Search

The most important and very difficult thing is to establish the cause (etiology) for the occurrence of nosocomial infections in medical facilities in the country and the world. Objective: To study the frequency and structure of nosocomial infections before and during the Covid-19 pandemic in the Ruse region for 2017-2021. Materials and methods: A retrospective analysis of the data on the registered nosocomial infections for a period of five years (2017 - 2021), reports, analyses, and laboratory studies of Regional Health Inspectorate Ruse, from national governmental studies, normative documents and literature are applied. Results: The analysis of the data from the etiological diagnosis of nosocomial infections in the Ruse region is from 9 medical facilities included in the national electronic system for the control of nosocomial infections (NIs). The etiological structure of NIs in the Ruse region is represented by 39 microbial species. The relative share of the untested varies from 10.59% in 2017 to 15.75% in 2021. For the etiologically unproven, it is from 2.39% for 2019 to 1.68% for 2021, with a decreasing trend. Conclusions: The analysis of the isolated microbial species by group shows that for the entire period, the proportion of gram-negative flora was 62% of the isolates (2017), followed by 23.02% of gram-positive microorganisms (2017), and the relative proportion of fungi and viruses was ~ 3 %.

Toxocariasis is a tissue zoonosis caused by Toxocara spp. and the exposure to these geohelminths varies in different parts of the population in a particular region. The purpose of the study is to reveal the seroprevalence of toxocariasis in North-eastern Bulgaria and to establish its demographic structure. Material/Methods: Within the scope of a broad seroepidemiological study, 701 individuals from North-eastern Bulgaria were tested for anti-Toxocara antibodies (ELISA) between 2017 and 2020. The results were stratified and analysed by age, gender, and place of residence. Results: The overall seroprevalence of human toxocariasis in North-eastern Bulgaria is 18.54%. Children (18.85%) and adults (18.30%) show similar levels of infection, but the stratified analysis by age in 5-years intervals revealed notable discrepancies. In younger children, the seroprevalence is higher than the observed for the entire population (0-4 years - 22.22%; 5-9 years - 22.22%), while in adolescents and adults is lower than average. In the elderly, the seroprevalence rises to its highest levels (60-64 years - 30.56% and over 65 years -31.67%). Although there are variations between males and females, gender is not a significant factor for the distribution of toxocariasis. Higher seroprevalence levels in residents of the smaller settlements of the region (children - 28.18%; adults -29.10%) correspond to a 2.5-fold increase in the odds of contracting toxocariasis in comparison to the ones living in Varna city. Conclusion: The overall seroprevalence of toxocariasis in North-eastern Bulgaria is alarmingly higher than the levels reported from other parts of the country, placing this unknown infection in a leading position among the parasitic zoonoses. The place of residence is the most significant factor driving the uneven distribution of the disease.

Toxocariasis in humans is a little-studied zoonosis, and there are no data on the impact of this parasitosis on the minority groups in our country. The purpose of this study is to establish the seroprevalence of toxocariasis among ethnic groups in the Varna region, North-eastern Bulgaria, and compare the results with a control group from the general population. Material/Methods: As a part of a large seroepidemiologic study, we assessed the presence of Toxocara IgG among 132 individuals, self-identified with Turkish and Roma ethnicities. As a control group, we used 250 sera from children and adults from a control group. The statistical comparison was performed regarding age, sex, and type of residence. Results: Toxocara IgG were established in 43 individuals from the minority groups (seroprevalence of 32.58%) and 39 persons in the control group (15.60%) with а statistically significant difference (odds ratio = 2.61). Considerably high seropositivity in the investigated ethnicities was discovered after separating by age: children-33.33%; adults-32.00% and gender: male-38.98%; female-27.40%. A detailed analysis revealed that the type of settlement is an important confounding factor. The seropositivity among the minority ethnic groups residing in small towns and villages is 35,40%, in contrast to the residents of Varna city of the same ethnical origin (15.79%); OR = 2.92. Conclusion: The established high seroprevalence for Toxocara IgG among minority ethnic groups, especially those residing in the rural settlements of North-eastern Bulgaria, shows undiscovered to this point increased risk for the spread of toxocariasis among this population.

Toxocariasis in humans is an unknown and underdiagnosed disease with increased risk of distribution determined by the large canine and cat populations. Contamination of the environment with pets faeces containing helminth eggs is the key route of transmission toxocariasis, threatening especially the youngest children. The purpose of this study is preliminary research of the degree of pollution of the environment with Toxocara spp. eggs by examining soil and sand samples from different public places of Varna, Bulgaria. Material and methods: In 2018, 40 soil and sand samples were collected from various locations of Varna city: public park areas, areas for dog-walking, playgrounds, sandboxes and yards with domestic animals. The samples were processed using a modified Romanеnko’s method. Results: Soil analysis showed Toxocara spp. eggs in one sample from a public park area in the central region of Varna. In another soil sample of a private yard with domestic dog typical ova of the Taeniidae family was observed (possibly of E. granulosus). In two other samples, eggs from other canine parasites were discovered. Conclusion: The first research on the environmental contamination with helminthic eggs in Northeastern Bulgaria showed Toxocara spp. eggs in one of the central and most populated areas of Varna city. Furthermore, at least 10% of the tested materials were contaminated with canine excrements that testify for the lack of proper control of domestic and stray animals, which represents a real and imminent danger from zoonotic infection for the public health in the region.