Etiology of acute suppurative destructive pneumonias in children]

Clinical, immunological and bacteriological studies were carried out in 63 children with the so-called staphylococcus destruction of the lungs. It was shown that in some of the cases destructive process in the lungs, along with the pathogenic staphylococcus, could be caused by the Gram negative bacteria (Proteus, Bac. pyocyaneus, etc.). It was found that in children of different age groups the titre of antistaphylococcus antibodies up to 0.5 AU/ml was normal and pointed to the absence of any inflammatory disease of staphylococcus etiology; a titre of 2 AU/ml - and overcould be considered as diagnostic. In connection with bacterial poly-etiology of acute destruction of the lungs in children it is suggested that it should be designated as "acute purulent destructive pneumonia". The importance of immuno-bacteriological studies in children with diseases with the mentioned pathology is emphasized; these examinations permit to choose proper complex therapy.     

Efficient use of gentamycin in treating suppurative puerperal mastitis]

A total of 80 patients with postnatal purulent mastitis were treated with gentamicins. The main causative agent was Staph. aureus resistant to the traditionally used antibiotic and sensitive to gentamicin, fusidin, rifampicin and semisynthetic penicillinase-stable penicillins. Gramnegative bacteria contaminated the purulent foci after opening. Gentamicin was highly effective in treatment of postnatal purulent mastitis in cases with mixed Staphylococcus-Proteus infection.     

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.     

An epidemiological analysis of postoperative suppurative pathology in surgical hospitals]

Approaches to the epidemiological analysis of postoperative wound complications in surgical hospitals are summarized. The indices for the evaluation of the epidemic situation in surgical departments (the ratio of severe and mild forms of complications, severe and posthospital complications) are proposed. To determine the site of infection, the method of graphic analysis, involving the fixation of dates of the operation and the appearance of the complication and taking into account regularities in the development of the outbreak, the depth and severity of the lesion, is proposed. Epidemiological surveillance at medical institutions permits the prognostication of the epidemiological situation. The realization of epidemiological surveillance at the level of individual medical institutions is the prerequisite of effective functioning of the program of epidemiological surveillance at a given territory.     

Clinical effectiveness of carbenicillin in suppurative inflammatory processes of varying localization]

The study on sensitivity of clinical strains of the causative agents of purulent infections to carbenicillin showed that 34.6% of the staphylococcal strains, 48.1% of the E. coli strains and 40.3% of the Proteus strains were sensitive to the antibiotic. The strains of Ps. aeruginosa were characterized by moderate sensitivity to carbenicillin. The MTC for most of the isolates ranged within 25-128 microgram/ml. High therapeutic efficacy of carbenicillin in treatment of cases with purulent inflammatory processes of various localization was shown. Positive results were obtained in 82.5% of the adults and 76.2% of the premature infants treated with carbenicillin. A satisfactory therapeutic effect was observed in the cases with sepsis, diffuse purulent peritonitis and abscessing pneumonia treated with carbenicillin in combination with gentamicin.     

Gentacycol--a delayed-action form of gentamicin in the treatment of suppurative infection]

Efficacy of gentacycol was studied in the treatment of various purulent infections. It was used in therapy of hematogenic and traumatic osteomyelitis, wound infections, soft tissue abscesses, purulent diffuse peritonitis as a complication of comissural ileus or appendectomy, pyothorax, destructive pneumonia and mediastinitis. Gentacycol ++ was also used for the prophylaxis in cholecystectomy, herniotomy and other conditions. The favourable results were stated in 93 per cent of the cases.     

Variability of the microfloral makeup of the pathological focus in suppurative infection]

During the period of hospital treatment a change in the composition of would microflora in 145 patients was found to occur, which affected the characteristics of microflora in respect of species, types and strains. This change consisted in the appearance of new (secondary) species, variants and strains and in the disappearance of some original (primary) ones. The populations of staphylococci were found to vary in the level and spectrum of their resistance to antibiotics (resistovars) and in the degree and spectrum of their sensitivity to staphylococcal typing phages (phagovars). Changes in the populations of staphylococci were caused mainly by the cange of S. aureus or by the additional appearance of their new variants which belonged, as a rule, to phage group II, had multiple resistance to antibiotics and corresponded to the phagovars of the hospital flora. The development of hospital variants in open wounds led to an increased general level of resistance of staphylococcal populations to antibiotics.     

Structure of the microflora of suppurative wounds and its sensitivity to antibiotics]

Clinico-bacteriological examination of patients with purulent infections showed that Staphylococcus was the predominating microflora in the wounds. Simultaneously an increasing role of gram-negative conditionally pathogenic bacteria was shown. Multiple drug resistance was found in the organisms tested. The highest sensitivity levels were observed to gentamicin, kanamycin, tetracycline, levomycetin. It was shown by means of special typing methods that staphylococci of phage group III and Ps. Aeruginosa of serotype II predominated in the infected wounds. When the pathological material contained the antibiotic resistant cultures of Ps. aeruginosa, Proteus, Klebsiella and toxigenic strains of Staphylococcus, a tendency for prolongation of the suppurative process was observed.     

Prevention and treatment with cefoperazone of postoperative suppurative complications in heart surgery]

Clinical trials of cefoperazone (cefobid, Pfizer, USA) were carried out in 49 patients with cardiovascular diseases who had undergone surgical operations. The pathogens of infectious complications were investigated bacteriologically. Good results of the treatment were observed in 43 patients. Allergic reaction developed in 1 patient. Cefoperazone was shown advantageous in treatment of pulmonary complications in the operated patients. It was found possible to use cefoperazone in combination with aminoglycosides. Cefoperazone was found to be one of the drugs of choice in the treatment of aerobic and anaerobic bacteriemia, as well as sepsis after surgical operations on the heart and great vessels. The results on the use of cefoperazone for short-term "perioperative" prophylaxis in cardiosurgery (in accordance with the WHO instructions) are also presented.     

Characteristics of the agents of acute suppurative destruction of the lungs in children]

The authors carried out bacteriological studies of the blood, the pleural cavity puncture material, the discharge from the bronchi in bronchoscopy, and also of smears from the nasopharynx of 40 children with acute purulent destruction of the lungs. Staphylococci, often in association with various Gram-negative bacilli, chiefly of the Pseudomonas genus, and Enterobacteriaceae family, prevailed in the cultures of the pathological material. Pathogenic staphylococcus was found in the nasopharynx of patients in 65% of cases. Along with staphylococci in over half of the patients there were revealed Gram-negative bacteria, and yeast-like Candida fungi. In the majority of patients the microbes isolated from the pharynx and the lungs were identical. In these cases bacteriological examination of pharyngeal smears can serve as an auxiliary method of laboratory diagnosis. The isolated straphylococcus strains possessed the majority of the pathogenicity signs; in the great majority of cases they were resistant to the antibiotics the most widely used in the therapeutic practice; among them strains of phage types 80, 54, 75, 77, and 81 prevailed. Thus, at different periods of the disease various types of the microbes prevailed in the materials obtained from the patients. In acute purulent destruction of the lungs bacteriological examination should be carried in dynamics.     

Antibacterial activity of rifampicin against the causative agents of suppurative, septic diseases]

The antibacterial activity of rifampicin was studied in comparison with other antibiotics with respect to clinical strains isolated from cases with various purulent inflammatory processes caused by Staphylococcus, E. coli, Ps. aeruginose, Proteus. The aim of the study was to define the role of rifampicin in the treatment of the above infections. No rifampicin resistant strains were found among staphylococci belonging to the phenotype carrying the determinants of resistance to 2-8 antibiotics. Rifampicin was less active against gramnegative organisms. High heterogeneity of the microbial population of rifampicin was shown with respect to all microbial strains tested. The rate of the spontaneous mutants was high. The average rate of the mutants was 1-7.7-10-8. The studies on the dynamics of the rifampicin resistance increase in the strains of Staphylococci, E. Coli, Ps. aeruginosa and Proteus showed that the resistance increased after 1-2 passages, which means that one-stage mutation was characteristic rifampicin.     

Macrolide antibiotics for oral intake in the treatment and prevention of suppurative surgical infection]

The authors studied the clinical efficacy of antibiotics of the macrolides group--erythromycin, oleandomycin, triacetylalleandomycin and leukomycin--in complex treatment of 280 patients with suppurative surgical infection caused by a gram-positive, mainly staphylococcal, microbial flora. Various medicinal forms were used: tablets, capsules, granules, syrup. Efficacy of treatment comprised 70-78 per cent. Tolerance of antibiotics was good in the majority of patients.