed according to the WHO Labora-
diagnostic tool, but it still remains the basic clinical tory Manual for the Examination and Processing
tool for the evaluation of male fertility potential (4). of Human Semen, 5th edition, 2010 (tab. 1). All
patients are part of infertile couples who made
Important treatment decisions in male infertility appointments for doctor`s consultation in the Re-
are largely based on spermiogram results. There- promed Center.
Table 1. Semen parameters and reference values according to WHO (2010).

Abstinence (days) 3-7 days
Volume (mL) ≥ 1.5 mL
Color ≤2 cm
Liquefaction time ≤60 min
Viscosity 2 cm
pH ≥7.2
Leukocytes ≤ 1 mln/mL
Sperm Concentration (mln/mL) ≥ 1.5 mL
Total number of spermatozoa (mln/ejaculate) ≥ 39 mln
Progressives sperm motility (%) ≥ 32 %
Concentration of motile spermatozoa (mln/mL) ≥ 10 mln/mL
Total number of motile spermatozoa (mln/ejaculate) ≥ 15 mln
Concentration of functional spermatozoa (mln/mL) ≥ 7 mln/mL
Total number of functional spermatozoa (mln/ejaculate) ≥ 10.5 mln/mL
Motility index ≥ 80
Morphology (Normal forms) (%) ≥4%
Vitality (9%) ≥ 58
37
Interpreting the results, the spermiogram diagno- – hyperspermia: semen volume >1,5 mL;
sis was made according to the descriptive termi- – leukospermia/pyospermia: presence of leu-
nology of the same WHO guidelines as follows: kocytes in ejaculate above reference limit;
– normozoospermia: total number/percentage – hematospermia: presence of blood in ejaculate;
of sperm with progressive mobility and normal – necrozoospermia: low percentage of live and
morphology, being of equal value or above the high percentage of immotile sperm;
reference values; – aspermia: complete lack of semen with ejaculation;
– oligozoospermia: total number of sperm/sperm – azoospermia: absence of spermatozoa in the
concentration below lower reference limit; sediment of a centrifuged semen sample.
– asthenozoospermia: sperm motility below 40%
or rapid progressive sperm motility <32%; RESULTS
– teratozoospermia: percentage of normal sperm In the biology laboratory of the Repromed Center,
below 4%; Chisinau, Republic of Moldova, the spermiogram
– oligoasthenozoospermia: low concentration and was performed in 4625 men, during 2012-2018.
low percentage of progressively motile sperm; The Repromed Center is an Assisted Reproduction
– oligoteratozoospermia: low total number of Center where the vast majority of infertility cou-
sperm and low percentage of normal forms; ples from all over the country present themselves.
– asthenoteratozoospermia: percentage of moti- Spermiograms were performed over the following
le sperm and normal sperm below low referen- years: 2012 – 206 patients, 2013 – 702 patients,
ce limit; 2014 – 854 patients, 2015 – 800 patients, 2016 –
– oligoasthenoteratozoospermia: low total num- 717 patients, 2017 – 703 patients, and 2018 – 643
ber of sperm/low percentage of motile sperm patients. The number of semen analyses in the
and normal forms; studied period is relatively constant. Except for
– cryptozoospermia: very low spermatozoa con- 2012, because patients were registered since the
centration in ejaculate ≤1 million/mL; middle part of the year since the Repromed Center
– hypospermia: semen volume < 1,5 mL; started activity (tab. 2).
Table 2. Distribution of men according to their semen characteristics in the period 2012-2018
in the Republic of Moldova.
Absolute number
Semen parameters %
2012 2013 2014 2015 2016 2017 2018 Total
Normozoospermia 103 358 348 340 260 235 217 1 861 40.2
Oligozoospermia 13 24 26 16 18 10 6 113 2.4
Oligoasthenozoospermia 27 90 166 173 165 170 182 973 21.0
Asthenozoospermia 44 179 245 231 235 250 210 1 394 30.2
Oligoasthenoteratozoospermia 5 13 11 12 11 13 3 68 1.5
Necrozoospermia 6 6 3 1 16 0.3
Azoospermia 14 32 52 28 25 25 24 200 4.3
Total 206 702 854 800 717 703 643 4 625 100
Of the total number of 4 625 men examined, 1 861 for 2.4%. In 113 men examined, oligozoospermia
(40.2%) presented normal values of semen – nor- was detected in 2.4%. Oligoasthenoteratozoos-
mozoospermia, 2 764 (59.8%) showed abnormal permia was diagnosed in 68 men (1.5%) and ne-
semen parameters. The most common profile of croszoospermia in 16 men (0.3%) (tab. 2, fig. 1).
abnormality recorded in our study was astheno-
Normozoospermia was considered according to
zoospermia in 1 394 men from 2012 to 2018 with
the following WHO criteria: sperm concentrati-
a frequency of 30.2%, followed by oligoastheno-
on ≥1.5 mln/mL, total number of sperm cells ≥39
zoospermia being diagnosed in 973 men – 21.0%.
mln, progressive sperm motility ≥32% and mor-
Azoospermia was recorded in 200 men with an
phology ≥4%. The results of normozoospermia
estimated prevalence of 4.3%. In 113 men exami-
analysis were recorded in 2012 and 2013 with a
ned, the frequency of oligozoospermia accounted
38
frequency of 50.9%. In 2014, the normal values of Over the following years a decrease of normal
spermiogram decreased by 10.2%, the frequency values of spermatogenesis was also observed. In
accounted for 40.7%. In 2015 the situation im- 2016 the frequency accounted for 36.3%, in 2017
proved insignificantly compared to 2014 by 1.8%. – 33.4%, in 2018 – 33.7% (fig. 2).
Figure 1. Distribution of patients according to semen analysis during the period 2012-2018.
Figure 2. Frequency of normozoospermia in men during 2012-2018.

According to the results of asthenozoospermia values of asthenozoospermia also increased, in
analysis in 2012 the frequency was 21.7%. In 2014 – 28.6%, in 2015 – 28.8%, in 2016 – 32.7%,
2013 the frequency increased by 3.7% compared in 2017 – 35.5%, and in 2018 – 32.6% (fig. 3).
to the previous year. Over the following years the
Figure 3. Frequency of men with asthenozoospermia during 2012-2018.
39
DISCUSSIONS affecting their fertility. The role of socio-psyc-

The study shows that during 2012-2018, the ab- ho-behavioral factors in the development of this
normal semen quality was found in approximately abnormality has been demonstrated. Psychologi-
59.8% of male partners of couples facing infer- cal stress, smoking and alcohol are modifiable risk
tility (tab. 2). A high incidence of spermatogenic factors for the number of motile sperm (12). Also,
disorders is also found in other studies (7, 8, 9) sperm motility depends on its specific structures
According to our data, this percentage increased such as microtubules, outer dense fibers and mi-
from 50% in 2012 to 66.3% in 2018 (tab. 2). tochondria that provide energy for sperm move-
ments (13).
This represents a significant increase in sperma-
togenesis abnormalities, although the WHO in- The second cause of spermatogenesis disorder
troduced lower baseline values in 2010. Thus, an identified in our study was oligoastenozoosper-
alarming phenomenon of decreased male fertility mia with a frequency of 21.0%. Oligoastenozoos-
can be observed in fertility clinics in the Republic permia is a combination of reduced sperm motility
of Moldova, which could be correlated with sperm and low sperm count. According to bibliographic
decline described in the literature. This has been sources it is the most common cause of male infer-
illustrated by several studies from multiple world tility (14). The causes of this disorder are hetero-
regions that argue that men’s reproductive heal- geneous, such as cryptorhidia, varicocele, chronic
th has been in rapid decline in the recent years infections, hormonal causes, psychoemotional cau-
(10, 11). ses, metabolic causes, etc. In 20% its etiology and
pathogenesis are not fully elucidated and may be
In the present study we observe that sperm con- associated with specific gene abnormalities (13).
centration in the semen and healthy sperm count
have decreased considerably. If in 2012 and 2013 The frequency of azoospermia in the current study
the frequency of normozoospermia was 50.9%, accounts for 4.3%. According to bibliographic so-
over the following years a decrease in the normal urces azoospermia is found in 8% of infertile men
values of spermatogenesis could be observed, ac- and in 1% of the male population (15). In the case
counting for 33.7% in 2018 (fig. 2). of lack of sperm or an extremely small number, a
genetic cause may be identified in about 21-29%
The most common profile of abnormality in our (16). In this context, cytogenetic tests for karyoty-
study was asthenozoospermia recorded in 1394 pe analysis as well as molecular genetic evaluati-
men with a frequency of 30.2% (fig. 1). It is very on of Y-chromosome microdeletions analysis and
noticeable that the abnormal frequency of sperm mutations in the Cystic Fibrosis Transmembrane
motility increased from 2012 to 2018. Thus, in Conductance Regulator (CFTR) gene are fully jus-
2012 the frequency of asthenozoospermia was tified and important to exclude a possible cause of
21.7%, in 2014 – 28.6% it increased, in 2015 – genetic origin. Abnormal genotype may be present
28.8%, 2016 –32.7%, in 2017 – 35.5%. In 2018 in up to 12% of azoospermic men and 4% of oli-
there was a slight decrease of asthenozoospermia gospermic men. Cystic fibrosis screening is recom-
– 32.6%, most probably due to a lower number of mended for azoospermia if it is due to congenital
appointments of couples with infertility compared bilateral absence of the vas deferens (CBAVD).
to the previous year (fig. 3). According to literatu- Optional Y-chromosome microdeletion screening
re data, this abnormality is found in 40% of men, can be carried out if sperm count is <5 million/mL.
CONCLUSION
1. Our results clearly show that semen quality in the population of men in couples with infertility in
the Republic of Moldova decreased from 2012 to 2018. As many authors suggest, we also believe that
environmental and lifestyle factors have negatively affected the quality of semen development. The con-
tribution of genetic factors cannot be excluded either.
2. Therefore, the analysis of the regional tendencies of semen quality is necessary and can be considered
an indirect factor in assessing the tendencies in male infertility.
CONFLICT OF INTEREST
No conflict of interest was declared by the authors.
40
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Stela RACOVITA, ORCID 0000-0002-0900-0096
41
CONTROLUL ȘI EVALUAREA RISCULUI EXPUNERII

POPULAȚIEI LA RADON ÎN REPUBLICA MOLDOVA
Liuba COREȚCHI1, Ion BAHNAREL1,2, Mariana GÎNCU1, Alexandra COJOCARI1,
Marcus HOFFMANN3
1
Agenț�ia Naț�ională pentru Sănătate Publică, Chiș� inău, Republica Moldova
2
Universitatea de Stat de Medicină ş� i Farmacie Nicolae Testemiţanu, Republica Moldova
3
Universitatea de Ș� tiinț�e Aplicate din Elveț�ia de Sud, Canobbio-Lugano, Elveț�ia
Autor corespondent: Liuba Coreț�chi, e-mail: coretchiliuba@gmail.com
DOI: 10.5281/zenodo.3701164 CZU: 614.73:546.296(478)
Key words: radon, CONTROL AND EVALUATION OF THE RISK OF POPULATION EXPOSURE TO RADON
public health, risk. Introduction. A safe way to reduce the onset of oncological diseases is to protect the pop-
ulation from exposure to radon. In order to know the risk of radon influence on the health
of the population, it is necessary to quantify the radon concentrations in the homes air and
environment components.
Material and methods. The aim of the study was to monitor radon concentrations in the
air from different types of housing (n=2500), in rural and urban areas, on the territory of the
Republic of Moldova, by using RADTRAK2-type detectors, with the assessment of the risk of
population exposure to radon. The exhibition period was 90 days.
Results. The results indicate on the radon problem existence on the country territory and
the need for a strict solution of the problem. Thus, in 615 homes from the studied ones (25%)
the radon concentration was higher than the national norms; in 662 homes (26%) radon
concentration was higher than European norms. In 1277 homes (51%) radon concentration
was higher than National/European norms. In connection with the above, the Government
Decision draft was elaborated. A special role is given to the need to elaborate and make
changes to the Building Code, with the need to monitor radon when commissioning residen-
tial buildings.
Conclusions. The results denote increased variability of the radon concentrations accord-
ing to the geographical area, the type of housing and other factors. Radon mapping identi-
fied the localities with high risk of exposure of the population to radon.
Cuvinte cheie: radon, Introducere. O cale sigură de diminuare a declanșării maladiilor oncologice o constituie
sănătate publică, risc protecția expunerii populației la radon. În vederea cunoașterii riscului influenței radonului
asupra sănătății populației este necesară cuantificarea concentrațiilor de radon în aerul din
locuințe și din componentele mediului ambiant.
Material și metode. Scopul studiului a constat în monitorizarea concentrațiilor de radon
în aerul din diferite tipuri de locuințe (n=2500), din zonele rurale și urbane, de pe teritoriul
Republicii Moldova, prin utilizarea detectorilor de tip RADTRAK2, cu evaluarea riscului ex-
punerii populației la radon. Perioada de expoziție a constituit 90 de zile.
Rezultate. Rezultatele indică asupra existenței problemei radonului în locuințe, pe teritoriul
țării și necesitatea soluționării stringente a problemei. A fost constatat că, în 615 locuințe
studiate (25%) concentrația radonului depășea normele naționale, iar în 662 de locuințe
(26%) a depășit normele europene. Astfel, în 1277 de locuințe (51%) analizate concentrația
radonului a fost mai mare decât normele naționale/europene. În rezultatul celor expuse a
fost elaborat proiectul Hotărârii de Guvern „Cu privire la aprobarea Strategiei Naționale
privind reducerea riscului asociat iradierii naturale, inclusiv a radonului”. Un rol deosebit
îl constituie elaborarea și efectuarea modificărilor la Codul construcțiilor, cu necesitatea
monitorizării radonului la darea în exploatare a clădirilor locative.
Concluzii. A fost stabilită variabilitatea sporită a radonului în aerul din locuințe în funcție
de zona geografică, tipul locuinței, dar și de alți factori. Cartarea radonului pe teritoriul
țării a rezultat identificarea localităților cu risc sporit de expunere a populației la radon.
42
INTRODUCERE efectuat î�n 40 de ț�ări ale Uniunii Europene pentru

Expunerea populaț�iei la sursele radioactive natu- a. 2018, a demonstrat rezultate impunătoare. Ast-
rale se datorează î�n primul rând radonului (222Rn), fel, au fost estimate 3,91 mln de cazuri noi de can-
aceasta constituind peste 50% din expunerea to- cer (exceptând cancerul de piele non-melanom) ș� i
tală (1). Radonul este un gaz radioactiv, care este 1,93 mln de decese, cauzate de cancer î�n Europa,
produs î�n mod continuu de 226Ra, descendent al cele mai uzuale fiind: cancerul de sân (523 000
uraniului. Radonul este elementul cu numărul de de cazuri), urmat de cel colorectal (500 000), de
ordine 86 din tabelul periodic, făcând parte din cancerul pulmonar (470 000) ș� i de cancerul de
grupa a VIII-a, deci este un gaz inert, care odată prostată (450 000). Aceste patru tipuri de cancer
format, prin dezintegrarea elementelor grele din reprezintă jumătate din rata totală a cancerului î�n
crusta terestră, difuzează î�n gazele din sol sau din Europa. Cele mai frecvente cauze de deces, cauza-
apă ş� i apoi este emanat î�n atmosferă. Radonul mi- te de cancer, au fost cancerul pulmonar (388,000
grează spre suprafaț�ă prin spaț�iile porilor din sol, de decese), colorectal (243 000), de sân (138 000)
fisuri etc. ș� i cancerul pancreatic (128 000). Numărul estimat
de noi cazuri de maladii oncologice a constituit
Radonul poate pătrunde î�n case datorită diferen- circa 1,6 mln la bărbaț�i ș� i 1,4 mln la femei, cu 790
ț�ei de presiune din clădire ș� i fundaț�ia sa din sol. 000 decese pentru bărbaț�i ș� i 620 000 – femei (9).
Gazul migrează prin fisurile din pereț�i, canale de Î�n vederea diminuării incidenț�ei maladiilor onco-
scurgere, conducte de comunicaț�ii, materiale de logice, cauzate de radon, au fost elaborate unele
construcț�ie ș� i apă potabilă (2). algoritme (modele) de informare a populaț�iei des-
Aportul radonului î�n expunerea internă ş� i externă pre riscul pentru sănătate, cauzat de expunerea la
a populaţ�iei constă î�n aceea, că acesta produce un radon (10, 11, 12).
ş� ir î�ntreg de alţ�i izotopi radioactivi pe de-o parte,
iar pe de altă parte, fiind un gaz inert, poate ajunge MATERIAL ȘI METODE
î�n orice parte a organismului, fiind, î�n special, im- Scopul studiului a constat î�n monitorizarea con-
plicat î�n afectarea sistemului respirator (2). centraț�iilor de radon î�n aerul din diferite tipuri de
Radonul este considerat o substanț�ă toxică din me- locuinț�e din localităț�ile rurale ș� i urbane ale princi-
diul ambiant ș� i prezintă riscuri pentru sănătate, palelor Zone ale Republicii Moldova: Nord, Centru
ceea ce a condus la creș� terea gradului de conș� tien- ș� i Sud cu evaluarea riscului expunerii populaț�iei
tizare a populaț�iei, efectuându-se cercetări extin- la radon. Obiectivele au constat î�n elaborarea ghi-
se, privind evaluarea concentraț�iei de radon din dului de plasare a detectorilor pasivi î�n locuinț�e,
locuinț�e (3, 4). Radonul din interiorul î�ncăperilor evaluarea caracteristicilor locuinț�elor ș� i a cunoș� -
sporeș� te riscul de dezvoltare a cancerului bron- tinț�elor populaț�iei referitor la impactul radonului
hopulmonar, poziț�ionându-se pe locul doi după asupra sănătăț�ii, măsurarea concentraț�iei de ra-
fumatul activ, care reprezintă cel mai mare risc de don î�n aerul de interior din 2 500 locuinț�e, prin
apariț�ie a cancerului pulmonar. Mai mult de 85% utilizarea detectorilor pasivi; citirea rezultatelor
din decesele cauzate de cancerul bronhopulmonar concentraț�iilor de radon î�n Laboratorul RADONO-
sunt printre fumători (2, 5, 6). Politica controlului VA, Uppsala, Suedia; analiza statistică a rezultate-
tutunului este cea mai promiț�ătoare direcț�ie î�n re- lor obț�inute, cartarea concentraț�iilor de radon î�n
alizarea obiectivelor de sănătate publică la capito- aerul din locuinț�e, pe teritoriul Republicii Moldo-
lul controlului expunerii la radon (8). va, cu identificarea localităț�ilor ț�ării cu risc sporit
la radon. Ipoteza de cercetare: confirmarea/infir-
Studiile epidemiologice ș� i ecologice, efectuate re- marea existenț�ei pericolului pentru sănătate, î�n
cent, demonstrează impactul radonului asupra rezultatul expunerii populaț�iei la radonul din ae-
dezvoltării cancerului bronhopulmonar. Riscul rul din locuinț�e.
creș� te î�n funcț�ie de durata expunerii ș� i de concen-
traț�ia radonului din interior. Expunerea totală la Ca material de studiu a servit aerul din 2500 lo-
radon are loc î�n locuinț�e, la ș� coală, la locul de mun- cuinț�e de diferite tipuri, plasate î�n zonele rurale ș� i
că, dar ș� i î�n localurile de agrement (3, 7). urbane ale principalelor Zone ale Republicii Mol-
dova: Nord, Centru ș� i Sud. Criteriul de selectare a
Studiul prin modele statistice, aplicate celor mai punctelor de măsurare a concentraţ�iei de 222Rn –
recent publicate date î�n domeniul estimării inci- punctele de măsurare a concentraţ�iei de 222Rn î�n
denț�ei ș� i mortalităț�ii pentru 25 de cancere majore, aerul interior au fost selectate randomizat, nemij-
43
locit din zonele incluse î�n studiu: Nord, Centru ş� i tate Publică (ANSP) au fost efectuate circa 2982 de
Sud, conform metodologiei Comisiei Europene măsurători ale concentraţ�iilor de 222Rn, prin meto-
(CE). Măsurările au fost efectuate preponderent la de active, realizate astfel:
parter, î�n dormitor sau î�n camera pentru oaspeț�i. • 1779 î�n aerul de interior (case de locuit, gră-
Au fost examinate datele cu privire la vechimea diniţ�e, ş� coli, Instituț�ii Medico Sanitare Publice
locuinţ�elor (tip nou sau vechi), anul construcţ�i- (expunerea ocupaț�ională), blocuri locative noi
ei, tipul materialelor de construcţ�ie ş� i de finisare date î�n exploatare etc.) prin metode active de
utilizate, adresa, prezenţ�a/lipsa fundamentului, măsurare a radonului;
conform chestionarului completat de proprietarul
• 891 î�n diverse surse de apă potabilă, inclusiv î�n
locuinț�ei. Măsurările au fost efectuate cu detectori
apele din sonde ş� i din fântânile de mină;
pasivi de lungă durată RADTRAK2, perioada de
expoziț�ie a constituit 90 de zile (fig. 1). • 312 la exhalarea 222Rn din sol.
Metoda de determinare a concentraţiilor de radon în
componentele mediului ambiant. Pentru efectuarea
măsurătorilor concentraţ�iilor de radon ş� i a descen-
denţ�ilor săi de viaţ�ă scurtă: 220Rn,218Po, 214Pb, 214Bi
ş� i 214Po î�n principalele componente ale mediului
ambiant, cât ș� i î�n aerul din interi-orul locuinț�elor a
fost utilizat dispozitivul german, al companiei SA-
RAD, Radonometru RTM 1688-2 (fig. 2).
Figura 1. Detector RADTRAK2 de măsurare

a concentraț�iilor de 222Rn î�n locuinț�e pe termen
lung – de la 2 luni până la 1 an.
Metodologia pentru realizarea hărţii de radon în

locuințele din Republica Moldova. Pentru reali-
zarea hărţ�ii de radon a fost utilizat caroiajul de-
finit î�n sistem Lambert – GISCO de către Centrul
Comun de Cercetare (Joint Research Center (JRC),
din cadrul CE. Conform caroiajului stabilit, harta
Republicii Moldova este reprezentată prin 336
de celule cu laturile de 10×10 km2. Pentru fiecare
celulă din gridul de referinţ�ă s-a calculat numărul
de măsurări, media aritmetică, media aritmetică a
valorilor logaritmate, deviaţ�ia standard, deviaţ�ia
standard geometrică, mediana, valoarea minimă
ş� i maximă. Gruparea rezultatelor ş� i redarea aces-
tora prin anumite coduri de culoare s-a efectuat
pornind de la valorile recomandate de CE. Pentru
compararea ş� i integrarea acestor rezultate î�n har-
ta europeană de radon este necesară utilizarea
claselor de frecvenţ�ă furnizate de JRC.
Î�n vederea implementării Directivei CE Nr.
2013/59/(13) ş� i a estimării igienice a nivelului de
expunere a populaţ�iei Republicii Moldova la sur-
sele naturale de radiaţ�ii ionizante ş� i a elaborării
măsurilor profilactice, î�n perioada 2010-2015 de
Figura 2. Radonometru RTM 1688-2.
către specialiş� tii Agenț�iei Naț�ionale pentru Sănă-
44
REZULTATE • Chestionarul de evaluare a cunoș� tinț�elor po-

Î�n perioada de studiu cercetările au fost axate pe pulaț�iei referitor la radon (Aprobat la Ș� edinț�a
elaborarea metodologiei noi de investigare a ra- Consiliului Ș� tiinț�ific al ANSP din 11.06.2019,
donului î�n interior, prin metode de măsurare de extras din procesul verbal nr. 4).
lungă durată. Metodologia î�n cauză a fost utilizată Materialele elaborate, î�mpreună cu detectorii, au
la măsurarea 222Rn î�n aerul de interior al diferitor fost repartizate medicilor ș� efi ai Centrelor de Sănă-
tipuri de locuinţ�e (n=2500), î�n arii rurale ş� i urba- tate Publică (CSP) regionale (n=10) î�n cadrul Ate-
ne, ale principalelor zone ale Republicii Moldova. lierului de lucru organizat de ANSP la 04.02.2019.
Detectorii RADTRACK2, oferiț�i de către Agenț�ia
Î�n luna iunie (perioada de expunere a constituit 90
Internaț�ională pentru Energie Atomică (AIEA) î�n
de zile) detectorii au fost colectaț�i ș� i expediaț�i î�n
cadrul Proiectului de cooperare tehnică MOL9007
laboratorul RADONOVA din Suedia pentru citirea
„Elaborarea Programului naț�ional (strategia ș� i
informaț�iei (concentraț�ia 222Rn), care a fost retri-
Planul de acț�iuni) al controlului expunerii popu-
misă î�n decurs de două săptămâni î�n Laboratorul
laț�iei Republicii Moldova la radon”, au fost plasate
Igiena radiaț�iilor ș� i Radiobiologie, ANSP.
î�n dormitoare/camere de oaspeț�i pe un termen de
circa 90 de zile. Rezultatele cercetărilor au demonstrat că activita-
tea 222Rn a variat î�n funcț�ie de tipul ş� i amplasarea
Î�n vederea realizării investigaț�iilor/sondajului
locuinț�elor, de tipul materialelor de construcţ�ie,
concentraț�iilor de radon î�n interior, prin metode
utilizate î�n construcţ�ia clădirii; tipul solului adia-
de lungă durată, au fost elaborate următoarele ce-
cent clădirii ş� i ventilaţ�ia î�ncăperilor.
rinț�e/metodologii:
• Cerinț�ele de plasare a detectorilor î�n locuinț�ă. Î�n Tabelul 1 este prezentată variabilitatea concen-
traț�iilor de radon î�n aerul din locuinț�e pe teritoriul
• Chestionarele de identificare a condiț�iilor/ ti-
Republicii Moldova. Rezultatele denotă că î�n circa
pului locuinț�elor.
1170 locuinț�e din cele investigate, adică î�n 49% de
• Acordul dintre investigatori ai radonului ș� i locuinț�e, concentraț�ia radonului corespunde nor-
proprietarul locuinț�ei. melor naț�ionale/europene.
Tabelul 1. Rezultatele măsurării concentraț�iilor de radon cu detectori RADTRAK2 (măsurare pasivă,

perioada de expoziț�ie 30 zile) î�n 2500 locuinț�e î�n zonele rurale ș� i urbane ale Republicii Moldova, a. 2019.
Nr. Concentrație radon, Bq/m3 Locuințe, număr %
1 Până la 150 1170 49,00
2 160-290 615 25,00
3 300- 490 338 13,52
4 500-790 251 10,04
5 800-990 58 2,30
6 > 1000 15 0,60
Totodată, î�n 615 locuinț�e (25%) concentraț�ia ra- proiectul HG este stipulată necesitatea elaborării
donului depăş� ea normele naț�ionale; î�n 662 locu- ș� i efectuării modificărilor la Codul construcț�iilor,
inț�e (26%) concentraț�ia radonului depăș� ea nor- cu obligativitatea monitorizării radonului la darea
mele europene. Astfel, î�n 1 277 locuinț�e (51%) î�n exploatare a clădirilor locative. Totodată, este
concentraț�ia radonului a fost mai mare ca norme- strict necesară monitorizarea radonului î�n soluri-
le naț�ionale/europene. Rezultatele indică asupra le pe care va fi amplasată clădirea. Î�n ț�ările vecine
existenț�ei problemei radonului î�n locuinț�e pe te- astfel de cerinț�e sunt deja implementate.
ritoriul ț�ării ș� i necesitatea soluț�ionării stringente
A prezentat interes ș� i studierea variabilităț�ii con-
a problemei. Î�n legătură cu cele expuse a fost ela-
centraț�iilor de radon î�n funcț�ie de coordonatele
borat proiectul Hotărârii de Guvern „Cu privire la
amplasării geografice a localităț�ilor. S-a stabilit o
aprobarea Strategiei Naț�ionale privind reducerea
variabilitate impunătoare pentru acest parametru,
riscului asociat iradierii naturale, inclusiv a rado-
cu variaț�ii de la 150 Bq/m3 î�n Chiș� inău până la 415
nului”, care a fost transmis Ministerului Sănătă-
Bq/m3 î�n r-nul Căuș� eni. Acest fapt poate fi explicat
ț�ii, Muncii ș� i Protecț�iei Sociale pentru avizare. Î�n
prin geologia neuniformă a teritoriului (fig. 3).
45
Cercetările au demonstrat variabilitatea concen- 250 Bq/m3, iar î�n Nord – 240 Bq/m3. Rezultatele
traț�iei radonului î�n locuinț�ele din ariile urbane ș� i denotă că, cea mai mare concentraț�ie a radonului
rurale ale Republicii Moldova, î�n funcț�ie de zonă. a fost detectată î�n Sudul ț�ării (330 Bq/m3), fiind
Astfel, î�n Zona de Sud valoarea medie a concentra- urmată de Centru (250 Bq/m3) ș� i de Zona de Nord
ț�iei radonului a constituit 330 Bq/m3, î�n Centru – (240 Bq/m3) (fig. 4).
Figura 3. Variabilitatea concentraț�iei radonului î�n aerul de interior al locuinț�elor amplasate î�n diferite raioane
geografice ale Republicii Moldova, a. 2019.
1 – r-nul Căuș� eni, 2 – Comrat, 3 – Vulcăneș� ti, 4 – Ceadâr Lunga, 5 – Ș� tefan-Vodă, 6 – Nisporeni, 7 – Leova,
8 – Hânceș� ti, 9 – Teleneș� ti, 10 – Cimiș� lia, 11 – Glodeni, 12 – Basarabeasca, 13 – Cantemir, 14 – Edineț�, 15 – Bălț�i,
16 – Cahul, 17 – Drochia, 18 – Floreș� ti, 19 – Soroca, 20 – Călăraș� i, 21 – Taraclia, 22 – Sângerei, 23 – Criuleni,
24 – Rezina, 25 – Străș� eni, 26 – Ungheni, 27 – Ialoveni, 28 – Ș� oldăneș� ti, 29 – Anenii-noi, 30 – Ocniț�a,
31 – Donduș� eni, 32 – Orhei, 33 – Briceni, 34 – Făleș� ti, 35 – Râș� cani, 36 – mun. Chiș� inău.
Figura 4. Variabilitatea concentraț�iei radonului î�n Republica Moldova î�n funcț�ie de zonă: Sud, Centru, Nord, a.
2019 (n=2500 măsurători cu detectori RADTRAK2, perioada de expoziț�ie 90 de zile).
Concomitent s-a analizat variabilitatea concentra- î�n comparaț�ie cu cele urbane – 241 Bq/m3. Fap-
ț�iei radonului î�n aerul din locuinț�ele, plasate pe te- tul î�n cauză poate fi explicat prin aceea că, casele,
ritoriul Republicii Moldova, î�n funcț�ie de localitate: î�n mediul rural, sunt amplasate direct pe sol sau
rurală sau urbană. Cercetările denotă că, valoarea au un fundament necorespunzător. Aceste condi-
medie a concentraț�iei de radon din interior a fost ț�ii permit ca radonul din sol/roci să pătrundă mai
mai mare î�n ariile rurale, constituind 260 Bq/m3, uș� or î�n î�ncăperea de locuit (fig. 5).
46
Î�n baza analizării rezultatelor măsurării concen- programele Google Maps, ArcGIS ș� i alte programe
traț�iei de radon î�n aerul de interior a 2500 locuin- de specialitate, a fost efectuată cartarea radonului
ț�e, prin utilizarea detectorilor pasivi RADTRAK2, pe teritoriul ț�ării (fig. 6). Rezultatele au fost trans-
s-a stabilit că media aritmetică a indicelui a con- mise la Joint Research Comission pentru include-
stituit 254,6 Bq/m3, iar media geometrică – 217,6 rea acestora pe harta Europeană a radonului.
Bq/m3. Î�n baza rezultatelor obț�inute, utilizând
Figura 5. Concentraț�ia radonului î�n aerul din locuinț�e, î�n localităț�ile rurale ș� i urbane ale Republicii Moldova,
a. 2019 (n=2500 măsurători cu detector RADTRAK2, perioada de expoziț�ie 90 de zile).
Figura 6. Cartarea radonului î�n aerul din diferite tipuri de locuinț�e, î�n arii rurale ș� i urbane, î�n zonele de Nord,
Centru ș� i Sud a Republicii Moldova.
47
DISCUȚII imposibilă diminuarea activităţ�ii echivalente me-

Î�n conformitate cu „Normele Fundamentale de dii anuale de echilibru pe o unitate de volum a
Radioprotecț�ie, Cerinț�e ș� i Reguli Igienice” (NFRP-
222
Rn până la valori mai mici de 300 Bq/m3 (15).
2000) ș� i „Regulamentul ş� i normele igienice privind Relevant e faptul că, valorile menț�ionate au fost
reglementarea expunerii la radiaţ�ii a populaţ�iei de stipulate ca norme naț�ionale de referinț�ă doar te-
la sursele naturale” nivelul naț�ional de referinț�ă a oretic, nu î�n baza efectuării măsurătorilor î�n ae-
222
Rn a fost stabilit la o concentraț�ie de 100 Bq/m3 rul din locuinț�e. Recent, î�n perioada a. 2018-2019,
pentru clădirile noi ș� i de 150 Bq/m3 pentru clădi- î�n rezultatul implementării proiectului naț�ional
rile existente (14). MOL9007, finanț�at de către AIEA, rezultatele fi-
Î�n cazul depistării concentraț�iilor sporite (peste ind prezentate î�n lucrarea î�n cauză, s-a observat
200 Bq/m3) trebuie să fie î�ntreprinse măsuri de că î�n 1277 locuinț�e (51%) concentraț�ia radonului
radioprotecţ�ie, î�ndreptate spre diminuarea pă- depăș� eș� te normele naț�ionale/ europene. Î�n baza
trunderii 222Rn î�n aerul spaţ�iilor locative ş� i amelio- acestor rezultate se propune modificarea valorilor
rarea ventilării î�ncăperilor. Dislocarea locatarilor naț�ionale de referinț�ă – 300 Bq/m3 care urmează a
(cu acordul acestora) ş� i reprofilarea î�ncăperilor fi implementate î�n urma aprobării proiectului Ho-
ș� i a edificiilor, poate avea loc î�n cazurile când este tărârii de Guvern la acest capitol.
CONCLUZII
1. Monitoringul concentraț�iilor de radon î�n aerul din diferite tipuri de locuinț�e (n=2 500), plasate î�n
localităț�ile rurale ș� i urbane, ale diferitor zone ale Republicii Moldova, prin utilizarea detectorilor alpha
de lungă durată, de tip RADTRAK2, cu perioada de expoziț�ie de 90 de zile, a stabilit variabilitatea indica-
torului î�n funcț�ie de zona geografică, condiț�iile abiotice, tipul casei, tipul pardoselii ș� i a pereț�ilor.
2. Studiul a demonstrat o creș� tere a concentraț�iilor de radon î�n aerul din locuinț�e î�n zona de Sud a ț�ării,
valoarea medie pe zonă constituind 330 Bq/m3, fiind urmată de zona de Centru – 250 Bq/m3 ș� i Nord –
240 Bq/m3.
3. Studierea variabilităț�ii concentraț�iei radonului î�n aerul locuinț�elor, amplasate î�n diferite raioane geo-
grafice ale Republicii Moldova, a evidenț�iat valori sporite î�n r-nul Căuș� eni ș� i diminuate î�n mun. Chiș� inău.
4. Cercetările denotă că valoarea medie a concentraț�iei de radon din locuinț�e a fost mai mare î�n ariile
rurale, constituind 260 Bq/m3, î�n comparaț�ie cu cele urbane – 241 Bq/m3.
5. Cartarea concentraț�iilor de radon î�n aerul din locuinț�e pe teritoriul ț�ării va fi utilă ministerelor ș� i
instituț�iilor de resort, inclusiv specialiș� tilor din construcț�ii, î�n vederea selectării terenurilor pentru con-
strucț�ia clădirilor cu risc diminuat de expunere la radon.
CONFLICT DE INTERESE from: https://blog.mass.gov/publichealth/environ-

Autorii n-au declarat conflict de interese. mental-health/exposure-to-Radon-increases-yo-
ur-risk-for-lung-cancer/ (Accessed 8th July 2019).
3. Scott BR. Residential Radon Appears to Prevent
FINANȚARE
Lung Cancer. Dose Response. 2011; 9(4):444-464.
Cercetările î�n cauză au fost efectuate î�n cadrul 4. Vuchkov D, Ivanova K, Stojanovska Z, Kunovska B,
proiectului MOL9007, susț�inut de Agenț�ia Inter- Badulin V. Radon measurement in schools and kinder-
naț�ională pentru Energie Atomică, Viena, Austria. gartens. National Center of Radiobiology and Radiati-
on Protection. Rom. Journ. Phys. 2012; 58:328-335.
REFERINȚE 5. Lantz P, Mendez D, Philbert M. Radon, Smoking,
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radiation. United Nations Scientific Committee on trol policy. American Journal of Public Health 2013;
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New York, 2010. 6. Song G. et all. Indoor Radon levels in selected hot
2. Fran M. Exposure to radon increases your risk for lung spring hotels in Guangdong, China. Science of Total
cancer. Mass Public Health Blog. Promoting public Environment. 2005; 339(1-3):63-70.
health & wellness in Massachusetts, 2017 Available 7. WHO handbook on indoor radon: a public health
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perspective/edited by Hajo Zeeb, and Ferid Shan- 12. Biblin A. Development of the model of radiation
noun. World Health Organization 2009. risk-communication with the public for the arrange-
8. Lantz PM, Mendez D, Philbert MA. Radon, smoking, ment of the research. Available from: https://www.
and lung cancer: the need to refocus radon control researchgate.net/publication/332131134 (Acces-
policy. Am J Public Health.2013; 103(3):443-7. sed 10th July 2019).
9. Ferlay J, Colombet M, Soerjomataram I, Dyba T, Ran- 13. Council Directive 2013/59/Euratom, Official Jour-
di G, Bettio M, Gavin A, Visser O, Bray F. Cancer inci- nal of the E.U. 2014.
dence and mortality patterns in Europe: Estimates 14. Normele Fundamentale de Radioprotecție, Cerin-
for 40 countries and 25 major cancers in 2018. Eur J țe și Reguli Igienice (NFRP-2000) nr. 06.5.3.34 din
Cancer. 2018; 103:356-387. 27.02.2001(Monitorul Oficial al Republicii Moldova,
10. Ragnar L. The communication of radon risk in Swe- nr. 40-41, 2001).
den: where are we and where are we going? Journal 15. RMS nr. 217: Regulament şi norme igienice privind
of Risk Research. 2019; 22(6):773-781. reglementarea expunerii la radiaţii a populaţiei de
11. Selim MK, James G. An Interdisciplinary Population la sursele naturale nr. 06-5.3.35 din 05.03.2001
Health Approach to the Radon Health Risk Manage- (Monitorul Oficial al Republicii Moldova, nr. 92 din
ment in Canada. Interdisciplinary Journal of health 03.08.2001).
sciences. 2017; 3(19):1-11.
Data recepționării manuscrisului: 16/02/2020

Data acceptării spre publicare: 28/02/2020
Liuba COREȚ� CHI, ORCID 0000-0001-5758-3831

Ion BAHNAREL, ORCID 0000-0002-7206-5490
Mariana GÎ�NCU, ORCID 0000-0001-5082-8250
Alexandra COJOCARI, ORCID 0000-0002-4105-3083
49
COMPARATIVE ANALYSIS OF LONG-EARED OWL (ASIO OTUS)

WINTER DIET FROM TWO EUROPEAN CITIES – CHISINAU
(REPUBLIC OF MOLDOVA) AND BACAU (ROMANIA)
Victoria NISTREANU1, Dalia PARASCHIV2, Alina LARION1
Institute of Zoology, Chisinau, Republic of Moldova,
1
Museum Complex of Natural Sciences, Bacau, Romania

2
Corresponding author: Victoria Nistreanu, e-mail: vicnistreanu@gmail.com
DOI: 10.5281/zenodo.3701168 UDC: 598.279.25:591.53(478-25+498-21)
Key words: Asio otus, Introduction. Many rodent species are important pests for agriculture and for urban areas.
urban environment, The long-eared owl is a predator that exerts constant pressure on rodent density.
trophic spectrum, ro- Material and methods. The studies were performed in winters of 2011-2013 in the cities of
dents, Microtus voles. Chisinau and Bacau, where 599 and 82 pellets of Asio otus were collected, respectively. The
prey items were identified from cranial bones extracted from pellets.
Results. Long-eared owl’s diet in both sites consists of mammals and birds, with rodents
being the dominant trophic component. The Microtus species were the main prey with the
abundance ≥70% in both sites. In Chisinau a high proportion of Mus species was registered
in the diet. The total biomass of prey constituted 43 953 g in Chisinau and 7 038 in Bacau.
The highest biomass belongs to Microtus species, with 31 710 g and 5 220 g, respectively.
The trophic niche width in Chisinau constituted 0.089 and varied monthly from 0.058 to
0.28. In Bacau the WTNs was of 0.134 and varied slightly among the study months.
Conclusions. The rodents were the main trophic source and constituted ≥96% in both sites.
The prey diversity was higher in Chisinau, that was due to a larger city territory and to a
higher number of wintering long-eared owls. The close values of trophic niche width in Chis-
inau and Bacau confirmed the high hunting specialization of the long-eared owl.
Cuvinte cheie: Asio ANALIZA COMPARATIVĂ A DIETEI DE IARNĂ A CIUFULUI DE PĂDURE (ASIO
otus, mediu urban, OTUS) ÎN DOUĂ ORAȘE EUROPENE – CHIȘINĂU (REPUBLICA MOLDOVA) ȘI BACĂU
spectru trofic, roză- (ROMÂNIA)
toare, speciile genului
Microtus. Introducere. Multe specii de rozătoare sunt dăunători ai agriculturii, inclusiv și zonele ur-
bane. Ciuful de pădure este o specie de păsări de pradă care exercită o presiune relativ
constantă asupra densității rozătoarelor.
Material și metode. Cercetările au fost efectuate în orașele Chișinău și Bacău, în perioada
de iarnă a anilor 2011-2013, unde au fost colectate 599 și, respectiv, 82 de ingluvii. Au fost
identificate speciile pradă după oasele craniene extrase din ingluvii.
Rezultate. Spectrul trofic al ciufului de pădure din ambele situri este format din mamifere
și păsări, rozătoarele fiind componentul trofic principal. În ambele situri speciile genului
Microtus au fost prada principală cu peste 70%. Biomasa totală a prăzii a constituit 43 953
g în Chișinău, iar în Bacău – 7 038 g. Cea mai mare biomasă aparține speciilor gen. Microtus
– 31 710 g la Chișinău, 5 220 g – la Bacău. Lățimea nișei trofice în Chișinău a fost de 0,089
și a variat lunar de la 0,058 la 0,28. La Bacău, WTNs a constituit 0,134 și a variat lunar în
limite mici.
Concluzii. Rozătoarele au reprezentat sursa trofică principală – peste 96% în ambele situri.
În localitatea cu suprafața mai mare, spectrul trofic s-a dovedit a fi mai variat. Diversita-
tea speciilor pradă este mai mare în Chișinău și se datorează suprafeței mai mari a orașu-
lui și numărului mai mare de ciufi în colonie. Valorile apropiate ale lățimii nișei trofice în
Chișinău și Bacău confirmă specializarea înaltă a ciufului de pădure.
50
INTRODUCTION The aim of the paper is to perform a comparati-

Many of the rodent species are important pests of ve analysis of long-eared owl winter diet in two
agricultural crops and cereal deposits, including European cities, Chisinau and Bacau, with similar
urban areas. The nocturnal prey birds are regu- environmental – climatic conditions and rather
latory species that contribute to maintaining ro- different anthropic impact, in order to emphasize
dent density at more or less constant level. The the similarities and the differences.
long-eared owl (Asio otus L.) is a sedentary bird
and one of the most widespread in Europe (1-5). MATERIAL AND METHODS
During the winter period the density of species The studies were performed in winter periods of
increases on the account of the migrant individu- 2011-2012 and 2012-2013 in Chisinau and Bacau
als from the northern regions and they form colo- cities. Chisinau is a large city with the surface of
nies of several tens of individuals. In most cases, 123 km2, situated in the central part of the Repu-
the owls prefer to winter each year in the same blic of Moldova at the altitude of 82 m, coordinates
place. The hunting sectors of the long-eared owl 47001ꞌ N 28052ꞌ E. Bacau city is the major city of
are open type biotopes, where they mainly hunt Bacau county, with the surface of 43.19 km2, situ-
rodents and occasionally birds, shrews and bats. ated in eastern part of Romania at the altitude of
Following the digestion process, the prey birds 165 m, coordinates 46035ꞌ N 26055ꞌ E. The clima-
regurgitate the indigestible remnants of eaten te of both cities is humid continental with warm
a-nimals (bones, hair, feathers, fur) in the form of summers and cool, windy winters. The winter pe-
pellets. The pellets analysis can provide important riod lasts 78-80 days. The average temperature in
data regarding the feeding regime of the bird, the winter is -2.3°C in Chisinau and -4 C in Bacau city,
fauna of small mammals in a certain area, their while the minimum temperature in January and
density and their seasonal and annual dynamics, February can drop below -20°C.
etc. The long-eared owl is well adapted to anthro-
In Chisinau city a colony of long-eared owl (Asio
pic environment and its wintering colonies are
otus L.) of 38 individuals was located in a cour-
frequently registered in urban localities (4).
tyard of a school from Ciocana district with seve-
Taking into consideration the huge importance of ral dozens of tall coniferous and deciduous trees
long-eared owl trophic activity in biological con- (Picea abies, Populus alba, P. tremula, Salix alba)
trol of rodent pest species, especially in winter suitable for long-eared owl individuals. In Bacau
period, its diet was rather well studied in many city a small colony of 7 individuals was located in
regions of Europe (1-10). In the Republic of Mol- the yard of the Astronomical Observatory, with
dova and Romania the diet of long-eared owl was several trees of Thuja orientalis, Picea abies, Carpi-
also rather well studied in different areas of the nus betulus. Both locations are situated within the
countries (11-18). There are several studies con- cities limits in heavily urbanized areas.
cerning the long-eared owl’s diet in urban areas
In Chisinau 599 pellets have been collected and
(19-26).
in Bacau 82 pellets. Each pellet was measured,
The long-eared owl is a feeding specialist preda- weighed and afterwards unfolded. The bone
tor and not all species are equally hunted prey. fragments were cleaned and sorted into catego-
The attractiveness of a prey species depends on ries. Small mammal species were determined ac-
specific qualities, the most important of which cor-ding to cranial bones and dentition (34, 35).
is the size (1). The long-eared owl shows strong The sibling species Microtus arvalis and M. rossiae-
preference for Microtus voles across Europe, but meridionalis, Mus musculus and M. spicilegus that
in urban areas it hunts in open type biotopes out- can’t be differentiated morphologically were con-
side the city and/or use alternative prey (27). In sidered as genus Microtus and Mus, respe-ctively.
winter, A. otus is capable to localize the prey under
The ecological analysis of the prey species was
a snow cover of 40-50 cm (14). As adaptations of
performed using the indexes of abundance
winter diet to urban environment can be conside-
(A=no*100/N, where no – number of individu-
red the use of higher ratio of synanthropic rodent
als of a species, N – total number of individuals);
species (Mus musculus, Rattus norvegicus), of bird
frequency (F=nop*100/N, where nop – number
species as well as more diverse trophic spectrum
of pellets with certain species, N – number of pe-
(4, 24, 28-33).
llets); total biomass of consumed prey (B=no*G,
51
where no – number of individuals of a species, G – morpha, Rodentia, Chiroptera) and passe-rine bi-
mean weight of one individual). The mean weight rds (fig. 1). In Bacau rodents and passerine birds
of prey individual was calculated from our own have been identified (fig. 2). In both sites Microtus
data gathered during long term studies of small species dominated with 70.99% in Chi-sinau and
mammals and bats. The trophic niche width was 76.31% in Bacau. The house mouse is the second
estimated using the B Levins’ index: B=1/Σp2, (36), species in Chisinau pellets (10.88%), while in Ba-
in its standardized version Bs (37): Bs=(B-1)/(n- cau it constituted less than 1%. The genus Apode-
1), where p is the fraction of items in the diet, and mus were represented by 4 species in Chisinau and
n is the number of possible food categories (38). by 3 species in Bacau. In both sites the most nume-
Bs ranges from 0 (100% utilization of a single food rous was A. sylvaticus with 10.34% and 10.97%,
category) to 1 (equal use of all categories). respectively (fig. 1, fig. 2). Other Apodemus species
constituted about 10% in Bacau pellets, while in
During the study none of animals was injured or
Chisinau their ratio was less than 4%. In Chisinau
sacrificed.
the diet of long-eared owl was more diverse, pro-
bably due to much larger number of individuals
RESULTS
that hunted in a larger variety of ecosystems. Here
In Chisinau the length of analyzed pellets varied were identified shrews and bats in lower ratio,
from 1.16 to 6.95 cm with the average of 3.32 cm. while the birds constituted 2.55% and in Bacau
The pellet weight varied between 1.2 and 6.07 g – 2.19%. Among rodents two more species have
with the average of 2.52 g. After cleaning the bones, been registered – the arboreal rodent Muscardinus
1489 individuals were identified. The number of avellanarius and the synanthropic species Rattus
individuals per pellet varied from 1 to 6, the avera- norvegicus with very low ratio of 0.13%.
ge constituted 2.46 individuals. In Bacau the pellet
length varied between 1.2 and 5.6 cm. The minimal The diversity indexes (Shannon and Simpson) are
number of individuals/pellets was 1, the maximal higher in Chisinau site 0.45 and 1.89, respectively,
number was 5 and the average was 2.56. After clea- than in Bacau 0.71 and 1.68. Although the species
ning the bones 223 individuals were identified. number is much higher in Chisinau, the difference
between diversity indexes is not very high, due to
The trophic spectrum of long-eared owl in Chi-si- more even distribution of the species in Bacau site.
nau consisted of mammals from 3 orders (Sorico-
Figure 1. Trophic spectrum of long-eared owl in Chisinau city in 2011-2012.
The highest frequency in pellets from both urban flavicollis in Bacau (tab. 1). The birds, represented
areas belongs to Microtus species that was found by Passeriformes had a frequency of 6.43% in Chi-
in most of the pellets followed by Mus species and sinau and 6.1% in Bacau.
A. sylvaticus in Chisinau and by A. sylvaticus and A.
52
The total biomass of prey items constituted 43 5 220 in Bacau (tab. 2). In both sites a decrease
953 g in 6 study months in Chisinau and 7 038 in of prey number and biomass was registered from
4 months in Bacau. The highest biomass belongs November to December and from November to
to Microtus species, with 31 710 g in Chisinau and February in Chisinau.
Figure 2. Trophic spectrum of long-eared owl in Bacau city in 2011-2012.
Table 1. Frequency of animal species in Asio otus pellets.
Chisinau Bacau
Nr. Genus/species
No pellets Frequency, % No pellets Frequency, %
1. Microtus 368 61.44 62 75.61
2. Mus 136 22.71 1 1.22
3. A. sylvaticus 125 20.87 21 25.61
4. A. uralensis 25 4.17 - -
5. A. flavicollis 6 1.0 12 14.63
6. A. agrarius 24 4.01 9 10.98
7. M. avellanarius 2 0.33 - -
8. R. norvegicus 2 0.33 - -
9. Soricomorpha 10 1.67 - -
10. Chiroptera 2 0.33 - -
11. Passeriformes 38 6.34 5 6.1
DISCUSSIONS
The trophic niche index in Chisinau site was In both cities the Microtus voles are the most im-
1.89 and varied monthly between 1.58 to 3.77. portant prey item in the winter diet of Long-eared
The standardized index was of 0.089 and varied owl, as previously registered in open land ecosys-
monthly from 0.058 to 0.28 and indicate that in tems thorough Europe (1, 2, 3, 5, 7, 9, 10, 39, 40,
December 2012 the prey used belonged to many 41, 42), as well as in urban areas (17, 21, 22, 24,
categories with more even distribution. In Bacau 25, 29, 43, 44). Apodemus species constitute an im-
the trophic niche index was 1.67 with low varia- portant trophic source for long-eared owl in urban
tion degree between months. The standardized area. Their share can vary between 3% and 66%
index was of 0.134 and varied slightly among the (17, 23, 28, 39, 40, 44) depending on location, cli-
studied months (tab. 2). In Bacau WTNs index was matic conditions, hunting sectors and prey availa-
slightly higher because only prey categories hun- bility. In some urban areas the Apodemus species
ted there were considered. even were the most abundant prey during winter
period (28, 29, 43).
53
The difference between the ratio of Mus species in na-rius. The last one is arboreal species and usu-
both cities is very high. This fact can be explain- ally hibernates during winter, therefore its share
ed by city size and structure. In Chisinau there are is very low in different regions of Europe, up to 1%
many tall buildings and a massive production of (21, 28), but in most of studies it wasn’t re-giste-
waste, while in Bacau small houses are most nu- red. The brown rat had a very low ratio in Chisinau
merous and the city is much cleaner. The higher pellets and wasn’t registered in Bacau, although in
ratio of Mus species (up to 10%) in winter diet of previous studies it was found in A. otus diet with
the long-eared owl was noted for large cities (9, 0.14% (23). In many other studies in European ci-
21, 29, 40, 45) and much lower ratio, up to 3% in ties the species also had a low share, up to 5% (9,
small cities (17, 24, 43). 20, 21, 29, 31, 39), but in some large cities the spe-
cies is one of the main preys, reaching about 20%
Among other rodent species in Chisinau pellets
and 60-70% biomass (28).
there were found R. norvegicus and M. avella-
Table 2. Individual number and biomass of prey species in studied months.

City Chisinau Bacau
Species Par. XI.11 XII.11 I.12 II.12 XI.12 XII.12 Total XI.11 XII.11 XI.12 XII.12 Total
No 346 242 175 174 67 53 1057 53 27 63 31 174
Microtus
BM 10 380 7 260 5 250 5 220 2 010 1 590 31 710 1 590 810 1 890 930 5 220
No 64 29 16 19 21 13 162 - - 1 - 1
Mus
BM 1 152 522 288 342 378 234 2916 - - 18 - 18
No 37 23 19 31 30 14 154 9 4 9 3 25
A. sylvaticus
BM 1 036 644 532 868 840 392 4 312 252 112 252 84 700
No 5 7 4 7 3 - 26 - - - - 0
A. uralensis
BM 115 161 92 161 69 - 598 - - - - 0
No 2 - 1 2 - 2 7 5 - 6 3 14
A. flavicollis
BM 70 - 35 70 - 70 245 175 - 210 105 490
No 8 7 2 4 3 2 26 2 1 5 1 9
A. agrarius
BM 200 175 50 100 75 50 650 50 25 125 25 225
No - - - - 2 - 2 - - - - 0
R. norvegicus
BM - - - - 300 - 300 - - - - 0
No - 2 - - - - 2 - - - - 0
M. avellanarius
BM - 40 - - - - 40 - - - - 0
No - - 4 1 5 2 12 - - - - 0
Soricidae
BM - - 32 8 40 16 96 - - - - 0
No - - - - 3 - 3 - - - - 0
Chiroptera
BM - - - - 36 - 36 - - - - 0
No 1 2 2 5 20 8 38 - 3 - 2 5
Passeriformes
BM 75 150 150 375 1 500 600 2 850 - 225 - 150 375
Total ind. No 463 312 223 243 154 94 1489 69 35 84 40 228
Total biomass BM 13 028 8 852 6 429 7 144 5 248 2 952 43 653 2 067 1 172 2 495 1 294 7 028
WTN 1.71 1.62 1.58 1.95 3.77 2.7 1.89 1.64 1.61 1.72 1.63 1.67
WTNs 0.071 0.062 0.058 0.095 0.28 0.17 0.089 0.128 0.122 0.144 0.126 0.134
Note: No – number of individuals, BM – biomass, WTN – width of trophic niche, WTNs – width of trophic niche standardized
Among other mammal groups in the diet of re of shrews in the owl’s diet depends on the abun-
long-eared owl from Chisinau representatives of dance of Microtus species and doesn’t depend on
shrews and bats have been registered in very low shrew abundance in certain area (46). The presen-
percent. The shrews were represented by 4 species ce of bats in the diet of A. otus is usually accidental
(Crocidura suaveolens, C. leucodon, Sorex minutus, and constitutes less than 0.5%, while in the diet of
S. araneus) and the bats – by 2 species (Eptesicus other owl species (Tyto alba, Bubo bubo) Chiropte-
serotinus and Vespertilio murinus). The shrews are ra groups can reach more than 10% (47, 48).
an alternative prey type for A. otus and are mostly
The passerine birds constituted about 2-3% in A.
hunted when the abundance of Microtus species is
otus diet from both cities, as well as in other urban
low. Furthermore, it was esta-blished that the sha-
studies, where their share constituted 0.5-10%
54
(26, 29, 39, 40, 43, 49). The higher ratio of birds in 29, 40), while in smaller localities the diversity is
some studies is conditioned by the abundant snow lower (22, 26, 39).
cover, when owls can shift their hunting areas into
The long-eared owl is a specialized predator and
urban habitats, where the availability and density
hunt individuals that weight between 15 g and 50
of bird populations, especially house sparrow, are
g, therefore, the ratio of preferred prey – Micro-
higher (4). In the studied period in urban localities
tus voles remain high in spite of the availability of
Chisinau and Bacau the snow cover did not exce-
other prey types (1, 2). According to optimal fora-
ed 10-20 cm and in November-December periods
ging theory only the abundance of preferred prey
there was no snow cover, therefore the share of
influence upon the optimal choice of prey type,
birds was rather low.
while the abundance of other prey types is not
The prey diversity is higher in Chisinau site than important (50). The close values of trophic niche
in Bacau, which is due to larger surface of Chi-si- breadth in Chisinau and Bacau prove the high hun-
nau city and to larger number of long-eared owl ting specialization of the long-eared owl and hig-
individuals. The higher diversity in larger cities hlight its importance in rodent regulation in urban
was mentioned in many other studied (21, 28, areas and surroundings.
CONCLUSIONS
1. The trophic spectrum of long-eared owl in Chisinau and Bacau cities consists of mammals and birds,
the rodents being the dominant trophic source (8 species in Chisinau and 5 species in Bacau with over
95%). The Microtus species were the main prey and constitute more than 70% in both sites.
2. The higher prey diversity in Chisinau in comparison to Bacau is due to larger surface of Chisinau city
and to larger number of long-eared owl wintering individuals. In larger cities the trophic spectrum is
more diverse.
3. The total biomass of prey items constituted 43 953 g in 6 study months in Chisinau and 7 038 in 4
months in Bacau. The highest biomass belongs to Microtus species, with 31 710 g in Chisinau and 5 220
in Bacau.
4. The trophic niche index in Chisinau site was 1.89 and varied monthly between 1.58 to 3.77. The stan-
dardized index was of 0.089 and varied monthly from 0.058 to 0.28 In Bacau the trophic niche index was
1.67 with low variation degree between months. The standardized index was of 0.134 and varied sli-
ghtly among the studied months. The close values of trophic niche breadth in Chisinau and Bacau prove
the high hunting specialization of the long-eared owl and highlight its importance in rodent regulation
in urban areas and surroundings.
CONFLICT OF INTERESTS
3. Romanowski J, Ż� mihorski M. Effect of season,
The authors do not declare any conflict of interest. weather and habitat on diet variation of a feedingspe-
cialist: a case study of the long-eared owl, Asio otus in
ACKNOWLEDGMENT Central Poland. Folia Zool. 2008; 57(4): 411–419.
The studies were performed within the funda- 4. Wijnandts H. Ecological energetics of the long-eared
mental project 15.187.02.11F and applicative pro- owl (Asio otus). Ardea. 1984; 72:1–92.
ject 20.80009.7007.02. 5. Korpimäki E. Diet composition, prey choice, and
breeding success of Long-eared Owls: effects of
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Victoria NISTREANU, ORCID: 0000-0002-9726-9684
57
ANTIMICROBIAL RESISTANCE AND BIOLOGICAL PROPERTIES

OF STAPHYLOCOCCUS SPP. ISOLATED FROM PIGS
Yuriy VISHOVAN, Valerii USHKALOV, Oleksandra KEPPLE, Andry GRANATE
Ukrainian Laboratory of Quality and Safety of Agricultural Products,
National University of Life and Environmental Sciences of Ukraine
Corresponding author: Yuriy Vishovan, e-mail: anatomi1991@gmail.com
DOI: 10.5281/zenodo.3701192 CZU: 579.861.2:615.33.015.8
Key words: Staphylococcus Introduction. Representatives of the genus Staphylococcus spp. cause a significant
spp., plasma coagulation, proportion of diseases in animals and humans. Nowadays the problem of their ac-
biological properties, an- quired antibiotic resistance is an urgent concern.
tibiotics, susceptibility, Material and methods. Isolation and identification of Staphylococcus spp. carried out
resistance. in accordance with DSTU EN 6888:2003 standard. The susceptibility of the strains to
antibiotics was determined by the disk diffusion method. Interpretation of the results
was carried out in accordance with the recommendations of the 8th version of EUCAST.
Results. 77 strains of Staphylococcus spp. Collected from sows at the farm No. 2, were
isolated: hemolytic properties were detected in 90.6% (39 coagulases positive and 19
coagulase negative); 22 (56.4%) strains of coagulase-negative Staphylococcus spp.;
13.6% of isolates had hemolytic properties. The results of antibiograms of crops from
the farm No.1: 51.8% of strains were susceptibile to penicillin, 47.6% – resistant; 13.62
– susceptibile to fluoroquinolones, 80.9% – resistant; 96.7% – susceptibile to chloram-
phenicol, no resistant strains were detected.
Conclusions. Acquired resistance of Staphylococcus spp. to certain groups of antibiot-
ics isolated from pigs, indicated the irrational use of antimicrobial therapy. Differences
were found in the susceptibility of coagulase-positive and coagulase-negative Staphy-
lococcus spp. to all groups of antibiotics.
Cuvinte cheie: Staphylo- REZISTENŢA LA ANTIMICROBIENE ŞI PROPRIETĂȚILE BIOLOGICE A STAPHYLO-
coccus spp., coagularea COCCUS SPP. IZOLATE DE LA PORCINE
plasmei, proprietăți biolog- Introducere. Reprezentanții genului Staphylococcus provoacă un număr semnificativ
ice, antibiotice, sensibili- de boli la animale și la oameni. Actualmente, o problemă majoră o prezintă rezistența
tate, rezistenţă. dobândită a acestor tulpini la antibiotice.
Material și metode. Izolarea și identificarea Staphylococcus spp. s-a realizat în con-
formitate cu standardul DSTU EN 6888:2003. Sensibilitatea tulpinilor la antibiotice a
fost determinată prin metoda disc-difuzimetrică, iar interpretarea rezultatelor a fost
efectuată potrivit recomandărilor EUCAST, versiunea 8.
Rezultate. De la scroafele din ferma nr. 1 au fost izolate 77 de tulpini de Staphylo-
coccus spp: proprietăți hemolitice au fost detectate la 90,6% din probe (39 coagula-
zo-pozitive și 19 coagulazo-negative). De la scroafele din ferma nr.2 au fost izolate 22
(56,4%) tulpini de Staphylococcus spp. coagulozo-negative, dintre care 13,6% posedau
proprietăți hemolitice. Rezultatele antibioticogramei culturilor de la ferma nr.1 ne
arată că 51,8% din culturi sunt sensibile și 47,6% sunt rezistente la peniciline; 13,6%
sunt sensibile și 80,9% sunt rezistente la fluorochinolone, iar 96,7% din tulpini au fost
sensibile la cloramfenicol, nefiind detectate culturi rezistente.
Concluzii. Rezistența dobândită la tulpinile de Staphylococcus spp, izolate de la por-
cinele din ferma nr.1, față de anumite grupuri de antibiotice, indică utilizarea irațion-
ală a terapiei antimicrobiene. Astfel, s-au constatat diferențe în sensibilitatea tulpinilor
de Staphylococcus spp, coagulazo-pozitive și coagulazo-negative, la toate grupele de
antibiotice.
58
INTRODUCTION and Guidelines “Determination of susceptibility of

Staphylococcus carriers were an important sour- microorganisms to antibacterial drugs” (12).
ce of contamination for food, raw materials, birds,
pigs and pork products (1, 2). It has been repea- RESULTS
tedly proven that pigs were sources of staphylo- Farm No. 1 proved to be a satisfactory farm in ter-
cocci, in particular methicillin-resistant S. aureus ms of safety against contagious diseases; number
(MRSA) (3). Such cases were especially common of pigs was up to 2 500 heads. There were 210
in Denmark (4), Canada (4), Germany (6) and pigs. Purulent diseases, abscesses and boils were
Switzerland (7). In young pigs, the disease ma- not reported in piglets. Of the 77 sows sampled
nifests itself in the form of exudative epidermitis from the nose Staphylococcus spp. were isolated in
(EE), caused by strains of Staphylococcus hyicus, 64 cases (83.1%). All strains grown on the Beard
Staphylococcus aureus and Staphylococcus chro- Parker agar had typical colonies of black and grey,
mogenes, which produce exfoliative toxins. Howe- shiny and convex with a diameter of 1 mm to 1.5
ver, pigs in most cases were hidden carriers (7). mm after incubation for 24 hours and a diame-
Experimental transfer of methicillin-resistant S. ter of 1.5-2.5 mm after 48 hours of incubation.
aureus to minks during feeding of pork waste con- The 39 isolates (60.94%) were coa-gulated with
taminated with MRSA is also known (9). In 2017, rabbit plasma. The ability to hemo-lysis of sheep
80 methicillin-resistant staphylococcus strains erythrocytes showed only 58 (90.6%) of strains.
were isolated in Ukraine, including 77.5% from Of these, 39 coagulase-positive strains and 19 coa-
domestic animals, 11.3% from poultry, 6.3% from gulase-negative strains did not show hemolytic
cattle and 5% from pigs (10). properties of 6 coagulase-negative strains.
The purpose of the study was to investigate the The farm No. 2 proved to be a satisfactory farm in
biological properties and antibiotic resistance of terms of contagious diseases; number of pigs was
Staphylococcus spp. isolated from pigs of two in- up to 3 500 heads. Diseases caused by Sta-phylo-
dustrial pig farms located in Kyiv (No.1) and Vin- coccus spp. we’re not registered. In 22 samples
nytsa regions (No.2). (56.4%), isolates of Staphylococcus spp. were iso-
lated from 39 sows from farm No.2.
MATERIAL AND METHODS
The isolates grew in the form of shiny black and
Isolation and identification of Staphylococcus grey colonies with a narrow white margin. The
spp. was conducted in accordance with: DSTU isolates did not coagulate plasma. The 3 strains
EN 6888:2003 “Microbiology of food and animal (13.6%) from the isolated strains had hemolytic
feed” standard was cultivated to the Baird Parker properties.
agar (Merck) medium and were incubated at 37°C
for 24-48 hours. Isolates produced on Baird Par- Staphylococcus had a natural susceptibility to pe-
ker agar at the end of this period were defined by nicillins, but subsequently acquired resistance to
morphology colony, Gram stain, catalase test, and them (13). In the study, were used: Natural Peni-
coagulation test. The hemolytic properties of sta- cillin, Benzylpenicillin; Semisynthetic Oxacillin,
phylococci were studied on Columbia blood agar Gentamicin, Tobramycin from the aminoglycosi-
(BioMerieux). Selected colonies from Columbia des group, and Erythromycin from the macrolids
blood agar introduced into Tryptone-soy broth group (13). The susceptibility to natural Tetracy-
and cultured at t 35°C for 2-4 hours. The optical cline and Semisynthetic Doxycycline; Lincomycin
density was determined using a densitometer and Clindamycin from the group of lincosamides
DEN-1(Biosan) and McFarland standard (HiMe- was investigated. Susceptibility for norfloxacin
dia). The susceptibility of strains to antibiotics was recommended for screening susceptibility
was determined by disc-diffusion method using for all fluoroquinolones (11). There were studied
Müller-Hinton agar, inoculum: 0.5 according to Norfloxacin, Ciprofloxacin, Ofloxacin, Pefloxacin,
the McFarland turbidity standard and were in- Lomefloxacin, Levofloxacin, Sparfloxacin and Ga-
cubated at 35°C, for 18±2 hours. The results were tifloxacin (12, 13). Susceptibility to Chloramphe-
assessed in accordance with the re-commenda- nicol, and Rifampicin was investigated (11).
tions of version 8 of the European Committee on 51.87% of the selected strains obtained at the farm
Antimicrobial Susceptibility Testing EUCAST (11) No.1 were susceptible to Penicillin antibiotics,
59
and 47.59% were resistant. 78.48% of bacterial 10 strains from 22 pigs, on farm No. 2, were isola-
strains showed susceptibility to aminoglycosides, ted and an antibiogram was determined (tab. 1). It
and 21.52% of the strains were resistant. 87.1% was established that 10 isolated strains were re-
of strains showed susceptibility to macrolides. sistant to oxacillin and clindamycin. 3 strains were
70.45% of the isolates were susceptible to tetracy- susceptible, and 7 – resistant to benzylpenicillin
clines. 70% of isolates showed susceptibility, and and norfloxacin. 1 culture was susceptible, and
30% were resistant to lincosamides. 13.62% were 9 – resistant to tetracycline and erythromycin. 4
susceptible, and 80.93% – resistant to fluoroqui- strains were susceptible, and 6 – resistant to chlo-
nolones. 96.72% of revealed strains were suscep- ramphenicol.
tible to chloramphenicol. 73.53% of the studied
isolates were susceptible to rifampicin.
Table 1. Ranges of growth inhibition diameters of the studied cultures isolated from pigs on farm No. 2, mm. Min-
Max.
Eucast interpretation (version 8.0) Ranges of diameters
and Guidelines “Determination of cultures growth S strains R strains
Name of antibiotic
of susceptibility of microorganisms inhibition mm. (n) (n)
to antibacterial drugs” Min-Max
Benzylpenicillin 26>s; 26<r 0-29 3 7
Oxacillin 18≥s; 17<r 0-16 0 10
16-25
Erythromycin 21>s; 18<r 1 9
Clindamycin 22>s; 19<r 0-17 0 10
Norfloxacin 24>s; 24<r 0-28 3 7
Tetracycline 22>s; 19<r 17-24 1 9
Chloramphenicol 18>s; 18<r 15-22 4 6
Note: “0” – continuous growth, “15-22” – the minimum and maximum value of growth inhibition
of the test culture
Number of coagulase-positive and coagulase-ne- cultures resistants and 3% isolates which showed
gative strains isolated from the farm No. 1 was susceptibility to Sparfloxacin. Gatifloxacin: inter-
showed in Table 2. mediate resistanse strains – 13% and 87% – resis-
tant strains. The 84.6% demonstrated resistance
There was 100% resistance to benzylpenicillin
to rifampicin 7.7% and intermediate resistanse
among 18 coagulase-positive strains of Staphylo-
7.7% of strains.
coccus spp. from isolated strains. Oxacillin: inter-
mediate resistanse (12) – 3% of isolated strains, In the group of coagulase-negative Staphylococcus
resistant – 6%, susceptibile – 91% of strains. All spp. isolated from pigs in farm No. 1, there were
resistant strains. Doxycycline: 28.5% – intermedi- 25% resistant strains and 75% strains showed
ate resistanse; 28.5% – resistant and 43% suscep- susceptibility to Benzylpenicillin. All 100% strains
tible strains. were susceptible to Oxacillin. Ampicillin: 13% of
strains were susceptible, 87% of strains – resis-
There were 7.8% of the strains from which 92%
tant. Gentamicin: 46% of strains were susceptible
were resistant to lincomycin. Clindamycin: 42% –
and 54% – resistant. There were 92% susceptible
resistant, 58% of susceptible isolates. 100% of the
and 8% resistant strains to Tobramycin. Erythro-
coagulase-positive Staphylococcus spp. were re-
mycin: 6.9% of strains were resistant and 6.9%-in-
sistant to Norfloxacin and Ciprofloxacinum. 4.7%
termediate resistanse, the rest all isolated strains
and 95.3% of resistant strains were susceptible
(86.2%) showed susceptibility.
to Ofloxacin. Pefloxacin: 10% – resistant, 60%
– intermediate resistanse and 30% susceptible Tetracycline: 81.5% of strains were intermedia-
isolates. Lomefloxacin was found to be resistant te resistanse, 11% – resistant, and 7.5% strains
in 87% of strains, intermediate in 6.5% and sus- were susceptible. Doxycycline: 4% of strains
ceptible in 6.5% of strains. 6.7% of the isolated were intermediate resistanse, 4% – resistant, and
strains were susceptible to Levofloxacin and the 92% susceptible isolates. Lincomycin: 84% of the
remaining 93.3% were resistant There were 97% strains were susceptible and 16% were resistant.
60
3% intermediate resistanse strains to Clindamy- the strains were susceptible to Levofloxacin and
cin, the remaining 97% – susceptible. Norfloxa- 92% were resistant. 64.5% of the strains showed
cin: susceptible – 3% and intermediate resistanse susceptibility to Sparfloxacin and 35.5% was re-
– 3% and 94% – resistant strains. 80% of strains sistant. There were 23% intermediate resistanse
were 20% susceptible to Ciprofloxacin. Ofloxacin: and 8% resistant and 69% of strains susceptible
susceptible – 25%, resistant – 75% of isolates. Pe- to Gatifloxacin. Chloramphenicol: intermediate
floxacin: resistant – 50%, intermediate resistanse resistanse – 7% of strains from 93% of strains. Ri-
– 23%, susceptible – 27% of strains. fampicin: 66.5% were susceptible, 24% were in-
termediate resistanse, and 9.5% of isolates were
Lomefloxacin: susceptible – 16%, intermediate re-
resistanse.
sistanse – 8%, and resistant – 76% isolates. 8% of
Table 2. Number of studied cultures of Staphylococcus spp. isolated in the farm No.1.
The number of cultures of Staphylococcus spp.
Name of antibiotic Coagulase-positive Coagulase-negative
S I R Total S I R Total
Penicillins
Benzylpenicillin 0 0 18 18 7 0 21 28
Oxacillin 30 1 2 33 31 0 0 31
Ampicillin 0 0 14 14 3 0 20 23
Aminoglycosides
Gentamicin (I) 13 0 1 14 12 0 14 26
Tobromycin (II) 14 0 0 14 23 0 2 25
Macrolides
Erythromycin 29 2 2 33 25 2 2 29
Tetracyclines
Tetracycline 10 0 11 21 22 3 2 27
Doxycycline 6 4 4 14 24 1 1 26
Linkosamides
Lincomycin 1 0 12 13 21 0 4 25
Clindamycin 18 0 13 31 30 1 0 31
Fluoroquinolones
Norfloxacin (ІІ) 0 0 27 27 1 1 28 30
Ciprofloxaine (ІІ) 0 0 15 15 5 0 20 25
Ofloxacin (ІІ) 1 0 20 21 7 0 21 28
Pefloxacin (ІІ) 3 6 1 10 7 6 13 26
Lomefloxacin (ІІ) 1 1 13 15 4 2 19 25
Levofloxacin (ІІІ) 1 0 14 15 2 0 23 25
Sparfloxacin (ІІІ) 1 0 32 33 11 0 20 31
Gatifloxacin (ІV) 0 2 13 15 6 2 18 26
Others
Chloramphenicol 32 0 0 32 27 2 0 29
Rifampicin 11 1 1 13 14 5 2 21
DISCUSSIONS
The obtained results indicate a significant coloni- increase of antibiotic resistance. Natural penici-
zation of coagulase-positive and coagulase-negati- llin is known to have little effect on staphylococci,
ve staphylococci in the nasal passages of sows. A while synthetic and semisynthetic penicillin anti-
significant percentage of isolated crops possesses biotics of other groups inhibit their growth.
“pathogenicity factors”. Plasma coagulation and The results showed that in the farm No. 1 polyre-
hemolysis were particularly important. The high sistant strain of coagulase-positive and coagula-
circulation of staphylococci in the herd leads to an se-negative staphylococci was present. A major
61
component of beta-lactam resistance is the so- confirmed by the resistance of these strains to
called mecA gene, which encodes the formation of Doxycycline. Also, indicative is the resistance of
modified penicillin-binding protein and thus in- some coagulase-positive staphylococci to both
terferes with the incorporation of beta-lactam into Lycomycin and Clindamycin, which is not obser-
the cell wall. When the cell is methicillin-resistant ved among coagulase-negative strains. Practically
Staphylococcus aureus in contact with β-lactam all staphylococci have been shown to be resistant
antibiotics, the additional β-lactam-resistant peni- to Fluoroquinolones of different generations, in-
cillin binding protein (PBP2a) takes on the biosyn- cluding Gatifloxacin. Two intermediate resistanse
thetic functions of normal PBPs. strains of coagulase-negative staphylococci were
detected for Chloramphenicol while all coagula-
Staphylococcus aureus resistance to methicillin
se-positive strains were susceptible.
(Oxacillin) may be due to the production of ad-
ditional PBP-2a, which is encoded by the chro- As a result, the circulation of polyresistant coagu-
mosomal mecA gene, inactivation through hyper lase-positive staphylococcus strains proved to be
production of β-lactamases and modification of resistant to almost all antibiotic groups, especially
normal PBPs. The presence two resistant strains to Fluoroquinolones – 4.6% susceptible, 6.0% –
of coagulase-positive staphylococci and one in- intermediate resistanse, and 89.4% – resistant.
termediate resistanse in pigs may indicate the Among coagulase-negative staphylococci, 20%
possible presence of the mecA gene. Also, the re- were susceptible, 5.0% were intermediate resis-
sistance of the isolated strains to Ampicillin indi- tanse, and 75% were resistant to Fluoroquinoli-
cates the synthesis of staphylococcal penicillinase. nes. Coagulase-negative strains from farm No. 2
The higher resistance to Tetracycline was shown also had poly resistant properties in tested antibi-
by coagulase-positive staphylococci, which was otics of all groups.
CONCLUSIONS
1. High percentage of staphylococcus circulation in pigs of experimental farms was detected.
2. The selected strains possessed “pathogenicity factors” by hemolysis and plasma coagulation.
3. Some staphylococci showed resistance to three or more antibiotics at the same time.
4. All these factors testify the misuse of antibiotics and the rapid manifestation of resistance to their
individual representatives.
5. To confirm the emergence of the mechanism of resistance, it is necessary to carry out molecular ge-
netic studies of isolated strains.
6. It is necessary to change fundamentally the pattern of antibiotic use in pigs in order to prevent sta-
phylococcus resistance and their subsequent transfer to humans.
CONFLICT OF INTERESTS 2. Kadariya J, Smith T.C, Thapaliya D. Staphylococcus

All authors declare no competing interests. aureus and Staphylococcal Food-Borne Disease: An
Ongoing Challenge in Public Health. Biomed Res Int.
2014; 2014:827965.
ACKNOWLEDGMENT
3. Armand-Lefevre L, Ruimy R, Andre Mont A. Clo-
Research was carried out with the financial nal comparison of Staphylococcus aureus isolates
support of the Ministry of Education and Science from healthy pig farmers, human controls, and pigs.
of Ukraine. Emerg. infect dis. 2005; 11(5):711-714.
4. Lewis H, Molbak K, Reese C, et al. Pigs as source of
REFERENCES methicillin-resistant Staphylococcus aureus cc398
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LA, Conway-Morris A, Cartwright RA, et al. Recent 2008; 14(9):1383-1389.
human – to – poultry host jump, adaptation, and 5. Khanna T, Friendship R, Dewey C, et al. Methicillin
pandemic spread of Staphylococcus aureus. Proc resistant Staphylococcus aureus colonization in pigs
Natl Acad Sci USA. 2009; 106(46):19545–19550. and pig farmers. Veterinary microbiology. 2008;
128(3-4):298-303.
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6. Cuny C, Nathaus R, Layer F, et al. Nasal colonization Animals. Proceedings of the BTRP Ukraine Regional
of humans with methicillin-resistant Staphylococcus One Health Research Symposium. 2019, Kyiv.
aureus (MRSA) CC398 with and without Exposure 11. Eucast. The european committee on antimicrobial
to Pigs. Plos one. 2009; 4(8):e6800. susceptibility testing (2018). Available from: http://
7. Oppliger A, Moreillon P, Charrière N, et al. Antimi- www.eucast.org/ [Accessed 10th September 2019].
crobial Resistance of Staphylococcus aureus Strains 12. Ministry of health of Ukraine. Determination of sus-
Acquired by Pig Farmers from Pigs. Appl Environ Mi- ceptibility of microorganisms to antibacterial drugs
crobiol. 2012; 78(22):8010-8014. (2009). Available from: https://zakon.rada.gov.ua/
8. Duijkeren E, Jansen MD, Flemming CS, et al. Methi- rada/show/v0167282-07 [Accessed 10th Septem-
cillin-Resistant Staphylococcus aureus in Pigs with ber 2019].
Exudative Epidermitis. Emerg Infect Dis. 2007; 13. Chambers H, Deleo F. Waves of resistance: Staphylo-
13(9):1408-1410. coccus aureus in the antibiotic era. Nat rev microbiol.
9. Fertner M, Pedersen K, Chriél M. Experimental 2009; 7(9):629-641.
exposure of farmed mink (Neovisonvison) to li- 14. Nicola F, McDougal L, Biddle J, et al. Characterizati-
vestock-associated methicillin-resistant Staphylo- on of Erythromycin-Resistant Isolates of Staphylo-
coccus aureus contaminated feed. Veterinary Micro- coccus aureus Recovered in the United States from
biology. 2019; 231:45-47. 1958 through. Antimicrob Agents Chemother. 1998;
10. Kozytska T, Garkavenko T. Circulation of Methicillin-Re- 42(11):3024-3027.
sistant Staphylococcus (MRS) in Livestock and Domestic

Yuriy VISHOVAN, ORCID 0000-0003-1128-593X

Valerii USHKALOV, ORCID 0000-0002-2328-1082, SCOPUS Author ID 36130483300
Oleksandra KEPPLE, ORCID 0000-0002-8123-3310, Web of Science Researcher ID B-2919-2018
Andry GRANATE, ORCID 0000-0002-5631-9139
63
DIALDEHIDA MALONICĂ – UN POTENȚIAL MARCHER

AL TOXICITĂȚII NANOPARTICULELOR ÎN MEDIUL ACVATIC
Liliana CEPOI, Ludmila RUDI, Tatiana CHIRIAC, Vera MISCU, Valeriu RUDIC
Institutul de Microbiologie ș� i Biotehnologie, Chiș� inău, Republica Moldova
Author corespondent: Liliana Cepoi, e-mail: lilianacepoi@yahoo.com
DOI: 10.5281/zenodo.3701197 CZU: 547.441:615.9:582.273
Key words: nanoparticles, MALONDIALDEHYDE – A POTENTIAL MARKER OF NANOPARTICLE TOXICITY IN

toxicity tests, malondial- AN AQUATIC ENVIRONMENT
dehyde, Porphyridium cru- Introduction. As a result of increased production and spread in the environment, na-
entum. noparticles can pose a significant risk to public health. To date, the toxicity data of
nanoparticles collected, using traditional models and methods, are contradictory and
inconsistent. Highlighting the significant methods and markers of nanoparticle toxicity
is a current research direction.
Material and methods. The strain of red microalgae Porphyridium cruentum CNM-
AR-01, known as a lipid manufacturer, was used as object of study. The toxic effect of
CdSe (3-7 nm), ZnSe (40 nm) and ZnS (30-35 nm) nanoparticles was tested. The amount
of malondialdehyde was determined based on thiobarbituric acid reactive substances.
Results. A close correlation between the amount of biomass and malondialdehyde in
the cells of red microalgae Porphyridium cruentum has been established for nanopar-
ticle concentration ranges which have a toxic effect on Porphyridium cruentum.
Conclusions. Malondialdehyde can be considered as a marker of nanoparticle toxicity.
Cuvinte cheie: nanopart- Introducere. Nanoparticulele pot prezenta un real pericol pentru sănătatea publică,
icule, teste de toxicitate, ca urmare a creșterii producției și a răspândirii lor în mediu. Până în prezent, datele de
dialdehidă malonică, Por- toxicitate a nanoparticulelor, colectate cu ajutorul modelelor și al metodelor tradițion-
phyridium cruentum. ale, sunt contradictorii și inconsistente. Relevarea metodelor și a marcherilor semni-
ficativi ai toxicității nanoparticulelor constituie o direcție de actualitate în domeniul
cercetărilor.
Material și metode. Ca obiect de studiu a servit tulpina microalgei roșii Porphyridi-
um cruentum CNM-AR-01, cunoscută în calitate de producător de lipide. A fost testat
efectul toxic al nanoparticulelor de CdSe (3-7 nm), ZnSe (40 nm) și ZnS (30-35 nm).
Cantitatea de dialdehidă malonică a fost determinată în baza substanțelor reactive ale
acidului tiobarbituric.
Rezultate. A fost stabilită relația strânsă între cantitatea de biomasă și cantitatea de
dialdehidă malonică în celulele microalgei roșii Porphyridium cruentum pentru acele
domenii de concentrații de nanoparticule, care au efect toxic asupra obiectului studiat.
Concluzii. Dialdehida malonică poate fi considerată marcher al toxicității nanopart-
iculelor.
64
INTRODUCERE ț�ei nanoparticulelor asupra activităţ�ii sistemelor

Ultimele două decenii se remarcă printr-o dezvol- vitale ale celulei, care pot reacţ�iona diferit la pre-
tare vertiginoasă a nanotehnologiei – domeniu de zenţ�a xenoparticulelor.
cercetare eminamente inedit, atât din punctul de Sistemele hibride nanomateriale – microorga-
vedere al cunoaş� terii fundamentale, cât ş� i din cel nisme oferă posibilitatea de a efectua un studiu
al aplicărilor practice, având î�nregistrate la activ perfect al toxicităţ�ii nanoparticulelor asupra orga-
succese spectaculoase. De exemplu, s-au obț�i- nismului, dar ş� i al posibilelor efecte benefice ale
nut unele nanometriale cu proprietăț�i deosebite: lor. Microorganismele acvatice, printre care ciano-
nanotuburi de carbon, fulerene, puncte cuantice, bacteriile ş� i microalgele, se prezintă ca obiecte de
dendrimere, nanoparticule ale diferiț�ilor oxizi studiu foarte comode ş� i reprezentative, oferind
metalici, nanoparticule ceramice, nanoparticule facilităţ�i enorme î�n modelarea diferitelor efecte ş� i
polimerice etc. (1). Pe lângă domeniile tradiț�iona- î�n stabilirea mecanismelor de acţ�iune a diferiț�ilor
le de utilizare, cum ar fi: electronica, optoelectro- compuş� i asupra proceselor vitale î�n celulele vii.
nica, nanotehnologia, nanoprodusele s-au afirmat
î�n medicina practică ș� i î�n produsele farmaceutice, Afară de obiectele de studiu, o importanț�ă ma-
contribuind semnificativ la ameliorarea sănătăț�ii joră pentru testele de toxicitate o au ș� i metodele
oamenilor, dar ș� i la î�nț�elegerea proceselor biologi- aplicate. Metodele de testare a efectelor toxice ale
ce î�n celulele sănătoase ș� i î�n cele afectate. Dezvol- nanoparticulelor asupra diferitelor tipuri de celu-
tarea nanotehnologiei a influenț�at inclusiv asupra le sunt foarte diverse – de la determinarea lactat
producerii de medicamente principial noi (mai dehidrogenazei (LDH), care semnalizează apopto-
eficiente ș� i cu efecte secundare minime) ș� i asupra za, până la detectarea stresului oxidativ. Ele fur-
elaborării de noi metode de diagnostic precoce ș� i nizează informaț�ii valoroase pentru identificarea
de tratament al maladiilor grave, cum ar fi: cance- biomarcherilor, care relevă daunele induse de
rul, diabetul zaharat, maladiile neurodegenerative nanoparticule (9).
etc. (2-4). Î�n studiile de toxicitate a nanomaterialelor
Creș� terea producț�iei de nanoparticule ș� i răspândi- sunt foarte răspândite testele bazate pe aplica-
rea lor î�n mediu pot prezenta un risc semnificativ rea tetrazoliumului (testul MTT cu utilizarea
pentru sănătatea publică. Î�n urma activităț�ii fizio- 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazolium
logice î�nalte ș� i a diversităț�ii căilor de pătrundere î�n bromidului, testul MTS cu utilizarea 3-(4,5-dime-
organism (prin inhalare, administrare orală, tran- tiltiazol-2-il)-5-(3-carboximetoxifenil)-2-(4-sul-
sdermic, prin injectare), efectele nanoparticulelor fofenil)-2H-tetrazoliumului ș� i testul WST cu
se pot amplifica enorm. Afară de eficienț�ă terape- utilizarea uneia dintre sărurile solubile ale tetra-
utică, nanoparticulele pot prezenta un nivel sporit zoliumului, de exemplu a 2-(2-metoxi-4-nitrofe-
de toxicitate pentru sistemele biologice. Î�n scopul nil)-3-(4-nitrofenil)-5-(2,4-disulfofenil)-2H-tetra-
anticipării ș� i al contracarării efectelor negative ale zoliumului), precum ș� i testele care evidenț�iază
nanoparticulelor pentru om, este necesar un stu- răspunsul inflamator celular, indus de nanopar-
diu prealabil, care ar demonstra efectele impuse ticule (cuantificarea biomarcherilor inflamatori,
de nanomaterialele străine î�n organism (5). cum ar fi IL-8, IL-6 ș� i factorul de necroză tumora-
lă). Diferite tipuri de culturi de celule, inclusiv linii
Studiile de acest tip cel mai des sunt efectuate pe de celule canceroase, au fost folosite ca modele de
culturi celulare ș� i pe obiecte-model, printre care toxicitate in vitro.
microorganismele se regăsesc destul de rar. Inves-
tigaț�iile ce ţ�in de domeniul interacţ�iunii nanoma- Până î�n prezent, datele de toxicitate a nanoparti-
terialelor cu microorganismele au î�n vizor studiul culelor, colectate cu ajutorul modelelor ș� i al me-
formării sistemelor hibride, î�n scopul obţ�inerii todelor menț�ionate mai sus, sunt contradictorii ș� i
vectorilor pentru preparatele medicamentoase ş� i inconsistente. Prin urmare, pe baza modelelor ex-
a dispozitivelor microelectronice, precum ş� i pen- perimentale disponibile, poate fi dificil de a trage
tru efectuarea imobilizării dirijate a nanomateri- concluzii despre potenț�ialul toxic al nanoparticu-
lalelor pe celulele microbiene (6, 7, 8). Î�n majo- lelor (10).
ritatea lucrărilor de acest fel, celulele vii nu sunt Stresul oxidativ, indus de anumite substanț�e, este
apreciate ca sisteme vii funcţ�ionale, motiv pentru considerat drept un indicator sigur al toxicităț�ii
care va apărea, î�n mod evident, problema influen- acestora. Pe lângă modificarea activităț�ii enzime-
65
lor antioxidante, stresul oxidativ este caracteri- algală a fost determinat spectrofotometric con-
zat ș� i prin degradarea macromoleculelor. Pentru form curbei de calibrare, care reflectă dependenț�a
multe nanoparticule a fost determinată creș� terea absorbanț�ei la 465 nm de cantitatea de biomasă.
dependentă de doză a gradului de deteriorare a
Conț�inutul produselor degradării oxidative a lipi-
AND-ului, a peroxidării lipidelor ș� i a carbonilării
delor a fost stabilit î�n baza substanț�elor reactive
proteinelor (5). Lipidele, ca element component
ale acidului tiobarbituric – testul dialdehidei ma-
esenț�ial al membranelor biologice, care asigură nu
lonice (MDA – malondialdehyde assay) (12). Con-
numai funcț�ionalitatea, dar ș� i integritatea acesto-
centraț�ia dialdehidei malonice a fost calculată cu
ra, sunt grav afectate de factorii nocivi. Dialdehida
utilizarea coeficientului extincț�iei molare a com-
malonică, care se formează î�n calitate de produs
plexului dialdehidei malonice sau î�n % inhibiț�ie
final al peroxidării lipidice, este unul dintre mar-
faț�ă de proba martorului pozitiv.
cherii moleculari universali ai stării de stres.
Generalizând cele expuse mai sus, relevăm scopul REZULTATE
acestui studiu – evidenț�ierea posibilităț�ii de apli- Unul dintre indicatorii esenț�iali ai adaptabilităț�ii
care a testului dialdehidei malonice î�n calitate de microalgei la componenta mediului de cultivare
marcher al toxicităț�ii nanoparticulelor pentru or- este productivitatea, prin urmare monitorizarea
ganismele acvatice. acestui parametru poate servi ca factor de bază
î�n procesul de stabilire a influenț�ei diferiț�ilor xe-
MATERIAL ŞI METHODE nobiotici, inclusiv a nanoparticulelor asupra orga-
Î�n cercetare au fost incluse nanoparticule de CdSe, nismului. Pentru toate tipurile de nanoparticule
ZnSe ș� i ZnS, care au fost sintetizate la Institutul de studiate, a fost determinat conț�inutul de biomasă,
Inginerie Electronică ș� i Nanotehnologii D. Ghițu. obț�inută la finele ciclului de cultivare a microalgei.
Naoparticulele luminiscente CdSe, cu dimensiu-
Concentraț�ia particulelor CdSe a fost calculată î�n
nea de 3-7 nm, au fost obț�inute prin metoda coloi-
mg/l mediul de cultivare. Au fost efectuate 3 serii
dală. Nanoparticulele de ZnSe, cu dimensiunea de
de experienț�e, î�n diferite intervale de concentraț�ii
40 nm ș� i nanoparticulele de ZnS, cu dimensiunea
(de la 0,01 la 0,1 mg/l; de la 0,1 la 1,0 mg/l ș� i de la
de 30-35 nm, au fost obț�inute prin sinteza hidro-
1 la 12 mg/l). Î�n figurile 1 ș� i 2, rezultatele conț�inu-
termală. Nanoparticulele au fost adăugate la me-
tului de biomasă sunt prezentate î�n %, prin com-
diul de cultivare sub formă de soluț�ie hidrică din
parare cu probele control.
prima zi. Domeniul de concentraț�ii a constituit:
pentru nanoparticulele CdSe – de la 0,01 la 12,0 Concentraț�iile de la 0,01 până la 0,1 mg/l au pro-
mg/l; pentru nanoparticulele de ZnSe – de la 0,01 dus abateri minime de la valorile martorului, iar
la 0,6 mg/l ș� i pentru nanoparticulele de ZnS – de î�n cazul concentraț�iei de 0,6 mg/l a fost observată
la 0,01 la 8,0 mg/l. o creș� tere statistic semnificativă (p<0,01) cu 20%
comparativ cu martorul (fig. 1).
Î�n calitate de obiect-model a fost utilizată tulpina
microalgei roș� ii Porphyridium cruentum CNM- Concentraț�ia de 0,09 mg/l CdSe a avut efect de re-
AR-01, cunoscută î�n calitate de producător de lipi- ducere a productivităț�ii (cu până la 16%, p<0,05)
de ș� i, î�n special, de acid eicosapentaenoic (11). Mi- comparativ cu martorul.
croalga a fost cultivată pe mediul nutritiv mineral O reacț�ie similară a culturii de Porphyridium cruen-
cu următoarea componentă: î�n g/l – NaCl-7,0; KCl- tum, la introducerea CdSe, a fost constatată ș� i î�n va-
7,5; MgSO4∙7H2O-1,8; Ca(NO3)2∙4H2O-0,15; KBr- riantele experimentale cu aplicarea concentraţ�iilor
0,05; KI-0,05; K2HPO4-0,2 ș� i 1,0 ml/l soluț�ie de mi- de la 0,1 până la 1,0 mg/l CdSe. Conț�inutul de bio-
croelemente, ce conț�ine î�n mg/l: FeCl3∙6H2O-2,7; masă a crescut cu 18-19% la concentraţ�ia CdSe de
NaVO3-0,05; ZnSO4∙5H2O-0,02; CuSO4∙5H2O-0,05; 0,6 ş� i 0,7 mg/l. Concentraţ�iile mai mici, precum ş� i
MnSO4∙5H2O-0,3; H3BO3-0,6; MoO3-0,02, î�n baloa- cele mai mari, s-au manifestat ca inerte, producti-
ne Erlenmeyer, cu volumul de lucru de 100 ml, la vitatea menț�inându-se la nivelul probelor martor.
temperatura de 28˚C, cu iluminare constantă cu
fluxul de fotoni de 40,5 µM/m2s ș� i agitare perio- Pentru experienţ�a cu utilizarea concentraţ�iilor
dică. Durata cultivării a fost de 14 zile. La sfârș� itul mari de particule, rezultatele obţ�inute (fig. 2) au
ciclului de cultivare, biomasa se separă de lichidul indicat un spor al productivităţ�ii cu 33,7-47,5%
cultural prin centrifugare. Conț�inutul de biomasă (p<0,001), î�n cazul concentraţ�iilor de 4,0-6,0 mg/l
CdSe ş� i cu 18% (p<0,01) pentru concentraţ�ia de
66
8,0 mg/l. Creş� terea î�n continuare a concentraţ�iei Concentraț�iile mai î�nalte de CdSe î�n mediul de
CdSe î�n mediul de cultivare a redus drastic pro- cultivare induc moartea celulelor î�n primele 5 zile
ductivitatea: cu 37%, î�n cazul concentraţ�iei de 10 (faza exponenţ�ială de creş� tere), ceea ce indică asu-
mg/l ş� i cu 77,3 %, î�n cazul concentraţ�iei particule- pra implicării toxicităț�ii nanoparticulelor la acest
lor de 12 mg/l. nivel de concentraț�ie.
Figura 1. Biomasa Porphyridium cruentum, % faţ�ă de proba martor (M) î�n prezenț�a nanoparticulelor CdSe
(0,01-0,1 mg/l; 0,1-1,0 mg/l).
Un alt compus studiat au fost particulele de ZnSe. cu agregarea ş� i sedimentarea lor. Rezultatele ex-
Î�n cadrul experienț�elor preliminare, a fost stabilit perienț�elor cu aplicarea concentraț�iilor de la 0,01
că depăș� irea concentraț�iei de 0,8 mg/l provoacă mg/l la 0,6 mg/l ZnSe sunt prezentate î�n Figura 3.
moartea celulelor î�n primele 5 zile de cultivare,
Figura 2. Biomasa Porphyridium cruentum, % faţ�ă de proba martor (M) î�n prezenț�a nanoparticulelor CdSe
(2,0 – 12,0 mg/l).
Figura 3. Biomasa Porphyridium cruentum, % faţ�ă de proba martor (M) î�n prezenț�a nanoparticulelor ZnSe
(0,01-0,06 mg/l; 0,1 – 0,6 mg/l).
67
Rezultatele indică o reducere a productivităţ�ii cu Experienţ�ele cu adăugarea nanoparticulelor de

42-28%, î�n comparaţ�ie cu proba martor, î�n cazul ZnS la mediul de cultivare a microalgei Porphyri-
concentraţ�iilor de 0,01-0,02 mg/l ZnSe ş� i cu 47- dum cruentum au pornit de la determinarea con-
36%, î�n cazul concentraţ�iilor de 0,1-0,2 mg/l ZnSe. centraţ�iilor maximale toxice pentru microalge. A
Pentru concentraţ�iile de 0,03-0,05mg/l ZnSe pro- fost stabilit că ZnS reduce productivitatea, indife-
ductivitatea este la nivelul probelor martor (90- rent de concentraţ�ia utilizată, 8,0 mg/l nanoparti-
95%), urmată de o scădere cu 38% î�n varianta cule generează o scădere a productivităţ�ii cu 46%
aplicării concentraţ�iei de 0,06 mg/l ZnSe. faţ�ă de probele martor (fig. 4).
Î�n seria experimentală cu utilizarea concentraţ�iilor Concentraţ�iile mai mici au manifestat, de aseme-
de 0,1-0,6 mg/l ZnSe, cea mai mare productivitate a nea, un grad pronunţ�at de toxicitate, excepţ�ie pre-
fost determinată î�n cazul concentraţ�iei de 0,03 mg/l zentând concentraţ�iile de 0,03 ş� i 0,2 mg/l, unde
ZnSe, care este de 94,6% faţ�ă de proba martor. productivitatea a fost la nivelul probelor control.
Figura 4. Biomasa Porphyridium cruentum, % faţ�ă de proba martor (M) î�n prezenț�a nanoparticulelor ZnS
(0,01-0,06 mg/l; 0,1 – 0,6 mg/L; 1,0-8,0 mg/l).
Un efect de reducere a nivelului de acumulare a specific de determinare a produselor peroxidării

biomasei s-a manifestat î�n probele cu concentraţ�ia lipidelor, testul dialdehidei malonice (MDA). Tes-
nanoparticulelor de 0,01 (cu 35%), 0,02 (cu 25%), tul de acumulare a radicalilor acizilor graş� i indică
0,1 (cu 25%) ş� i 0,3 (cu 32%). influenţ�a negativă a condiţ�iilor de cultivare asupra
celulelor vii (fig. 5).
Unul dintre cele mai semnificative teste ale evo-
luţ�iei stresului oxidativ î�n celulă este testul ne-
Figura 5. Dialdehida malonică, % C î�n biomasa de Porphyridium cruentum la cultivare

î�n prezenţ�a nanoparticulelor CdSe.
68
Rezultatele obţ�inute demonstrează că pentru ma- cesul biosintetic al algelor, urmat de micş� orarea
joritatea concentraţ�iilor de CdSe aplicate nu are productivităţ�ii.
loc afectarea structurilor membranare ale por-
Determinarea produselor de oxidare a lipidelor
firidiumului. Prin urmare nu se produce deteri-
prin testul acumulării dialdehidei malonice a scos
orarea statutului oxido-reducător, cu formarea
î�n evidenţ�ă impactul toxic al nanoparticulelor
radicalilor lipidelor structurale. Concentraţ�iile
ZnSe asupra celulelor prin inducerea proceselor
toxice ale CdSe de 10-12 mg/l au indus oxidarea
de oxidare a lipidelor ş� i acumularea radicalilor
lipidelor membranare. Astfel, mecanismul toxici-
acili. Rezultatele obţ�inute (fig. 6) indică o acumu-
tăţ�ii nanoparticulelor de CdSe se manifestă prin
lare a dialdehidei malonice î�n celulele de porfiri-
implicarea lor î�n deteriorarea structurilor mem-
dium. Valorile testului MDA relevă o creş� tere cu
branare. Radicalii formaţ�i participă activ î�n pro-
20-30%, comparativ cu proba de control.
Figura 6. Dialdehida malonică, % C î�n biomasa de Porphyridium cruentum la cultivare î�n prezenţ�a ZnSeNP.
Prin urmare, toxicitatea nanoparticulelor ZnSe se A fost constatată, de asemenea, o majorare a con-
manifestă prin implicarea lor î�n oxidarea lipide- ţ�inutului dialdehidei malonice, produse î�n rezulta-
lor structurale ale membranelor celulare, ceea ce tul aplicării concentraţ�iilor de 0,01-0,02 mg/l ZnS;
duce la modificarea permeabilităț�ii membranelor 0,1 ș� i 0,3 mg/l ZnS ş� i 4-8 mg/l ZnS (fig. 7).
ș� i la afectarea proceselor metabolice celulare.
Valori mai mici ale testului MDA, comparativ cu
proba de control, nu au fost determinate.
Figura 7. Dialdehida malonică, % C î�n biomasa de Porphyridium cruentum la cultivare î�n prezenţ�a ZnSNP.
DISCUȚII
Analizând influenț�a pe care o are concentraţ�ia că dependenţ�a dată, î�n limitele studiate, poartă un
nanoparticulelor de CdSe asupra productivităţ�ii caracter de undă, cu efecte de stimulare a produ-
culturii de Porphyridium cruentum, putem afirma cerii de biomasă la unele concentraţ�ii, urmat de
69
scăderi ş� i de creş� teri ulterioare, fenomen atestat asupra culturii de porfiridium, a fost calculat co-
destul de frecvent î�n lumea vie. eficientul de corelare î�ntre productivitate si canti-
tatea dialdehidei malonice.
Productivitatea microalgei obţ�inute, prin aplica-
rea nanoparticulelor de ZnS, este redusă, valorile Rezultatele prezentate î�n Figura 8 demonstrează
testului MDA sunt crescute, prin urmare mecanis- că, î�n cazul manifestării reacţ�iilor toxice de către
mul acţ�iunii toxice este rezultatul implicării lor î�n Porphyridium cruentum, se î�nregistrează o corela-
activitatea biosintetică. re inversă puternică dintre conț�inutul de biomasă
si valorile dialdehidei malonice, produsă î�n rezul-
Î�n scopul evaluării impactului nanoparticulelor
tatul peroxidării lipidelor.
Figura 8. Corelarea î�ntre productivitatea culturii de porfiridium ş� i procesul de peroxidare a lipidelor

î�n biomasă la acţ�iunea nanoparticulelor CdSe, ZnSe ş� i ZnS.
Au fost stabilite manifestări toxice pentru concen- varianta experimentală, având concentraț�iile Cd-
traț�iile 1,0-12 mg/l CdSeNP, cu un coeficient de SeNP î�ntre 0,1 ș� i 1,0 mg/l. Î�n cazul dat se observă
corelare r=0,885. Dependenț�a corelaț�ională este o corelare directă, unde conț�inutului sporit de bi-
una inversă, pentru care reducerea conț�inutului omasă algală î�i corespund valori joase ale testului
de biomasă este asociată cu valori crescute ale MDA. Valorile moderat majorate ale dialdehidei
dialdehidei malonice, determinate pentru con- malonice pot fi rezultatul unei activităț�i biosin-
centraț�ia nanoparticulelor de peste 8,0 mg/l. Un tetice intensive, cu formare de specii reactive ale
raport corelaț�ional mare a fost stabilit ș� i pentru oxigenului, nefiind vorba despre manifestarea to-
70
xicităț�ii nanoparticulelor î�n concentraț�iile deter- de corelare r=0,925 foarte puternic. Dependenț�a
minate. corelaț�ională este una inversă, pentru care bio-
masa redusă este asociată cu valori ridicate ale
Coeficientul Pearson ridicat, cu valori de peste 0,7,
dialdehidei malonice. Coeficientul de corelare mic
a fost determinat î�n cazul aplicării nanoparticule-
r=0,273 a fost stabilit pentru concentraț�iile 0,01-
lor ZnSe. Raportul corelaț�ional este puternic ș� i in-
0,06 mg/l ș� i r=0,254, pentru concentraț�iile de
vers, reducerea conț�inutului de biomasă fiind aso-
0,1-0,6 mg/l a nanoparticulelor de ZnS. Î�n cazul
ciată cu valori crescute ale dialdehidei malonice.
concentraț�iilor 0,1-0,6 mg/l ZnS se stabileș� te co-
Putem confirma existenț�a efectului toxic al nano-
relarea inversă, astfel că putem releva manifesta-
particulelor ZnSe, î�n limita concentraț�iilor aplicate
rea efetului toxic al nanoparticuleor î�n limita con-
asupra microalgei.
centraț�iilor date, ceea ce nu a fost stabilit pentru
Manifestări toxice au fost determinate pentru con- seria experimentală având concentraț�iile de 0,01-
centraț�iile 1,0-8,0 mg/l ZnS NP, având coeficientul 0,06 mg/l ZnS NP.
CONCLUZII
1. Dialdehida malonică poate fi considerată drept marcher al toxicităț�ii nanoparticulelor. Metoda nespe-
cifică de determinare a procesului de peroxidare a lipidelor structurale permite a stabili efectul toxic al
nanoparticulelor studiate, î�n cazul existenț�ei unei corelări dintre cantitatea de dialdehidă malonică ș� i
biomasa acumulată.
2. Toxicitatea tipurilor de particule menț�ionate descreş� te î�n ş� irul ZnSe >ZnS>CdSe.
3. Nivelul î�nalt de corelare î�ntre cantitatea de biomasă ş� i produsele degradării oxidative a lipidelor evi-
denț�iază mecanismul acestei influenț�e, care constă î�n degradarea membranelor biologice, î�n modifica-
rea permeabilităț�ii ş� i î�n dereglarea proceselor vitale.
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org/10.1155/2013/148578. lar Biology. 2019; 1894:1–29.
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care and multi-dimensional applications in medical mental models. Iran Biomed J. 2016; 20(1):1-11.
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2018; 97:1521-1537. Sánchez Pérez JL, Guil G. Biomass nutrient profi-
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ZnO on WAG Cell Line. In Vitro Toxicity Evaluation 12. Hodges DM, DeLong JM, Forney F, Prange RK. Im-
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Data recepționării manuscrisului: 31/01/2020
Data acceptării spre publicare: 02/03/2020
Liliana CEPOI, ORCID 0000-0002-7516-948X, Web of Science Researcher ID 55246094000, SCOPUS Author ID
J-9640-2019
Ludmila RUDI, ORCID 0000-0002-0752-8153, SCOPUS Author ID 55681134100
Tatiana CHIRIAC, ORCID 0000-0003-2933-0751, SCOPUS Author ID 38861074900
Vera MISCU, SCOPUS Author ID 55681768700
Valeriu RUDIC, ORCID 0000-0001-8090-3004, SCOPUS Author ID 6508235623
71
ARTICOLE DE SINTEZĂ – ОБЗОРНЫЕ СТАТЬИ – SYNTHESIS ARTICLE –

ARTICLES DE SYNTHÈSE
MEDICAL AND SOCIAL ASPECTS OF FLOODS AND THEIR MEDICAL

RISK MANAGEMENT
Vasile DUMITRAS1, Sergiu CIRLAN1,3, Andrei MARFIN1,3, Catalina CROITORU2, Elena CIOBANU2
1
Department of Military and Disaster Medicine, Nicolae Testemitanu State University of Medicine and Pharmacy,
Republic of Moldova
2
Department of General Hygiene, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of
Moldova
3
Ministry of Defense, Republic of Moldova
Corresponding author: Vasile Dumitras, e-mail: vasile.dumitras@usmf.md
DOI: 10.5281/zenodo.3701200 CZU: 614.87-026.1:551.577.6
Key words: flood, calami- Introduction. Currently, there is a steadily increasing trend in losses due to flooding.
ties, victims, medical man- Nevertheless, global warming, followed by an inevitable overuse of river valleys might
agement. further contribute to an increase in the frequency and destructive power of floods. It is
quite important to trace the cause and effect chain of the economic, social and ecolog-
ical impacts during the flood hazard.
Material and methods. A bibliographic research was carried out by using historical
and descriptive methods based on the keywords, underlining the medical, social and
economic significance of the present issue.
Results. There are 57 natural lakes and about 3 400 artificial water reservoirs found
on the territory of the Republic of Moldova, including 90 amounting to over 1 million
m3 per each. The accumulation basins help in preventing and combating overflows and
flooding during spring and summer periods. Most of the dams do not comply with the
technical norms, as they do not have channels of respite and drainage, thus, a dam
failure on top dike might generate the collapse of the others at the lower watercourse,
resulting in disastrous consequences. Therefore, individual health protection measures
and appropriate population behavior are vitally important in catastrophic floods.
Conclusions. Over the last decades, the floods occurring in the Republic of Moldova
have conditioned the need to increase interventions for prevention and reduction of
both economic and human losses both at national and international levels.
Cuvinte cheie: inundații, ASPECTE MEDICO-SOCIALE ALE INUNDAȚIILOR, MANAGEMENTUL MEDICAL ȘI
calamități, victime, man- AL RISCURILOR
agement medical. Introducere. În prezent, există o tendință de creștere a prejudiciilor provocate de
inundații. În același timp încălzirea globală a climei și creșterea inevitabilă a va-lori-
ficării văilor râurilor va contribui pe viitor la creșterea frecvenței și puterii distructive
a inundațiilor. În timpul inundațiilor, este importantă constituirea lanțului cauză-efect
a consecințelor economice, sociale și ecologice.
Material și metode. Au fost studiate surse bibliografice care redau informații ample cu
referire la inundațiile ce au avut loc în Republica Moldova și în regiunile din vecinătate.
Rezultate. Pe teritoriul Republicii Moldova sunt amplasate 57 de lacuri naturale și cir-
ca 3400 de rezervoare artificiale de apă, inclusiv 90 cu un volum de peste un milion de
m3 fiecare. Lacurile de acumulare servesc pentru prevenirea și combaterea revărsărilor
și inundațiilor în timpul viiturilor de primăvară și vară. Barajele multora din ele sunt
construite fără respectarea normelor tehnice, nu au canale de degrevare și scurgere,
de aceea ruperea unuia, în partea de sus, generează ruperea celorlalte din cursul in-
ferior, urmările fiind catastrofale. O importanță deosebită în inundațiile catastrofale
au măsurile de protecție medicală individuală și comportamentul corect al populației.
Concluzii. Inundațiile din ultimele decenii în Republica Moldova au condiționat necesi-
tatea intensificării activităților de prevenire și minimizare a consecințelor materiale și
umane, atât la nivel național cât și internațional.
72
INTRODUCTION MATERIAL AND METHODS

Humanity faced flooding since ancient times, a fact The purpose of the bibliographic study was to un-
confirmed by the biblical Great Flood. According derline both the medical and social aspects and
to Robert Ballard, a marine explorer, there is an flood-health risk management. The studied bibli-
evidence of a catastrophic flood that happened ographic sources provide ample data on floods oc-
7500 years ago in the Black Sea at about 170 me- curring both in the Republic of Moldova and in the
ters deep that is possible effects of “Noah’s Flood”. neighboring regions. A bibliographic study was
carried out by using the historical and descriptive
Floods are both natural disasters and technolo-
methods based on the keywords, emphasizing the
gical and social phenomena (1), considered the
medical, social and economic impacts of the pre-
most widespread hazard on earth. According to
sent problem.
the Centre for Research on the Epidemiology of
Disasters of the Catholic University of Louvain
(Belgium), they make up 37% of the total number RESULTS
of natural hazards resulting in severe outcomes Catastrophic floods make up about 33-35% of to-
and extremely severe human losses with consi- tal floods. They can result from heavy rainfalls;
derable economic damages, followed by negative overflow of accumulation basins of hydroelectric
economic, social and ecological impacts (2, 3, 4). stations and lakes; sudden melting of snow and
glaciers; and coastal water waves and tsunami.
The study analysis of the floods throughout the
Dam and levee failure might cause landslides and
last century confirms a steadily increasing ten-
earthquakes, etc. The size of the flood outbreak
dency of damages caused by floods worldwide,
depends on the amount of water, the affected area
one of the main causes being the irrational use of
and the rainfall duration and intensity.
the river valleys and the increase of the economic
activity in risk-prone areas (5). Nevertheless, glo- There are several types of floods depending on
bal warming and the inevitable overuse of river their triggering factors and the flood-affected are-
valleys might further contribute to an increase as. The most commonly occurring floods are as
in the frequency and destructive power of floo- following (7,8):
ds. Floods can be caused by natural phenomena – fluvial flooding is the overflowing of water
such as: water flows (flash floods, clogging of the body, generated by a high flow over the boun-
running water streams and sloping into the river- daries of the minor riverbed to the major one
bed, crowding of glaciers or other floating objects due to several causes, such as: heavy rainfall,
in narrow curves or sections, the increase of the an increased water level, resulting from the de-
sea or ocean level in the area of the watercourse gradation of the riverbed by alluvium, ice bloc-
overflow due to high tides or strong winds); rain kages, dam and levee collapse etc.;
or stagnant melting snow, dripping from the slo- – coastal flooding might affect the coastal areas,
pes; an increase in groundwater level due to high caused by strong storms, which trigger lar-
infiltration rates; hurricanes or typhoons; and ge wind waves that might sometimes lead to
submarine volcanic eruptions. Floods triggered by a dam failure and storm surges, magnified by
accidental scenarios are due to a dam failure and rising sea levels. Depending on the generating
collapse or other hydrotechnical constructions, as factors, coastal areas might be flooded with sal-
well as due to inappropriate and non-compliant ty or brackish water;
actions related to the hydrological situation at the
water drainage systems and sudden sliding slopes – urban flooding occurs due to improper sizing
into the accumulation basins. or poor maintenance of urban drainage sys-
tems, which cannot provide a proper rainwater
The human-induced floods occur due to the over- runoff during heavy rainfall episodes.
filling of the artificial basins, the deliberate cut-
Other types of floods occur due to accumulation
ting of the dam defense structures, inadequate
of the running water in the low-lying areas at the
irrigation system performance, characterized by
base of the slope and because of groundwater ex-
great water loss with no proper drainage measu-
cess (in areas where groundwater is close to the
res, and earthquake‐triggered floods due to accu-
topographic surface).
mulations (6).
73
The most severe floods that have caused major Republic of Moldova and Romania (1). On June 1,
human losses were as following: torrential rains caused massive flooding in the Re-
China (1931) – 3,700,000-4,000,000 victims, public of Moldova. A great number of streets and
China (1887) – 900,000-2,000,000 victims, basements of flat blocks were flooded in Chisinau,
China (1938) – 500,000-700,000 victims, including Albisoara Street, where the water was
China (1975) – 231,000 victims, over one and a half meter high due to the sewer
Indonesia (2004) – 230,000 victims, system failure. 200 houses were flooded in Iargara
China (1935) – 145,000 victims, village, Leova district. The water flooded into the
Vietnam (1971) – 100,000 victims, courtyards and borderlines of dozens of houses in
China (1911) – 100,000 victims. Logăneș� ti, Hî�nceș� ti district (6).
The Republic of Moldova has 57 natural lakes and In June-August 2008, the Ukraine, Romania and
about 3400 artificial water reservoirs, including 90 the Republic of Moldova were hit by one of the
with over one million m3 per each (3, 10). Accumu- worst floods over the last two centuries. In July 22-
lation basins might prevent and combat overflows 28, 2008, in Western Ukraine, where the Dniester
and floods during spring and summer seasons. and Prut upper courses are located, the amount of
The largest storage tanks are found in Costinesti precipitation was 63-260 mm, which is 1-3-month
Stî�nca (735 mln m3), situated on the Prut river and norm fell. In the third decade of July 2008, preci-
in Dubăsari (277.4 mln m3), on the Dniester river. pitations fell everywhere on the territory of the
Most dams do not comply with normal technical Republic of Moldova. The largest amount of preci-
standards and do not have respite and drainage pitation during the decade, was 225 mm in Ocniț�a,
channels, thus, a dam failure on top dike might ge- exceeding 10 times the de-cade normal amount,
nerate the collapse of the others at the lower wa- which was first reported during the entire period
tercourse, resulting in disastrous consequences. of instrumental mea-surements. In the northern
In 1991, the heavy torrential rains led to catastro- and in some of the central and southern regions
phic floods in Ș� oldanesti, Orhei district. As a result, of the republic the amount of precipitation per de-
21 people died, 8 thousand houses were damaged, cade made up 85-185 mm or 440-800% of the de-
of which 516 were completely destroyed, and 400 cade norm. The remainder of territory amounted
thousand ha of agricultural land was flooded. In precipitation of 15-70 mm or 100-420% of the de-
1994, the Republic of Moldova experienced one of cade norm. As a result, the floods occurring during
the most unfavorable episodes throughout the last the period from July to August 2008 on the Dnies-
century (11). ter and Prut rivers were historical flash floods (6,
11, 12, 13).
On August 26-27, 1994, the downpour intensity
was over 40 mm/hour, accompanied by strong It is crucial to establish the cause and effect chain
winds and hail, which caused enormous damage during flooding while considering the following
($ 100 million) and human comorbidities (29 pe- aftermath (13, 14, 15, 16):
ople). – economic destruction or damage of: industri-
Over the last years, the major floods occurring on al buildings, roads and railways, locations, oil,
the territory of the Republic of Moldova were on water or gas system supply, electrical and te-
June 16-17, 2003 and on August 7, 18-19, 2005, lecommunications lines, bridges and culverts,
being caused by heavy rainfalls. These led to and the zootechnical sector;
stream flows, as well as the formation of intensi- – negative social impacts: human comorbidities,
ve leakage from the slopes, causing huge financial people evacuation, risks of epidemics, educati-
losses within different national economic sectors. onal process disruption, damage to cultural as-
The total land area of the Republic of Moldova, sets, panic disorder, reducing the disaster rate
which are periodically flooded makes up about of flood-affected areas and income of the popu-
20% of the entire country’s surface or more than lation;
600 thousand ha (3, 11). – negative ecological consequences: environ-
At the end of May and the beginning of June 2016, mental degradation, pollution of the surface or
following the heavy lasting downpours across groundwater, soil pollution, excess humidity,
Central Europe, the floods affected dozens of lo- slope degradation, destruction of fauna and
cations in Austria, Belgium, France, Germany, the flora.
74
Additionally, to the direct effects, there is a nu- A series of factors might influence the volume and
mber of indirect effects that might interrupt the structure of health losses in catastrophic flood
manufacturing processes, delay goods delivery, outbreak, such as: timely notification of the popu-
trigger expenditures for defense works and for lation in the area at risk of flooding; the degree of
normalization of life after floods, as well as reduce preparedness for people evacuation; the popula-
exports. tion density in the risk-prone areas; the building
patterns; the day time (night, day); season; the
Most floods might lead to considerable financial
distance between different locations (village, city)
and human losses, being termed as catastrophic
and the dams; the flood wave height and duration,
flood events, faced by a community or region. For a
water temperature; exacerbation of area – based
better objective determination of financial and hu-
socio-economic status (19).
man losses, the territory is divided into four flood
zones with the following determinants: the height The efficiency of medical assistance and the use of
of the water level, the flood onset, the water drai- the trained forces and means of emergency heal-
nage velocity and the flooded surface area (17). thcare services will increase considerably, if the
flood outbreak is divided conventionally into four
The catastrophic floods occurring on large areas
zones (9). The volume and structure of the health
might influence the strategies of the health and
losses (tab. 1) vary depending on the speed of the
civil protection bodies and the healthcare servi-
water, the height of the water wave, the distance
ces of the Ministries and Departments of defense
from localities to the hydrological object with flo-
appropriations for liquidation of disaster consequ-
od phenomenon (typhoon, tsunami, disturbances
ences, as well as on the organization and use of the
of the sea, the ocean, etc.) The amount and struc-
trained forces and means of medical assistance. In
ture of the health losses (tab. 1) vary according
these cases, great attention is paid to the flooded
to water velocity, water wave height, the distan-
land surface, since the population might be depri-
ce between the locations and the flood-related
ved of sheltering, food and water supply, as well
hydrological objects. (typhoon, tsunami, sea and
as of medical or social assistance that should be
ocean disturbances, etc.)
commonly provided during the first flood hours
(hours, days). The population in this area might be The volume and structure of the health damages
subjected to the action of low-temperature water, (tab. 2) will differ in different floodplains depen-
winds, air humidity and other meteorological fac- ding on the day and night time.
tors (18).
Table 1. Characteristics of flood pains.
Distance between the Water wave
Flood plains height Flow velocity Wave duration
dam and water wave
I. Catastrophic flood 6-12 km >3m > 30 km /h 30 min
II. Fast flow 15-20 km 1.5-2 m 15-20 km/h 50-60 min
III. Medium flow 30-50 km <1 m 10-15 km / h 2-3 hours
IV. Slow flow (overflow) 36-70 km - 6-10 km / h 5-6 hours
In order to eliminate the catastrophic effects of trict and republican medical esta-blishments.
floods, the local healthcare services (civil protec-
It is highly important to be aware of the sanitary
tion, the Ministry of Health, Labor and Social Pro-
and epidemiological conditions of the risk-prone
tection) develop early health-action planning for
areas for the liquidation of the aftermath calami-
medical assistance of the population and the affec-
ties, it might worsen due to the destruction of the
ted – area victims.
water supply and sewerage systems, the pol-luti-
The presidents of the commissions for exceptional on of the wells etc.
affairs will administer the Special Forces and the
Wastes and garbage that spread to other neighbo-
emergency medical assistance services that help
ring places might pose a threat on spreading in-
in evacuation and rescue of the population, and
fectious morbidity within the affected floodplain.
who otherwise administer the local institutes, dis-
75
Overcrowding of people on a small area, as well require medical services of the Armed Forces,
as exacerbation of the social and economic status according to the relevant directive documents,
can also cause an outbreak and spread of commu- available in the National Army and documents, re-
nicable infections and zoonotic diseases (decay of gulating medical assistance under exceptional cir-
animal bodies and rodents). cumstances. Specially trained teams will provide
premedical aid (paramedics) and first medical aid
Additionally, to civil protection and Ministry of
(doctors) during the outbreak.
Health, Labor and Social Protection means, the
liquidation of aftermath catastrophic floods will
Table 2. The characteristics of the losses within the flood plains (in %, according to the number of population
in the flood-affected areas).
Overall losses Out of the total loss amount
Flood plains Irretrievable losses Health losses
day night
day night day night
I 60.0 90.0 – – – –
II 13.0 25.0 10.0 20.0 90.0 80.0
III 5.0 15.0 7.0 15.0 93.0 85.0
IV 2.0 10.0 5.0 10.0 95.0 90.0
Mean loss value 20.0 35.0 15.0 30.0 85.0 70.0
Persons joining the immediate rescue operations negative flood aftermaths in small river basins, in-
of the victims must be well trained and provided dicates that the optimal economical effect can be
with various salvation (belts, circles, lifejacket) achieved when applying both the passive metho-
and floating means (boats). Emergency medical ds (digging, forest improvement works, etc.) and
assistance brigades (paramedics and doctors), the active methods of protection by regulating the
mobile detachments of the Ministry of Health, La- water flowing into a system of maximum water
bor and Social Protection, as well as Ministries of storage capacity tanks, followed by a subsequent
Armed Forces and Civil Protection will also be ac- water evacuation amounted at a 1-3% insurance
tivated during the outbreak. volume (19).
Specially trained teams and health-epidemic assis- The planning schemes for flood mitigation works
tance brigades from various preventive medicine in the river basins consist of correlative and cu-
centers (district, city, republican) will be provided mulative effects of the following works: embank-
for flood- affected areas. ments, works for the regularization of the river-
beds, non-permanent accumulations and polders,
In many cases, flooding can be a very serious tes-
permanent accumulation basins provided with
ting of the community’s responsiveness. The abi-
volume-control storage to mitigate floods.
lity and capacity to effectively cope with a flood
has become increasingly relevant nowadays due The first stage on reducing floods by embank-
to a higher-risk flood tendency, especially in re- ments was actually a mistake because it elimina-
cent years. tes the natural effect of mitigation of meadows
and leads to the increase of maximum overflows.
The major objective of risk identification refers
As the lower sectors of the large watercourses are
to flood risk management (20). It determines the
embanked, new embankment works should be
application of policies, procedures and even prac-
avoided without being compensated in the accu-
tices that would tend towards this objective. The
mulation basins or into polders.
flood risk management is aimed at analysis and
assessment, treatment, monitoring and re-assess- Although most of the extreme phenomena cannot
ment of risks in order to reduce them, so that hu- be completely overcome yet, a prior knowledge
man communities and all citizens would survive, on the area patterns and the possible intervals
work and meet their needs and aspirations within between the disaster episodes would significantly
a sustainable physical and social environment. reduce their destructive impact (21). Farmers
should be aware and familiar with the achieve-
The experience of Moldova on the reduction of
ments of modern science, as well as timely access
76
of qualitative forecasting services, which would – Reports on implementation action plans.

ensure a considerable increase in the productivity The measures on population individual health
of agricultural crops, by significantly reducing the protection and appropriate behavior is of parti-
losses and negative consequences of various natu- cular importance in catastrophic floods. Prior to
ral hazards. a flood episode, the population should be trained
Currently, the perfection of the long-term weather and urged to follow and carry out certain recom-
forecasting methods on negative phenomena oc- mendations:
currence has become vitally important for the Re- • To show interest in the possible local floodpla-
public of Moldova since both the amplitude and ins, found at the town halls.
the incidence rate of the natural disasters have • To avoid building houses nearby the risk-prone
obviously increased over the last years. This step flood areas.
can be defined and highlighted as regional trends • To use waterproof walls for the basements in
of climate change and variability that refers to order to prevent water flow.
long-term climate predictions, being categorized • To build barriers to prevent water from floo-
as more qualitative, rather than quantitative ones ding into the houses.
(including the daily weather forecasts) (22, 23). • To clean the ditches and storm sewers, to pre-
vent clogging of the rainwater.
In order to reduce the risk of flooding, the following
• To safely dispose the household waste and ve-
measures are recommended:
getable debris not to contaminate the running
• Mapping of the land surfaces and river cour- streams.
se that are mostly exposed to flooding, as well • To prepare the emergency backpack in advan-
as the quasi-horizontal surfaces of the plains, ce.
where the water can stagnate during periods of • To participate to simulated emergency exerci-
excess humidity. ses organized by emergency professional servi-
• Overall embankment works of the major river- ces and local authorities.
beds and meadows, as well as polder formation • To learn about the warning alarm signals and
should be avoided in order to provide “bre- the evacuation procedures.
athing” spaces during flood periods. • In case of imminent flood risk, to turn off the
• Anti-erosion works in the accumulation basins heating, gas and electricity devices.
should be carried out, as well as the unclogging • To place the toxic substances in a safe place so
of minor riverbeds. as to avoid pollution.
• Any kind of construction near the minor ri-ver-
In case of flooding:
beds, which are at risk of flooding and are mar-
ked red, should be prohibited. Strong involve- – To stay calm.
ment of local and national authorities regarding – To warn the neighbors and support the disa-
the environmental protection is required, in bled people, children and the elderly.
order to apply flood prevention measures to – To be aware about the danger and its evolution.
protect the population and environment. – To use the phone only in emergencies as not to
• Information system efficiency regarding the overload the network.
warnings for hydrometeorological hazards. – To follow the radio or television broadcast re-
• Education of the population on the protection commendations given by the authorities.
of the riverbeds from solid wastes pollution. – In case of evacuation, to move towards an im-
mediate or nearby high level area, specified by
The Republic of Moldova has developed the “Re-
the authorities; in case of flash floods, people
gulation on Flood risk Management” that provi-
should move up towards the upper parts of the
des (24):
house or on the roof, until the rescue teams
– Normative framework for flood risk manage- arrive.
ment. – To move the essential objects to the upper flo-
– Preliminary Flood Risk Assessment. ors of the house, if there is enough time.
– Flood hazard and flood risk mapping. – To disconnect the general power switch. To
– Flood Risk Management Planning. disconnect all the electrical devices. Not to
– Public consultations and plan approval and re- touch the electrical devices if they are dirty or
vision. in water.
77
– To switch off water and gas supply systems. – To avoid using the electricity, water, gas supply
– To evacuate animals and valuable assets into equipment unless specialized services approve.
specific prior- established refuge places. – To clean and disinfect all objects that have been
– To avoid moving through the water flows, as in contact with floodwater: there is a life-thre-
people might lose the balance in about 15 cm atening situation of disease contamination due
high waters. to the lack of hygiene and the affected sewers.
– To avoid traveling by car across the flooded If any suspicions arise regarding the contaminati-
area: in case of about 20 cm of floodwaters, on of the drinking water, bottled or boiled water
water may enter the vehicle, resulting in loss should be used.
of control. At about 40 cm of floodwaters, the
vehicle starts floating. In 60 cm of water, most Prevention and reduction of the negative effects,
vehicles are carried away by floodwater. as well as disaster preparedness, including floo-
– To be prepared of quick evacuation at short no- ding are crucially important issues and policies
tice of those in charge of rescue operations. promoted by the World Health Organization (25,
– To use the itinerary indicated by those in charge. 26) – a specialized agency within the United Na-
– To avoid shortcut pathways as not to get into a tions that is responsible for coordinating global
dangerous place. health problems. Another key aspect of the “One
– To take only the strictly necessary belongings health” approach concerns the need to include the
(identity documents, medicines). health institutions, all the available private sec-
tors, the military medical services, etc., within the
After the flooding:
planning process. Risk reduction and emergency
– To help the injured. preparedness are the responsibility of all national
– To listen to local authorities regarding the in- actors. At the national level, the Ministry of Health,
formation on the local drinking water supply. Labor and Social Protection is the leading agency
– To avoid areas with still water: the water may responsible for the healthcare sector, which apart
be contaminated with gasoline, diesel or sewa- from the medical services of the Armed Forces, in-
ge debris; it can also be electrically charged cludes the Red Cross society, the non-governmen-
with high-voltage power lines or grounded tal healthcare organizations, the private health
electrical cables. facilities and professional associations. Emergen-
– To avoid water currents. cy preparedness requires a multi-sectoral appro-
– To learn about the water withdrawal areas: ach. This approach might be applied to all types of
roads or bridges may exhibit low resistance emergencies and crises including those of health
and collapse due to vehicle overloading. origin such as major epidemics, food poisoning,
– To be careful when entering the flooded buil- waterborne diseases or toxic chemical leaks and
dings since their resistance might be affected, spills.
particularly the foundations.
CONCLUSIONS
1. Floods remain some of the most frequent and powerful natural phenomena that have aggravated the
situation of many countries, including the Republic of Moldova, especially in the last decades and have
conditioned the need to increase interventions for prevention and reduction of both economic and hu-
man losses both at national and international levels.
2. While assessing the tremendous increase in direct flood damages, the expenses involved in their liqui-
dation and rehabilitation of the affected population, as well as the experience of the developed countries
worldwide, we can conclude that the problem of the flood risk management requires enormous financi-
al costs that show an unprecedented growth rate along with the increased level of security.
3. The major purpose of the health care system, while liquidating the medical flood consequences, is
to provide primary emergency medical care to the injured, according to the medical indications and to
evacuate people safely to health-care institutions away from the flood outbreak.
4. Since floods, particularly the catastrophic ones, lead to a sudden exacerbation of the sanitary-hygienic
and anti-epidemic status within the flooded areas, medical assistance to the injured, along with sani-
78
tary-hygienic and anti-epidemic measures should be necessarily carried out by both the regional and
national health care systems, for the purpose of maintaining the health status of the affected population
as well as to prevent the occurrence and spread of infectious diseases.
CONFLICT OF INTERESTS Revistă ştiinţifică, de informaţie şi cultură ecologică.

2008; 5(41):47-48.
All authors declare no competing interests.
13. Domenco R. Dinamica precipitațiilor excedentare pe
teritoriul Republicii Moldova în anii 1960-2015. tz de
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Vasile DUMITRAS, ORCID 0000-0002-9444-706X

Catalina CROITORU, ORCID 0000-0002-7411-2393, Web of Science Researcher ID AAB-4330-2019
Elena CIOBANU, ORCID 0000-0002-8969-922X, Web of Science Researcher ID P-2844-2018
79
OPINII ALE EXPERȚILOR – МНЕНИЯ ЭКСПЕРТОВ – EXPERTS› OPINIONS –

AVIS DES EXPERTS
STRENGTHENING GLOBAL BIOSAFETY & BIOSECURITY

Maureen ELLIS, Executive Director, International Federation of Biosafety Associations
Corresponding author: Maureen Ellis, e-mail: m.ellis@internationalbiosafety.org
UDC: 614.4:579.61
INTRODUCTION The IFBA and its members are assisting national

The International Federation of Biosafety Associa- authorities in integrating biosafety into policies
tions (IFBA) is a global community of 46 biosafety and programs, to improve sustainable laboratory
associations, 774 certified biosafety professionals, infrastructure and equipment, and to increase bi-
and other partners with the mission of “safe, secu- osafety skills and competencies among those wor-
re and responsible work with biological materials”. king with infectious diseases. Our objective is to
The IFBA works globally to enhance multi-sectoral build and operate safe, yet, cost-effective labora-
collaboration and foster partnerships between its tories and prevent laboratory exposures to infec-
members, government ministries, and other sta- tious diseases. IFBA’s members understand local
keholders in the deve-lopment and implementati- challenges in operating safe laboratories and are
on of comprehensive national biosafety/biosecu- facilitating simple, yet, effective approaches that
rity strategies. This includes the implementation can be cost-effectively sustained over the long
of the Global Health Security Agenda’s Action Pac- term. Rather than simply taking a high technology
kage 3, International Health Regulations, UN Secu- approach of focusing on engineering and equip-
rity Council Resolution 1540, Biological Weapons ment, approaches to laboratory containment fa-
Convention, and other health security initiatives. cilities must balance engineering controls with
operational, scientific and management controls.
The effectiveness of public health functions in- There is no “one size fits all” approach to BSL-2
cluding surveillance, diagnosis and research are and BSL-3 facilities. Every biocontainment labo-
influenced by reliable laboratory services, of ratory should be based primarily on a solid risk
which biosafety and biosecurity are central ele- assessment and the specific laboratory program
ments. Yet, many laboratories still lack sufficient requirements.
biosafety and biosecurity practices, equipment
and infrastructure to conduct their work in a safe
Bridging the Policy Implementation Gap
and secure manner. Safe disposal of potentially
contaminated laboratory waste also remains a While some progress is being made in the deve-lo-
challenge. Attention must be drawn to the serious pment of national biorisk management and biose-
dangers that can arise from the fai-lure to imple- curity strategies, there is an increasing awareness
ment effective biosafety and biosecurity and, im- on whether these policies do not succeed or fail on
portantly, must highlight the signi-ficant benefits their own merits; rather their progress is depen-
offered by the implementation of sound biosafety dent upon the process of implementation (i.e. tur-
and biosecurity practices including: ning policy into practice). The space between go-
vernment’s motivation behind the passage of new
• minimising the socio-economic impact of hu- legislation and how that intent is translated into
man and animal disease outbreaks and better reality in many countries becomes an implemen-
protection of laboratory staff, the wider com- tation gap when that policy remains on paper only
munity and the environment; and, or is implemented poorly. More needs to be done
• contributing to better biosecurity through con- to try to ensure intentions for the safe and secure
trol of access to dangerous pathogens, tracking handling of biological materials are turned into re-
their use, and improving reporting of incidents. sults – in short, that policy failure is avoided.
80
The IFBA has been advancing ways in which the the IFBA adopts a risk-based approach to desig-
implementation phase can be strengthened and ning “built-to-purpose” laboratory equipment and
supported. We recognize that in addition to gover- infrastructure that is:
nment accountability and funding investments, • relevant to local circumstances;
implementation is highly dependent on local con- • tailored to the actual risks of an individual la-
text and that high-level decision makers cannot boratory;
succeed without having some understanding of • economically feasible and cost-effective to
what happens on, or close to, the front line. In many maintain.
cases, biosafety professionals and those who work
In 2010, the IFBA’s Biocontainment Engineering
directly with biological materials in laboratories
Working Group (BEWG) was created to serve as a
on the front line of global health security know a
“think-tank” to identify practical and sustainable
great deal about the challenges and solutions of
solutions for biocontainment laboratories around
implementing national biosecurity strategies. A
the world. This network of biocontainment engi-
key success factor for bridging the policy imple-
neers and private industry partners are working
mentation gap, therefore, is to tap into the experi-
together on sustainable laboratory design appro-
ences and competencies of these individuals who
aches to reduce initial capital and on-going opera-
can positively shape the implementation process.
tional costs. Laboratories in lower resource coun-
Moving beyond the dichotomy, between the top- tries often struggle to implement containment
down and bottom-up approaches, the IFBA’s solutions, which have been designed for use in
approach to implementing biosecurity policy is other parts of the world where different working
a synthesis of both perspectives. We encourage conditions prevail. Compounding the problem is
a strong collaboration between decision makers a lack of well-trained biocontainment engineers
and front line biosafety professionals to develop that can adequately maintain and operate labo-
strategies and innovations that will be successful ratories and critical containment equipment (e.g.
and sustainable over the long term. Additionally, biological safety cabinets) over the longer term.
participation in local, national, and international Effective supplier networks, maintenance provisi-
networks allow for a multilateral type of exchange on and other basic measures are often unavailable
and collaboration between individuals and a vehi- to those most in need.
cle for innovation in best practices. A range of vir-
To meet these challenges, the IFBA promotes
tual exchange and on-line collaboration formats
risk-based approaches to laboratory and equip-
allows for an information flow across institutions,
ment design that are cost-effective, locally driven,
nations and regions.
and can be practically implemented over the long
Using the internet and social media, the IFBA is term. The vision for risk-based approaches is not
connecting individuals that might not otherwise to lay out the requirements for a BSL2 or BSL3 la-
be able to share best practices and sustainable boratory, but rather to describe “how” these faci-
solutions. These settings also give individuals lities should be planned and designed, based on a
opportunities to acquire new skills that may not local biocontainment risk assessment. The resul-
be offered by traditional capacity building appro- ting facilities would be built-to-purpose, utilizing
aches. What’s more, participation in these initiati- a more nuanced set of requirements, and would
ves fuels their intention to stay in the bio-security allow for investment in infrastructure, equipment
and biorisk management field. and precautions suited to the type of procedures
performed. It is important to note that building
Risk-based Sustainable Laboratories sustainable laboratories also requires a strong
Laboratories are an integral component of global focus on procedural and human factors, including
health security and play a major role in the safe trained and competent engineering and mainte-
and secure handling of biological materials. Buil- nance staff.
ding laboratory infrastructure that is highly de-
pendent on engineering controls and technology Professional Competency
presents a challenge in many countries where Ensuring that individuals, who handle biological
construction and maintenance costs are prohibiti- materials, demonstrate competencies on the safe
ve. Rather than taking a high technology approach, and secure handling of biological materials is an
81
essential component of the overall effort of redu- Global Mentorship Program

cing biosafety and biosecurity risks. The IFBA’s The newly launched IFBA Global Mentorship Pro-
certification program is the only internationally gram recruits biosafety and biosecurity champi-
recognized program to certify the competency ons across all regions of the world to provide re-
of individuals in biorisk management and a vari- gionally relevant peer mentorship to developing
ety of related technical disciplines. The program professionals in their geographic region. Mentors
is structured in compliance with the policies and and their mentees discuss foundations of biosafe-
procedures of ISO/IEC 17024: 2012 Conformity as- ty and biosecurity as it pertains to global and re-
sessment – General Requirements for Bodies Opera- gional standards of practice, as well as emerging
ting Certification of Persons. Examinations are de- trends and threats in health security across di-
livered to candidates worldwide in the following verse professional disciplines in the human, ani-
disciplines: mal and security sectors. Working collaboratively
• Biorisk Management (Pre-requisite certificati- with governments, strong partnerships are being
on for all others); forged between decision makers and frontline
• Biological Waste Management; workers in turning policy into practice. Feedback
• Biocontainment Facility Design, Operations & from mentorship teams is collected as an informal
Maintenance; horizon scan of current norms in biosafety and bi-
• Biosafety Cabinet Selection, Installation and osecurity practices across regions.
Safe Use;
The pool of mentor/mentee pairs, from an array
• Biosecurity.
of professional disciplines and sectors, have been
To date, the IFBA has issued 959 Professional Cer- sharing knowledge, skills and experiences towar-
tifications to individuals in 65 countries worldwi- ds translating policy objectives into action on
de, a milestone for our growing program. The or- the frontlines. Mentorship pairs use One Health
ganization recently collected feedback from their approach to harmonize health security appro-
network of certified professionals in Southeast aches across the human and animal health sectors.
Asia to assess the program’s impact in the regi- Mentees are learning how to best translate princi-
on. Many respondents said the IFBA’s certification ples in global health security into strategies and
program is recognized internationally as a high innovations that will be successful and sustainable
standard of competency in managing biological on the front lines over the long term. In addition
risks and was a pathway to enhanced responsibili- to meaningful mentee-mentor collaboration, pairs
ties at their workplace. The survey also showed a are participating in regional and international ne-
number of ways in which certification has a positi- tworks to gain additional skills and knowledge for
ve impact on enhancing biosafety and biosecurity strengthening health security implementation at
practices in the region. The IFBA credential sets the local level. The IFBA’s south-to-south mento-
biosafety and biosecurity competency standards ring program has demonstrated its success as a
and recognizes professionals who have demon- vehicle for forming crucial links between frontline
strated the knowledge and skills to safely and se- biosafety professionals, laboratory workers and
curely handling of biological materials. With the government decision makers. By supporting re-
continued dedication and commitment from IF- gionally relevant peer mentorship programs, the
BA’s global community of biosafety associations, gap between health security policy development
and other key partners, the momentum is expec- and implementation can be narrowed.
ted to grow through 2020.
CONCLUSIONS
Over the past years, the IFBA’s network of biosafety associations, certified professionals and mentees/
mentors have exercised considerable initiative, ingenuity, and drive to implement and sustain biosafety,
biosecurity and biorisk management programs and activities in their respective countries. Our activities
have formed crucial links between front line biosafety professionals and governments and are partici-
pating in the policy-making process and providing input to their governments about biosecurity best
practices. They also serve to monitor government actions, helping to hold officials accountable and keep
them responsive to actual needs. In this way, biosafety associations can assist government to ensure
that practical and locally relevant solutions are reflected in biosecurity laws and their implementation.
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Finally, we must remember that the most important aspects of biosafety and biosecurity are the practices
and procedures used by trained laboratory staff. The World Health Organization’s Laboratory Biosafety
Manual states “no biosafety cabinet or other facility or procedure alone guarantees safety unless the
users operate safe techniques based on informed understanding.” It is the responsibility of everyone, in-
cluding managers and laboratory workers, to ensure their work is performed in a safe manner. Whether
you are new to the field or an experienced biosafety professional, a policy maker or a bench scientist, we
need to work together to increase biosafety awareness, leadership, and support for the implementation
of national biosafety strategies and laboratory capacity building.

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EVENIMENTE/ANIVERSĂRI – СОБЫТИЯ/ЮБИЛЕИ – EVENTS/

ANNIVERSARIES– ÉVÉNEMENTS/ANNIVERSAIRES
CONSTANTIN SPÎNU – PILONUL CERCETĂRII, PERSONALITATE NOTORIE

DEVOTATĂ ȘTIINȚEI MEDICALE
Sănătatea este un cuvânt mare. Ea
cuprinde nu numai corpul, mintea
și spiritul, ci și perspectiva unui om.
James H. West
Medicina este nu numai o ş� tiinţ�ă, ci este, de asemenea, o artă. Ea nu consistă doar din prescrierea me-
dicamentelor, ea se ocupă cu adevărat de procesele vieţ�ii, care trebuie bine cunoscute î�nainte ca aces-
tea să fie bine călăuzite. Prin urmare, cei care î�ș�i dedică î�ntreaga carieră pentru a aduce un progres la
menț�inerea sănătăț�ii oamenilor, trebuie cunoscuț�i ș� i apreciaț�i cu cele mai lăudabile cuvinte. Profesorul
Constantin SPÎ�NU este unul dintre cei care s-a dedicat pe parcursul mai multor decenii acestei misiuni
importante.
Domnul Constantin SPÎ�NU – academician AȘ� M (2018), profesor universitar (1996), doctor habilitat î�n
ș� tiinț�e medicale (1991) ș� i actualmente ș� ef Direcț�ie cercetare ș� i inovare, din cadrul Agenț�iei Naț�ionale
pentru Sănătate Publică, s-a născut la 19 martie 1950 î�n comuna Nicoreni, raionul Râş� cani, Republica
Moldova î�ntr-o familie de intelectuali.
Î�n anul 1967 absolveş� te cu medalie de aur ş� coala medie din satul natal, iar î�n 1973 – Facultatea de sani-
tarie a Institutului de Stat de Medicină din Chiş� inău.
După absolvirea cu menţ�iune a facultăţ�ii, lucrează î�n sfera de supraveghere sanitaro-epidemiologică,
activând succesiv î�n funcţ�iile de cercetător ş� tiinţ�ific stagiar la Institutul de Cercetări î�n Igienă ş� i Epide-
miologie (Chiş� inău, 1973-1974), doctorand la Institutul de Virusologie „D.I. Ivanovski” (Moscova, 1974-
1977), cercetător ş� tiinţ�ific stagiar, superior, ş� ef de laborator, ş� ef de sector la Institutul de Cercetări î�n
Igienă ş� i Epidemiologie (Chiş� inău, 1977-1988). Din anul 1988 deţ�ine funcţ�ia de ş� ef de laborator la In-
stitutul de Cercetări Ş� tiinţ�ifice î�n Medicina Preventivă ş� i Curativă, iar î�ncepând cu 1995 până î�n 2018
– activează î�n calitate de prim-vicedirector, vicedirector î�n probleme ş� tiinţ�ifice ş� i de inovare la Centrul
Naţ�ional de Sănătate Publică.
Î�n anul 1977 Constantin Spî�nu susţ�ine cu succes teza de doctor î�n medicină la specialitatea „Epidemio-
logie”, iar î�n anul 1991 – teza de doctor habilitat la specialitatea „Virusologie”. Î�n anul 1996 i se conferă
titlul de profesor universitar.
Munca asiduă s-a soldat cu rezultate remarcabile ale activităț�ii sale: sute de publicaț�ii ș� tiinț�ifice, multi-
ple brevete de invenț�ii, manuale, monografii, un preparat medicamentos „Pacovirina” folosit î�n medici-
na autohtonă ș� i o mulț�ime de discipoli î�n ș� tiinț�ă. Realizările profesorului Constantin SPÎ�NU au fost pro-
84
movate ș� i apreciate de foruri ș� i instituț�ii ș� tiinț�ifice naț�ionale ș� i internaț�ionale. Datorită performanț�elor

obț�inute î�n domeniul de cercetare, i-au fost acordate cele mai î�nalte distincț�ii ș� i titluri onorifice din ț�ară
ș� i de peste hotare.
Profesorul universitar Constantin SPÎ�NU se bucură de popularitate ş� i î�n străinătate: este Coordonator
Naţ�ional î�n problemele de poliomielită (Organizaţ�ia Mondială a Sănătăţ�ii), Coordonator Naţ�ional î�n ac-
tivitatea de inventică ş� i transfer tehnologic pentru saloanele internaţ�ionale (România – Cluj-Napoca,
Bucureş� ti, Iaş� i) ş� i membru activ al Academiei de Ş� tiinţ�e din New-York, SUA.
Pentru merite deosebite î�n dezvoltarea medicinii ş� i rezultate remarcabile î�n activitatea profesională
ş� i de inovare a fost menţ�ionat cu următoarele distincţ�ii de stat: Diplome de Onoare ale Parlamentului
ş� i Guvernului Republicii Moldova, titlul „Om Emerit” (1998), Medalia „Meritul Civic” (2005), laureat al
Concursului Naţ�ional de Susţ�inere a Ş� tiinţ�ei ş� i Inovării „Savantul Anului î�n domeniul ş� tiinţ�elor reale”
(2008), laureat al Premiului Organizaţ�iei Mondiale pentru Proprietatea Intelectuală, Medalia „60 ani ai
Academiei de Ş� tiinţ�e a Moldovei”, Crucea Regatului Belgia (Bruxelles) î�n grad de Cavaler (2007), Ofiţ�er
(2008) ş� i Comandor (2009), Diplomă de Onoare a Guvernului Republicii Moldova (2020).
Cunoș� tinț�ele profunde, abilităț�ile manageriale, fructificate cu rezultate remarcabile î�n domeniul cerce-
tărilor ș� tiinț�ifice ș� i controlul infecț�iilor virale au servit drept temei pentru a fi promovat î�n calitate de
coordonator naț�ional al OMS pentru aspecte legate de combaterea poliomielitei, gripei ș� i hepatitelor
virale.
Profesorul Constantin SPÎ�NU a inspirat ș� i î�ncurajat colegii săi cu idei, care fiind aplicate, au adus plus
valoare.
Este onorabil pentru noi, consiliului de redacț�ie, să colaborăm î�mpreună cu academicianul, profesorul
universitar, doctorul habilitat, Constantin SPÎ�NU. Î�l apreciem, deoarece a devenit unul din cei mai valo-
roș� i ș� i notorii specialiș� ti î�n virusologia medicală, este fondatorul ș� colii de virusologie medicală, recunos-
cută la nivel mondial.
Cu ocazia jubileului de 70 ani, din partea consiliului de redacț�ie, î�i dorim multă sănătate, noi succese ș� i
realizări frumoase î�n domeniul cercetării ș� i inovării, realizarea a cât mai multe proiecte de cercetare
valoroase pentru asigurarea bunăstării sănătăț�ii populaț�iei ș� i a sănătăț�ii publice.
Mulți ani prosperi, Domnule Academician!
Cu profund ș� i deosebit respect, consiliului

de redacț�ie al Revistei One Health & Risk
Management
85
PROFESORUL RODICA STURZA: MUNCA ŞI MODESTIA

SUNT CREZUL VIEŢII SALE
A fi om înseamnă în chip neîndoielnic
a fi responsabil. Înseamnă a simți,
punând și tu piatră la temelie, că
astfel contribui la clădirea lumii.
Antoine de Saint-Exupery
Se spune că timpul trece – mai corect, noi trecem prin timp – ș� i doar Omul poate să contribuie la atin-
gerea scopului său î�n viaţ�ă prin insistenţ�ă, efort ș� i muncă asiduă, prin omenie ș� i dăruire faţ�ă de tot ce
face ș� i gândeș� te, ș� i î�ncă prin multe altele din care să-ș� i realizeze Eul î�n viaţ�ă. Toate acestea dau sens ș� i
bogăţ�ie î�mplinirilor.
Doamna Rodica STURZA s-a născut î�n comuna Caracuş� enii Vechi, raionul Briceni, Republica Moldova, la
6 ianuarie 1960 ş� i a urmat studiile gimnaziale ş� i liceale la ş� coala din localitate. Anii de ş� coală i-au marcat
profund destinul: descendentă dintr-o familie de profesori, Rodica STURZA a dat dovadă de perseveren-
ţ�ă ş� i capacităţ�i remarcabile, a fost membru al lotului olimpic la fizică ş� i chimie, fiind laureat al olimpiade-
lor internaţ�ionale la aceste discipline. Ulterior, studiilor medii, a devenit studentă la facultatea de chimie
a Universităţ�ii de Stat din Chiş� inău. Î�n anii de studenţ�ie, Rodica STURZA a participat activ la activităţ�ile
ş� tiinţ�ifice studenţ�eş� ti ş� i proiecte de cercetare, fiind menţ�ionată cu burse de merit republicane.
Cariera doamnei Rodica STURZA debutează î�n acelaş� i an cu absolvirea cursurilor universitare (1981), î�n
cadrul catedrei absolvite – Chimie fizică, î�n calitate de colaborator ş� tiinţ�ific inferior, unde a activat până
î�n anul 1983, când s-a î�nscris la doctorat î�n laboratorul de electroflotaţ�ie al Institutului de Fizică Apli-
cată al Academiei de Ş� tiinţ�e a Moldovei. Î�n anul 1989 a obț�inut titlul de doctor î�n chimie susţ�inând teza:
„Proprietăţ�i electrochimice ale anozilor titan-dioximanganici obţ�inuţ�i prin metoda cu scântei electrice”
la Institutul de Chimie ş� i Tehnologie Chimică din Vilnius, Lituania, iar doi ani mai târziu, î�n anul 1991, a
î�mbrăţ�iş� at cariera universitară, devenind conferenţ�iar la catedra de Chimie din cadrul Facultăţ�ii de Teh-
nologie ş� i Management î�n Industria Alimentară, Universitatea Tehnică a Moldovei. Î�ncepând din această
perioadă, cariera ş� tiinţ�ifică ş� i universitară a doamnei Rodica STURZA sunt nedespărţ�ite, cercetările sale
ş� tiinţ�ifice fiind axate pe chimia ş� i ingineria alimentelor.
Prodecan al Facultăţ�ii de Tehnologie ş� i Management î�n Industria Alimentară (1993-2005), ş� ef catedră
Chimie (2005-2007), doamna Rodica STURZA participă la realizarea a numeroase proiecte de cercetare
naţ�ionale ş� i internaţ�ionale, implicând î�n aceste activităţ�i studenţ�ii, doctoranzii ş� i colaboratorii tineri
din cadrul facultăţ�ii. Activitatea sa este î�ncununată de succes, fiind menţ�ionată cu titlul de „Cel mai bun
profesor al anului 2005” de către Senatul UTM, iar doctoranzii sub conducerea doamnei Rodica Sturza
fiind menţ�ionaţ�i cu burse de merit republicane.
Î�ncepând cu anul 1997, doamna Rodica STURZA devine profesor al filierei francofone „Technologies
Alimentaires”, unde realizează numeroase proiecte internaţ�ionale de cercetare ş� i formare.
Î�n anul 2007 doamna Rodica STURZA este aleasă prin concurs î�n postul de director al Centrului Naţ�ional
de verificare a calităţ�ii produselor vinicole, î�nfiinţ�at prin Hotărâre de Guvern î�n toamna anului 2006. Pe
86
parcursul a doi ani a creat un laborator de excelenţ�ă, care a permis organizarea controlului calităţ�ii la un
nivel recunoscut prin acreditare europeană drept laborator de referinţ�ă.
Î�n anul 2009 doamna Rodica STURZA a susţ�inut teza de doctor habilitat î�n tehnică „Principii teoretice ş� i
practice de fortificare a alimentelor cu micronutrimente: iod, fier, calciu”, fiind notificată cu menţ�iunea
„Cea mai bună lucrare de doctor habilitat a anului” de către Consiliul Naţ�ional pentru Acreditare ş� i Ates-
tare a cadrelor ş� tiinţ�ifice (CNAA), iar î�n anul 2011 obţ�ine titlul de profesor universitar.
Î�n calitate de profesor invitat prezintă cursuri speciale la Universitatea de Tehnologie Chimică ş� i Meta-
lurgie din Sofia, Bulgaria; Universitatea de Tehnologii Alimentare (UTA) din Plovdiv, Bulgaria; Univer-
sitatea Paul Sabatier, Toulouse, Franţ�a. Recunoaş� terea internaţ�ională a meritelor ş� tiinţ�ifice ale doamnei
Rodica STURZA rezultă din participarea sa î�n calitate de membru al colegiului de redacţ�ie a unor reviste
ş� tiinţ�ifice internaţ�ionale ş� i naţ�ionale cu circulaţ�ie internaţ�ională.
Savant cu pregătire universală, autor a peste 300 de lucrări ş� tiinţ�ifice, inclusiv peste 150 de lucrări
publicate î�n reviste internaţ�ionale recenzate, preş� edinte al Seminarului ş� tiinţ�ific de profil al UTM la spe-
cialităţ�ile ş� tiinţ�ifice: Tehnologia produselor alimentare, Procese ş� i aparate î�n industria alimentară, Con-
trol ş� i certificare a produselor alimentare, doamna profesor Rodica STURZA a contribuit la promovarea
imaginii Republicii Moldova pe plan internaţ�ional ş� i la integrarea ei î�n spaţ�iul european.
Pentru merite deosebite î�n dezvoltarea ingineriei ş� i controlului calităţ�ii alimentelor, î�n anul 2012 doam-
nei profesor universitar doctor habilitat Rodica STURZA i s-a acordat titlul de Doctor Honoris Causa de
către Universitatea Ş� tefan cel Mare din Suceava.
Din anul 2019 ş� i până î�n prezent doamna Rodica STURZA deţ�ine funcţ�ia de ş� ef Departamentul Oenologie
ş� i Chimie din cadrul Universitpţ�ii Tehnice din Moldova.
Cu ocazia î�mplinirii frumoasei vârste, Vă urăm să atingeţ�i treptele cele mai î�nalte ale î�mplinirilor ș� i rea-
lizărilor. Vă dorim multă sănătate, bucurii î�n familie, activitate prodigioasă ș� i noi realizări î�n activitatea
pedagogică ș� i cercetarea ș� tiinț�ifică.
Mulți ani prosperi, Doamnă Profesor!

Cu profund ș� i deosebit respect, consiliului
de redacț�ie al Revistei One Health & Risk
Management
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CERINŢE PENTRU AUTORI

Reguli de tehnoredactare − MATERIAL ȘI METODE
Pregătirea manuscrisului (elaborat î�n limbile ro- − REZULTATE
mână, engleză, franceză ș� i rusă) va fi î�n conformi- − DISCUȚII
tate cu instrucț�iunile publicate î�n: Uniform Requ-
− CONCLUZII
irements for Manuscripts Submitted to Biomedical
Journals (1994) Lancet 1996, 348, V2; 1-4 (www. − CONFLICT DE INTERESE
icmje.org). Manuscrisele trebuie să fie cu font − MULȚUMIRI ȘI FINANȚARE
Cambria, dimensiune 11 puncte, spaț�iat la inter- − REFERINȚE
val 1,5, aliniere justificată, câmpurile 2 cm pe toate
Rezumatul va conț�ine până la 1 600 de semne cu
laturile. Toate paginile trebuie să fie numerotate
spaț�ii ș� i va cuprinde:
consecutiv (î�n colț�ul de jos, î�n partea dreaptă) ș� i să
includă numerotarea continuă a paginilor. Abrevi- − Introducere
erile trebuie să fie explicate la prima apariț�ie î�n − Material și metode
text ș� i nu trebuie utilizate excesiv. Manuscrisele − Rezultate
nu trebuie să depăș� ească (fără a număra titlul, afi- − Concluzii
lierea, rezumatul ș� i referinț�ele): pentru articole de
sinteză/referate – 4500 de cuvinte; pentru artico- − Cuvinte cheie: 3-5 cuvinte
le de cercetare – 3 000 de cuvinte; pentru opinii Î�n rezumat nu vor fi incluse tabele, grafice ș� i note
ale experț�ilor – 2 500 de cuvinte; prezentare de bibliografice; informaț�ii care nu sunt prezentate î�n
caz ș� i imagini din practica clinică/laborator – 1 studiu.
700 de cuvinte; note experimentale ș� i clinice – 1 Figuri. Textul inclus î�n figuri trebuie să fie scris cu
300 de cuvinte; recenzii ș� i prezentări de carte – 2 font Cambria, dimensiune 10 puncte. Fiecare figu-
000 de cuvinte; articole didactice – 4 000 de cu- ră trebuie să fie î�nsoț�ită de titlu ș� i legendă. Ele vor
vinte. Volumul tabelelor ș� i figurilor nu trebuie să fi numerotate cu cifre arabe ș� i vor fi menț�ionate î�n
depăș� ească ⅓ din volumul manuscrisului. Revista text î�n paranteze (ex: fig. 1). Titlul (ex: Figura 1) ș� i le-
î�ș�i rezervă dreptul de a face orice alte modificări genda figurii trebuie să fie scrisă centrat, sub figură.
de formatare. Manuscrisele respinse nu sunt re-
turnate. Tabele. Textul inclus î�n tabele trebuie să fie scris
cu font Cambria, dimensiune 10 puncte. Fiecare
Toate manuscrisele transmise spre publicare tabel trebuie să fie î�nsoț�ită de titlu. Tabelele vor fi
trebuie să fie însoțite de două rezumate: în lim- inserate î�n text, fără a depăș� i lăț�imea unei pagini.
ba de origine al articolului și în limba engleză. Ele vor fi numerotate cu cifre arabe ș� i vor fi men-
Titlul și autorii ț�ionate î�n text î�n paranteze (ex: tab. 1). Titlul ta-
belului va fi poziț�ionat deasupra tabelului centrat
Titlul ar trebui să fie cât mai scurt posibil (maxi-
(ex: Tabelul 1).
mum – 120 de semne cu spaț�ii), elocvent pentru
conț�inutul manuscrisului. Numele autorilor vor fi Referințele trebuie să fie numerotate î�n ordinea
scrise deplin: prenume, nume de familie (ex: Ion apariț�iei î�n text. Citarea sursei de referinț�ă va fi
RUSU). Afilierea va include: Secț�ia/Departamen- conform stilului Vancouver, plasată la sfârș� itul ar-
tul/Catedra, Universitatea/Spitalul, Oraș� ul, Ț� ara ticolului ș� i va include doar referinț�ele citate î�n text
pentru fiecare autor. Se vor menț�iona obligatoriu, (menț�ionând numărul de referinț�ă î�n paranteză
mai jos, datele autorului corespondent ș� i informa- rotundă). Dacă aceeaș� i referinț�ă este citată de mai
ț�iile de contact – adresa de e-mail (ex: autor cores- multe ori, ea va fi trecută î�n text cu acelaș� i număr
pondent: Ion Rusu, e-mail: ion.rusu@gmail.com). ca la prima citare. Numărul total de referinț�e nu
va depăș� i 50 de surse. Acurateț�ea datelor ț�ine de
Structura manuscrisului
responsabilitatea autorului.
Manuscrisul va cuprinde următoarele subtitluri
Pentru mai multe informaț�ii consultaț�i: http://
(scrise cu majuscule):
journal.ohrm.bba.md/index.php/journal-ohrm-b-
− REZUMAT (vezi cerinț�ele mai jos) ba-md/editing_guidelines
− INTRODUCERE
88
ТРЕБОВАНИЯ ДЛЯ АВТОРОВ

Правила составления Структура Рукописи
Подготовка рукописи (разработанной� на ру- Рукопись будет включать в себя следующие
мынском, англий� ском, французском и русском подзаголовки (они должны быть заглавны-
языках) будет осуществляться в соответствии ми):
с инструкциями, опубликованными в: Uniform
− РЕЗЮМЕ (см. требования ниже)
Requirements for Manuscripts Submitted to
Biomedical Journals (1994) Lancet 1996, 348, V2; − ВВЕДЕНИЕ
1-4 (www.icmje.org). Авторы должны исполь- − МАТЕРИАЛЫ И МЕТОДЫ
зовать шрифт Cambria, размер 11 точек, с ин- − РЕЗУЛЬТАТЫ
тервалом 1,5, выравнивание по ширине, поля 2
− ДИСКУССИИ
см со всех сторон. Все страницы должны быть
пронумерованы последовательно (в правом − ВЫВОДЫ
нижнем углу) и включать непрерывную ну- − КОНФЛИКТ ИНТЕРЕСОВ
мерацию страниц. Сокращения должны быть − БЛАГОДАРНОСТИ И ИСТОЧНИКИ ФИНАН-
объяснены при первом появлении в тексте и СИРОВАНИЯ
не должны использоваться чрезмерно. Объем − ЛИТЕРАТУРА
рукописей� не должен превышать (без назва-
нии, принадлежности, резюме и литературы): Резюме должно содержать 1 600 знаков с про-
для обзорных статей� /рефератов – 4 500 слов; белами и будет включать в себя следующие
для научных статей� – 3 000 слов; для эксперт- подзаголовки:
ных заключений� – 2 500 слов; для презента- − Введение
ции случаев из клинической� /лабораторной� − Материалы и методы
практики – 1 700 слов; для эксперименталь- − Результаты
ных и клинических заметок – 1 300 слов; для
рецензий� и презентаций� книг – 2 000 слов; для − Выводы
учебных статей� – 4 000 слов. Объем таблиц и − Ключевые слова: 3-5 слов
рисунков не должен превышать ⅓ от объема Резюме не должно включать таблицы, диа-
рукописи. Журнал оставляет за собой� право граммы и библиографические заметки, а так-
вносить любые другие изменения формати- же информацию, не представленную в иссле-
рования. Отклоненные рукописи не возвраща- довании.
ются.
Рисунки (графики, диаграммы). Текст, вклю-
Все рукописи, представленные для публи- ченный� в рисунки, должен быть написан в
кации, должны сопровождаться двумя ре- Cambria, размер 10 пунктов. Каждый� рисунок
зюме: на языке оригинала статьи и на ан- должен сопровождаться заголовком и описа-
глийском языке. нием. Название (например: Рисунок 1) и описа-
Название и авторы ние рисунка должны быть вписаны по центру,
в низу рисунка. Они должны быть пронумеро-
Название должно быть как можно короче (мак- ваны арабскими цифрами и указаны в тексте в
симум – 120 знаков с пробелами), но достаточ- скобках (например: рис. 1).
но информативным для содержания рукописи.
Фамилии авторов будут написаны полностью: Таблицы. Текст, включенный� в таблицы, дол-
имя, фамилия (например: Иван ИВАНОВ). При- жен быть написан в Cambria, размер 10 пун-
надлежность будет включать: Отделение/Де- ктов. Каждая таблица должна сопровождаться
партамент/Кафедра, Университет/Больница, заголовком. Они должны вставляться в текст,
Город, Страна для каждого автора. Данные со- не превышая ширину страницы. Они должны
ответствующего автора и контактная инфор- быть пронумерованы арабскими цифрами и
мация – адрес электронной� почты (например: указаны в тексте в скобках (например: таб. 1).
контактная информация: Иван Иванов. e-mail: Название таблицы должно располагаться над
ivan.ivanov@gmail.com) будут обязательно таблицей� в центре (например: Таблица 1).
ниже.
89
Литература должны быть пронумерованы ственность за точность данных лежит на авто-

в порядке их появления в тексте. Ссылки на ре. Будут цитироваться только те источники,
источники должны быть в стиле Vancouver, с которыми ознакомились авторы рукописи.
помещены в конце статьи и включать только Компоненты справочных источников должны
источники, цитируемые в тексте (упоминание быть написаны строго в соответствии с требо-
номера источника в круглых скобках). Если ваниями.
один и тот же источник цитируется несколь-
Для получения дополнительной� информа-
ко раз, он будет передан в тексте с тем же но-
ции см.: http://journal.ohrm.bba.md/index.php/
мером, что и первый� раз. Общее количество
journal-ohrm-bba-md/editing_guidelines
источников не должно превышать 50. Ответ-
90
REQUIREMENTS FOR AUTHORS

Rules of drafting − CONCLUSIONS
The manuscript (written in Romanian, English, − CONFLICT OF INTERESTS
French and Russian) should be in accordance with − ACKNOWLEDGEMENT
the guidelines published in: Uniform Requirements − REFERENCES
for Manuscripts Submitted to Biomedical Journal The summary should contain 1 600 signs with spaces:
(1994) Lancet 1996, 348, V2; 1-4 (www.icmje.org).
The manuscripts should be written in font Cam- − Introduction
bria, size 11 points, spaced at 1.5, fully justified − Material and methods
alignment, fields 2 cm on all sides. All pages must
− Results
be numbered consecutively (in the right bottom
corner) and continuously. Abbreviations should − Conclusions
be explained at first occurrence in the text and − Key words: 3-5 words
should not be excessively used. The manuscripts The summary should not include tables, charts,
must not exceed the number of words (without and bibliographic notes; information not included
the title, affiliation, abstract and references): re- in the article.
view articles – 4,500 words; research articles –
3,000 words; expert opinions – 2,500 words; case Figures. The text included in figures should be
presentation – 1,700 words; experimental and cli- written in font Cambria, 10 point. Each figure
nical notes – 1,300 words; book reviews and pre- should be accompanied by a heading and legend.
sentations – 2,000 words; teaching articles – 4,000 They should be numbered with Arabic numerals
words. The volume of tables and figures should and placed in parentheses (e.g.: fig. 1). Both the ti-
not exceed ⅓ from the volume of the manuscript. tle (e.g. Figure 1) and legend are centred, below
The journal reserves the right to make any other the figure.
formatting changes. Rejected manuscripts are not Tables. The text included in tables should be writ-
returned. ten in font Cambria, 10 point. Each table should
All manuscripts submitted for publication sho- be accompanied by a heading. Tables should be
uld be accompanied by two abstracts: in the inserted into the text and adjusted to the width of
language of origin of the article and English. the page. The tables are numbered in Arabic nu-
merals and mentioned in body text in parentheses
Title and authors (e.g. tab. 1). The title of the table is centred on the
The title should be as short as possible (maxi- top of the table (e.g. Table 1).
mum – 120 signs with spaces), relevant for the References are numbered in the order they
manuscript content. The names of the authors appear in the paper. The reference sources are
should be written in full: name, surname (e.g.: Jon cited at the end of the article by using Vancouver
JONES). Affiliation should include: Department/ style and will include only the references cited
Unit/Chair, University/Hospital, City, Country of within the text (the reference is numbered within
each author. Beneath the affiliation, the author`s round parentheses). The in-text citations that
details and contact information – e-mail address appear more than once are numbered similarly as
(e.g.: corresponding author: Jon Jones, e-mail: jon. in the first citation. The number of references sho-
jones@gmail.com). uld not exceed 50 sources. The scientific authors
The structure of the manuscript are responsible for the accuracy of their writings.
The reference list should include only those refe-
The manuscript should comprise the following rences that have been consulted by the authors of
subheadings (capitalized): the manuscript. The elements of the reference so-
− SUMMARY urces are written exactly in accordance with the
− INTRODUCTION requirements.
− MATERIAL AND METHODS For more information see: http://journal.ohrm.
− RESULTS bba.md/index.php/journal-ohrm-bba-md/edi-
− DISCUSSIONS ting_guidelines
91
EXIGENCES POUR LES AUTEURS

Normes de rédaction − DISCUSSIONS
La préparation des manuscrits (rédigés en rou- − CONCLUSIONS
main, anglais, français et russe) sera conforme aux − CONFLIT D’INTERETS
instructions publiées dans Uniform Requirements − REMERCIEMENTS ET FINANCEMENT
for Manuscripts Submitted to Biomedical Journals
− REFERENCES
(1994) Lancet 1996, 348, V2; 1-4 (www.icmje.org).
Le résumé contiendra 1 600 signes avec espaces:
Les manuscrits doivent être en police Cambria,
taille 11 points, espacés à l’intervalle 1,5, ali- − Introduction
gnement justifié, champs 2 cm de tous les côtés. − Méthodes
Toutes les pages doivent être numérotées consé- − Résultats
cutivement (dans le coin inférieur droit) et inclure − Conclusions
une numérotation continue des pages. Les abré-
viations doivent être expliquées lors de la pre- − Mots clés: 3-5mots.
mière apparition dans le texte et ne doivent pas Le résumé ne comprendra pas des tableaux, gra-
être utilisées de manière excessive. phiques et des notes bibliographiques; des infor-
mations non présentées dans l’étude.
Les manuscrits ne doivent pas dépasser (sans men-
tionner le titre, l’affiliation, le résumé et la bibliogra- Figures. Le texte inclus dans les figures doit être
phie) le volume suivant: pour articles de synthèse/ écrit avec police Cambria, taille 10 points. Chaque
rapports – 4 500 mots; pour les articles de recherche figure doit être accompagné par un titre et une lé-
– 3 000 mots; pour les opinions d’experts – 2 500 gende. Ceux-ci seront numérotés avec des chiffres
mots; présentation de cas et photos de la pratique arabes et mentionnés dans le texte entre paren-
clinique/de laboratoire – 1 700 mots; notes expéri- thèses (ex: fig. 1). Le titre (ex: Figure 1) et la lé-
mentales et cliniques – 1 300 mots; commentaires gende de la figure doivent être centrés, au-des-
et présentations de livres – 2 000 mots; articles pé- sous de la figure.
dagogiques – 4 000 mots. Le volume des tableaux
Tableaux. Le texte inclus dans les tableaux doit
et des figures ne doit pas dépasser ⅓ du volume du
être écrit avec police Cambria, taille 10 points.
manuscrit. La revue se réserve le droit d’apporter
Chaque tableau doit être accompagné par un titre.
toute autre modification de formatage. Les manus-
Les tableaux seront numérotés avec des chiffres
crits rejetés ne sont pas retournés.
arabes, mentionnés dans le texte entre paren-
Tous les manuscrits à publier doivent être ac- thèses (ex : tab. 1), et seront insérés dans le texte,
compagnés par deux résumés : dans la langue sans dépasser la largeur d’une page. Le titre du ta-
originale et en anglais. bleau sera placé au-dessus du tableau, centré (ex:
Tableau 1).
Titre et auteurs
Les références doivent être numérotées dans
Le titre doit être le plus court que possible (maxi-
l’ordre où elles apparaissent dans le texte. La ci-
mum – 120 signes avec espaces), éloquent pour
tation de la source de référence sera de style Van-
le contenu du manuscrit. Les noms des auteurs
couver, placée à la fin de l’article et n’inclura que
seront écrits complets : prénom, nom (ex : Albert
des références citées dans le texte (mentionnant le
LEBRUN). Quant à l’affiliation, on devra indiquer:
numéro de référence entre parenthèses rondes).
Section/Département/Chaire, Université/Hôpi-
Si la même référence est citée plusieurs fois, elle
tal, Ville, Pays – pour chaque auteur. Les données
sera transmise dans le texte avec le même numéro
de l’auteur correspondant et les coordonnées –
que celui de la première citation. Le nombre total
adresse e-mail (ex: auteur correspondant: Albert
de références ne dépassera pas 50 sources. La res-
Lebrun, e-mail: albert.le-brun@gmail.com) seront
ponsabilité pour l’exactitude des données est à la
obligatoires ci-dessous.
charge de l’auteur. Il faut indiquer dans le manus-
Structure du manuscrit crit seulement les références vraiment consultées
Le manuscrit comprendra les sous-titres suivants par les auteurs. Les composants des sources de ré-
(avec lettres majuscules): férence doivent être rédigés strictement selon les
exigences.
− RÉSUMÉ (voir les exigences ci-dessous)
Pour plus d’informations, voir : http://journal.
− INTRODUCTION
ohrm.bba.md/index.php/journal-ohrm-bba-md/
− METHODES editing_guidelines
− RESULTATS
92

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ONE HEALTH & VOL.

CUPRINS – СОДЕРЖАНИЕ – CONTENTS – TABLE DES MATIÈRES

ARTICOLE DE SINTEZĂ – ОБЗОРНЫЕ СТАТЬИ –

OPINII ALE EXPERȚILOR – МНЕНИЯ ЭКСПЕРТОВ –

Cerinţe pentru autori 88

A great valuable start!

Maureen Ellis, Executive Director,

ARTICOLE DE CERCETARE – НАУЧНЫЕ СТАТЬИ – RESEARCH ARTICLES –

THE EFFICACY OF DIRECT-ACTING ANTIVIRAL THERAPY IN PATIENTS

DOI: 10.5281/zenodo.3700945 UDC: 616.36-002.2-085.281.8

INTRODUCTION eliminate the virus and get negative RNA-HCV at

Table 3. Mean values of biochemical indices at the initiation of antiviral treatment.

Lot SOF+LDV Lot SOF+DCV

Figure 2. Virologic response in chronic Hepatitis C patients.

Table 4. SVR-related predictive factors for Sofosbuvir+Ledipasvir treatment.

Table 5. SVR-related predictive factors for Sofosbuvir+Daclatasvir treatment.

Table 6. Adverse reactions to antiviral treatment in patients with chronic HCV.

CONFLICT OF INTERESTS REFERENCES

Date of receipt of the manuscript: 03/02/2020

Irina RUSU, ORCID 0000-0002-2759-3171

DOI: 10.5281/zenodo.3700955 УДК: 616.914-036.22(470+571)

Key words: chicken- CURRENT EPIDEMIOLOGICAL CHARACTERISTIC OF CHICKENPOX IN RUSSIA

Cuvinte cheie: CARACTERISTICA EPIDEMIOLOGICĂ ACTUALĂ A VARICELEI ÎN RUSIA

ВВЕДЕНИЕ ся внедрить в Национальный� календарь про-

Рисунок 1. Заболеваемость ветряной� оспой� населения Россий� ской� Федерации, Москвы

Установлено неравномерное распределение стрирован в 2007 году и составил 8400,5 на 100

Рисунок 3. Заболеваемость ветряной� оспой� детей� различных возрастных групп в России

ми помесячной� заболеваемости всего населе- учреждения (r=0,83; p<0,05), а также школьни-

При этом в целом по стране наметилась тен- та гной� но-септических и внутриутробных

Рисунок 5. Заболеваемость ветряной� оспой� и количество проведенных прививок

С введением вакцинации заболеваемость де- Результаты количественного анализа не вы-

В условиях начального этапа вакцинопро- демонстрировала тенденцию к росту, однако

ДИСКУССИИ лицензирована в Канаде в 1998 г., а плановая

мического паротита. Развитие вакцинопрофи- двукратной� прививки и использованием ком-

КОНФЛИКТ ИНТЕРЕСОВ 4. Приказ Минздрава России от 21.03.2014 г.

Дата получения рукописи: 10/09/2019

Наталия АФОНИНА, ORCID 0000-0002-3205-4025,

STUDY OF ANTIBIOTIC SUSCEPTIBILITY OF SALMONELLA SPP.

DOI: 10.5281/zenodo.3700957 CZU: 579.842.14:615.33.015.8

Cuvinte cheie: Salmonella STUDIEREA SENSIBILITĂŢII LA ANTIBIOTICE A SPECIILOR DE SALMONELLA,

CONFLICT OF INTERESTS Conference on International Participation. Kyiv;

Date of receipt of the manuscript: 31/08/2019

Liliia VYGOVSKA, ORCID 0000-0001-6745-5753

К ВОПРОСУ ВАКЦИНОПРОФИЛАКТИКИ ПНЕВМОКОККОВОЙ

ФГБОУ ВО ПГМУ им. академика Е. А. Вагнера Минздрава России, Пермь, Россия

Контактная информация: Елена Зубова, e-mail: zubovaes@mail.ru

DOI: 10.5281/zenodo.3700973 УДК: 053.32-022.7-007.17-24./614.47:616.233

ВВЕДЕНИЕ Оценка количества детей� , родившихся живы-

Реактогенность вакцины оценивали по нали- зации недоношенных детей� с БЛД использова-

Таблица 1. Данные о численности новорожденных детей� , родившихся живыми и количество

Количество новоро- Количество недо- Количество детей Количество де-

Таблица 2. Структура первичной� заболеваемости недоношенных детей� , родившихся живыми с ЭНМТ,

В структуре первичной� заболеваемости детей� составил 157,3±2,3 при общем показателе

Таблица 3. Структура первичной� заболеваемости детей� , родившихся живыми с ОНМТ, в г. Перми

Фоновая клиническая характеристика детей� до 1500 граммов). В группе сравнения детей� с

зе) имели 21,0±1,02 детей� основной� группы и домизированного клинического наблюдения

В группе привитых недоношенных детей� с БЛД купировались самостоятельно без назначе-

В ходе мониторинга за показателями общего и не привитых детей� в динамике представле-

Таблица 5. Показатели общего анализа крови детей� привитых и непривитых – до вакцинации