The sensitivity to 12 antibiotics of 125 strains of Streptococcus group B isolated in a maternity home

Sensitivity of 125 strains of group B streptococci isolated from newborns, their mothers and personnel in a maternity home was studied with respect to 12 antibiotics: benzylpenicillin, ampicillin, methicillin, cephalotin, erythromycin, lincomycin, levomycetin (chloramphenicol), oxacillin, tetracycline, streptomycin, gentamicin and ristomycin. The method of serial dilutions in a solid medium was applied. All the strains were sensitive to ristomycin and erythromycin. The predominating number of the strains were sensitive to lincomycin, levomycetin and the beta-lactam antibiotics. Strains resistant or moderately resistant to benzylpenicillin, ampicillin, oxacillin, methicillin and cephalotin were detected. The majority of the strains were resistant to streptomycin, tetracycline and gentamicin. Multiple antibiotic resistance with 2-7 determinants was revealed in 11.2 per cent of the strains. The antibiotic sensitivity of the strains isolated from the newborns, their mothers and the personnel in the maternity home was on the whole similar or insignificantly differed.     

Antibiotic sensitivity of the causative agents of suppurative surgical infection]

Sensitivity of 1492 strains of the causative agents of the surgical purulent infections, i. e. pathogenic Staphylococcus, Proteus, Ps. aeruginosa and E. coli to benzylpenicillin, streptomycin, levomycetin, tetracycline, erythromycin, oleandomycin, monomycin, kanamycin, novobiocin, ampicillin, oxacillin, ceporin, gentamicin and rifampicin was studied. Gentamicin was most active against all the bacterial species tested. The staphylococci were in addition sensitive in a high percentage of the cases to rifampicin, novobiocin, ceporin, monomycin and kanamycin. The isolates of E. coli were in addition sensitive to ceporin, monomycin and kanamycin. Sensitivity of the strains of Ps. aeruginosa and Proteus was low to all of the antibiotics except gentamycin. Most of the strains of the causative agents of the surgical purulent infections were multiresistant to 4 antibiotics. The number of the staphylococcal strains sensitive to benzylpenicillin, streptomycin and levomycetin increased in 1976 as compared to 1975 on the background of a limited use of these antibiotics in clinics.     

Antibiotic sensitivity of the Salmonella isolated from children in Krasnodar]

The results of the comparative study of antibiotic sensitivity of 138 Salmonella strains isolated from children patients in Krasnodar are presented. The isolates belonged to 9 serological types and were classified into 4 serogroups. Salmonella fo group B prevailed. The highest sensitivity was found with respect to neomycin. Strains sensitive to levomycetin and streptomycin were rare. Single strains were sensitive to all antibiotics tested. A tendency to polyresistance in ever increasing numbers of the strains was noted, which should be taken into consideration in treatment of salmonellesis in children with antibacterial drugs.     

Chemotherapy of Campylobacter infections]

A total of 600 patients with suspected alimentary food poisoning were hospitalized. The ++clinico-laboratory findings showed that 27 (4.5 per cent) of them had Campylobacter infection. The cultures of Campylobacter jejuni and Campylobacter coli were isolated from 24 and 3 patients, respectively. The patients underwent complex pathogenetic treatment with oral rehydration saline solutions, symptomatic agents, enzymatic preparations and diet (the basic therapy) supplemented with biological bacterial preparations in less severe cases (8 patients). Antibacterial drugs such as furazolidone (roxytromycin), gentamicin and levomycetin, as well as fluoroquinolones such as ofloxacin and ciprofloxacin were additionally used in the treatment of both the patients with the generalized infection and those with more severe processes of the disease, pronounced diarrhea with blood traces and persisting isolation of Campylobacter (12 patients). The most favourable results in the treatment of more severe patients with Campylobacter infection were obtained with the fluoroquinolones used after inadequately efficient therapy with furazolidone or antibiotics especially in the cases with repeated isolation of campylobacteria.     

Benzylpenicillin efficacy for neutropenic infection prophylaxis in patients with cancer and postcytostatic neutropenia]

Evaluation of benzylpenicillin (penicillin G) effect for infection prophylaxis at the oncological patients with severe postcytostatic neutropenia was performed. All the patients with neutrophils levels lower than 0.5 x 10(9)/L were recommended to use antibiotics for infection prophylaxis. Test-group (n = 40) used ciprofloxacin (0.5 g twice daily, per os) combined with benzylpenicillin (1.0 g four times daily, i/v); control group was treated by ciprofloxacin in the same dose only. Combination with benzylpenicillin resulted in statistically significant reduction of infections frequency among oncological patients.     

Indwelling catheter infection

A “catheter team”, consisting of two hospital assistants specially trained to catheterize male patients, inserted indwelling catheters in 435 men over a two-year period. The infection rate was 33%; in the 200 patients not treated with antimicrobial drugs (study group) the rate was 37%, while in the 235 patients who were so treated (antibacterial group) the infection rate was 29%. Fifty percent of patients not treated were infected after 6.3 days, whereas in patients on antibacterial therapy a 50% infection rate was not reached until 14 days after insertion. Therefore, no antibacterial therapy is necessary if it is anticipated that the catheter will be necessary for less than four days. On the other hand, prophylactic antibacterial therapy would delay the onset of infection considerably if catheterization were expected to continue for more than four days. Sulfisoxazole was our drug of choice for prophylactic treatment.     

血清降钙素原(PCT)检测对于老年心衰抗感染治疗的指导意义分析

目的:探讨血清降钙素原(PCT)对于老年心衰患者抗感染治疗中的指导意义。方法:选取我院于2013年1月-2014年6月间收治的130例老年心衰患者,将其随机分为观察组以及对照组,每组65例,对照组根据患者的病情变化决定是否使用抗菌药物,而观察组根据PCT变化决定是否使用抗菌素治疗。比较2组患者的体温、PCT、WBC、CRP变化情况,治疗效果,住院情况以及抗菌素使用情况。结果:观察组在使用抗菌药物当日的PCT水平明显低于入院时,P0.05,而体温、WBC、CRP水平比较无明显差异,使用抗菌药物3 d后,血清PCT水平相比于使用抗菌素当日明显下降,体温相比于入院时显著下降,P0.05。观察组的二重感染率明显低于对照组,P0.05,观察组的抗菌药物使用疗程、费用以及总住院费用均明显低于对照组,组间比较有明显差异,P0.05。结论:PCT指标应用于老年心衰患者应用抗菌素的指导治疗,能够减少抗菌药物的使用量,降低住院费用,减少住院时间,减少二重感染的发生率。     

Efficacy of penicillin therapy of meningococcal infection in children undergoing different regimes of pathogenetic therapy

The course of meningococcal infection and nonspecific and specific immunity in children subjected to different regimens of pathogenetic therapy were studied. It was shown that the clinico-immunological indices were more favourable in children treated with lasix as a diuretic agent. Recovery with defects was observed in 6.8 per cent of the children of this group, while in patients subjected to routine treatment the respective value amounted to 14.6 per cent. The use of lasix in combination with penicillin increased the efficacy of penicillin therapy and shortened the recovery period by 8.4 +/- 0.2 days as compared to that of routine treatment. No unfavourable effect of elevated penicillin concentrations on the lysozyme activity, blood bactericidal characteristics and composition of immunoglobulins A, M and G in the children was recorded.     

动态监测血清降钙素原水平在优化全身性感染患者抗菌治疗策略中的价值

目的:评估动态监测血清降钙素原水平(PCT)在优化全身性感染患者抗菌治疗策略中的价值。方法:选取2015年4月~2015年12月全身性感染患者85例,随机分为常规组42例和PCT组43例。常规组按照《抗菌药物临床应用指导原则(2015年版)》决定抗生素疗程;PCT组在抗生素治疗后第3、5、7、10、14 d监测血清PCT水平,若PCT0.25 ng/mL停用抗生素、PCT≥0.25 ng/mL继续使用抗生素。分别比较两组患者间一般情况、传统全身炎症性反应指标及抗生素使用的种类、时间、费用以及预后的差异。结果:两组患者间治疗前后传统全身炎症性反应指标无明显差异(P0.05);两组患者间常用的抗生素种类并无明显统计学差异(P0.05);PCT组患者抗生素使用的天数为(9.9±3.9)d,明显少于常规组的(13.9±5.2)d,差异有统计学意义(P0.05);PCT组患者抗生素日均费用为(422.39±139.9)元,明显低于常规组的(514.78±155.2)元,差异有统计学意义(P0.05);两组患者间停用抗生素后14天后全身感染复发率以及28天病死率无明显统计学差异(P0.05)。但PCT组患者总住ICU时间明显少于常规组,差异有统计学意义(P0.05)。结论:动态监测血清PCT水平在优化全身性感染患者抗菌治疗策略中具有重要价值。     

Antibiotics in the treatment of wounds in the victims of the earthquake in the Armenian SSR

Purulent wounds in 88 victims of the Armenian earthquake with the syndrome of long-term squeezing were examined microbiologically and the experience with using antimicrobial drugs for their treatment was analyzed. In all the cases microbial associations were detected, coliform and nonfermenting gram-negative bacilli, enterococci, anaerobes and yeast-like fungi being isolated from 80, 20, 15 and 25 per cent of the patients respectively. 130 bacterial strains were studied in detail. 80 to 100 per cent of the bacterial isolates were resistant to the antibiotics routinely used in surgical practice, i.e. benzylpenicillin, tetracycline, levomycetin, kanamycin, cephalothin and cefazolin and highly sensitive to new antimicrobial drugs belonging to ureidopenicillins (mezlocillin), quinolones (ciprofloxacin) and cephalosporins of the 3rd generation (cefoperazone and ceftazidime). Retrospective estimation of the antibiotic therapy revealed its inadequacy in 55.7 per cent of the patients for the most part because of the isolates resistance. The 19 variants of the antibiotic use prescribed by the physicians mainly included penicillins, aminoglycosides and their combinations (in 67.2 per cent of the cases). The use of the highly efficient drugs of the groups of ureidopenicillins and quinolones was extremely rare which was likely due to lacking of information on the drugs.     

Clinical evaluation of antibiotic therapy of NAG-infection]

It is not concluded yet whether it is expedient to use antibiotic therapy with respect to patients and vibrio-carries with NAG-infection. Observation of a group of patients with acute gastro-intestinal infections caused by NAG-vibrio and carriers of NAG-vibrioes showed that the rate of vibrio isolation after a course of antibiotic therapy (tetracycline, levomycetin) significantly decreased as compared to that in the group of the patients subjected only to symptomatic therapy. The data of the study provided recommendation of antibacterial therapy with respect to patients with NAG-infection especially in cases with accompanying infections or invasions. As for "asymptomic" carriers antibiotic therapy is required only with respect to persons with repeated vibrio isolation.     

Intralymphatic administration of antibiotics in the complex treatment of suppurative complications in patients with neurosurgical pathology

The efficacy of endolymphatic route of gentamicin and ceporin administration was studied in 89 patients with neurosurgical pathological processes complicated by acute pneumonia (80 patients) and meningoencephalitis (9 patients) usually after ineffective antibiotic therapy according to the routine methods. The antibiotics were used in accordance with the antibiograms of the causative agents isolated from the bronchial tree or CSF. The endolymphatic use of gentamicin or ceporin once a day in doses of 80 mg or 1 g respectively provided rapid sanation and arresting of the inflammatory foci, lowering of the intoxication level, more rapid promotion of the positive time course of the clinico-roentgenological and laboratory indices and decreasing of the recovery periods by 1.5-2 times in 86 per cent of the patients with pneumonia. The endolymphatic administration of gentamicin in a dose of 80 mg twice a day or ceporin in a dose of 1 g twice a day allowed one to maintain the antibiotic therapeutic levels in the cerebrospinal fluid and to obtain satisfactory clinical results in the combined treatment of meningoencephalitis. The endolymphatic administration of the drugs was well tolerated by the patients and no adverse reactions were observed. This route of administration of antibiotics and in particular broad spectrum antibiotics may be recommended for urgent antibacterial therapy of especially severe neurosurgical patients with pyo-inflammatory complications and patients who did not respond to the routine antibiotic therapy.     

Early treatment with parenteral penicillin in meningococcal disease.

OBJECTIVE--To measure the effect of parenteral antibiotics given before admission to hospital on mortality and on bacteriological investigations in meningococcal disease. DESIGN--Retrospective review of hospital notes and laboratory and public health medicine department records. SETTING--Three health districts in south west England. SUBJECTS--Patients with meningococcal disease in Gloucester district presenting between 1 January 1982 and 31 December 1991 (n = 190); patients with meningococcal disease in Plymouth (n = 118) and Bath (n = 73) districts presenting between 1 January 1988 and 31 December 1991 (total = 381). MAIN OUTCOME MEASURE--Number of deaths from meningococcal disease. RESULTS--Parenteral antibiotic given by general practitioners was associated with a substantial reduction in mortality (from 9% to 5%; relative risk 0.6, 95% confidence interval 0.2 to 1.5); patients with a rash were more likely to be given parenteral antibiotics, and mortality was further reduced (from 12% to 5%; 0.5, 0.2 to 1.4). In a district where such treatment was regularly encouraged its use increased from 5% to 40% of cases over 10 years (p = 0.00001). Treatment with parenteral antibiotics before admission made isolation of meningococci from blood and cerebrospinal fluid less likely but did not affect nasopharyngeal cultures. CONCLUSIONS--General practitioners should carry benzylpenicillin in their emergency bags at all times and should administer it promptly, preferably intravenously, whenever meningococcal disease is suspected, unless the patient has had an anaphylactic reaction to penicillin. Specimens for culture should include a nasopharyngeal swab.     

Study of the combined action of an antibiotic and an immunostimulator using mathematical modeling

A mathematical model of antibiotic and immunostimulator (IMS) combined effect on various elements of the immune system and general state of patients with infectious diseases is described. The model was constructed as a system including 6 usual differential equations of the 1st order. With the use of this model and a computer many diverse variants of infection development under conditions of treatment with IMS at the background of antibiotic therapy were modeled. Ii was shown that IMS-antibiotic complexes markedly improved the indices of antibiotic therapy as compared to the use of the antibiotics alone. In combined use of IMS and antibiotics it was possible to lower the antibiotic doses without lowering the antimicrobial effect. The use of IMS at the optimal period led to balanced activation of the host specific and nonspecific resistance factors at the background of antibacterial therapy. The results of the mathematical modeling corresponded to the data on protective effect of salmozan (IMS) and doxycycline (antibiotic) combination in animals (albino mice). It was concluded that the described mathematical model was adequate for validation and optimization of schemes for combined use of IMS and antibacterial agents.     

Effect of antibiotics on the resistance of white mice to C1. perfringens toxin]

The effect of potassium benzylpenicillin, streptomycin sulfate and chlortetracycline on experimental gangrenous intoxication was studied. When the antibiotics were injected before intoxication, the albino mice resistance did not significantly change. When the antibiotics were injected immediately after the toxin administration, the resistance of the test animals markedly decreased.     

Sensitivity of Sherman's propionic acid bacilli to antibacterial preparations and vitamin B12 synthesis

Sherman propionic acid bacilli were sensitive to benzylpenicillin, ampicillin, ceporin, tetracyclines, oleandomycin, oletetrin, tetraolean, sigmamycin, levomycetin and furadonine. Methicillin, oxacillin, monomycin, kanamycin, polymyxin and furazolidone had an insignificant effect on the above organism. The subbacteriostatic concentrations of methicillin, oxacillin, streptomycin, monomycin, kanamycin, neomycin, tetraolean, sigmamycin, polymyxin M and ristomycin increased the biosynthesis of vitamin B12 by Sherman propionic acid bacilli, while benzylpenicillin, ampicillin, tetracyclines, oleandomycin, oletetrin, levomycetin and furadonine in the subbacteriostatic concentrations inhibited this process.     

Antibiotic resistance dynamics of plasma-coagulating staphylococci isolated from patients in 1970-1975]

Resistance of 2345 strains of plasmocoagulating staphylococci isolated from purulent inflammatory foci of surgical patients was studied with respect to the widely used antibiotics by the method of standard paper discs in 1970--1975. It was noted that the cultures resistant to erythromycin and monomycin were more frequent, i.e. from 24.2 +/- 2.5 to 51.4 +/- 3.4 per cent and from 1.0 +/- 0.6 to 28.0 +/- 2.1 per cent respectively, p less than 0.001 in both cases, while the percentage of the strains resistant to benzylpenicillin and tetracycline steadily increased, i.e. from 69.9 +/- 2.4 to 47.0 +/- 2.3 per cent and from 72.8 +/- 2.4 to 28.4 +/- 2.1 per cent respectively, p less than 0.001 in both cases. The number of the resistant cultures to streptomycin and levomycetin slightly changed and was relatively high (about 50 per cent and more). Direct correlation (mean and pronounced) between the amount of levomycetin, tetracycline, erythromycin or monomycin used per citizen of Minsk and the frequency of the strains isolated from the patients to these drugs was noted.     

Effect of antibiotics on the resistance of white mice to infection caused by antibiotic-resistant Staphylococcus strains]

The effect of benzylpenicillin, streptomycin and tetracycline on the animal resistance to infection caused by the antibiotic resistant staphylococci was studied. It was found that the effect of the antibiotics on the infectious process outcome was not limited by their antibacterial properties. Changes in the natural resistance of the host under the effect of the antibiotics were not always the same and depended on both the antibiotic type and the moment of its administration.     

Sensitivity of bifidobacteria to antibacterial drugs

Twenty one strains of bifidobacteria belonging to various species were studied with respect to their sensitivity to antibacterial drugs most widely used in medical practice. The strains were isolated from practically healthy persons and from persons in contact with antibiotics in their production. It was found that sensitivity of the strains was the highest with respect to penicillins and tetracyclines. With respect to kanamycin, monomycin and levomycetin the strains were resistant. Strain differences in resistance to separate antibacterial drugs were observed. Increased streptomycin and tetracycline resistance of the strains isolated from the persons being for a prolonged period in contact with these antibiotics in their production, was stated.     

Side effects of antibiotics in patients with thermal burns]

The possibilities of antibacterial therapy in the clinics of burn diseases has at present decreased because of increasing microflora resistance to antibiotics. This phenomenon is one of the most often causes of antibacterial drug side effects in burn patients. For control of infections complications in burn patients which are most often lethal it is necessary to use biologically active subtance, such as prodigiozan and lysozime in addition to the directed antibiotic therapy. The use of specific antitoxic antistaphylococcal drugs, such as antistaphylococcal plasma and antistaphylococcal gamma-globulin in combination with the antibiotics of the direct action provided effective control of infectious complications and sepsis of staphylococcal genesis in burn patients. Decamine proved to be effective along with the usual use of nystatin in cases with dysbacteriosis as a result of the antibiotic side effects. In the patients treated with decamine the sings of candidosis disappeared by the 5th--7th day. Therefore, for decreasing the side effects of antibiotics in the clinics of burn patients it is expedient to use antibiotics in combination with the biologically active and immune preparations which increases the efficacy of antibiotic therapy, impfoves the treatment results and decreases the antibiotic side effects.