Microflora of patients with purulent septic diseases in the Moscow region

The microflora of clinical material (blood, wound discharge, abdominal exudate, pleural exudate, milk in mastitis, as well as feces in dysbiosis of the large intestine), obtained from patients with purulent septic diseases in the Moscow region was studied. The study revealed the change of microflora from surface biotopes to closed cavities of the body. Gram-positive cocci, primarily coagulase-negative staphylococci, mainly epidermal, were shown to play the leading etiological role in the development of purulent septic diseases. The development of bacteriemia was found to be caused by the penetration of staphylococci from local pyoinflammatory foci (appearing in purulent mastitis, wounds, peritonitis, pleural empyema and pleuritis), as well as by the translocation of staphylococci and Escherichia coli from the large intestine in dysbiosis.     

Changes in the structure and antibiotic sensitivity of the wound microflora in suppurative surgical infection of the soft tissues

The results of the study on the composition, properties and antibiotic sensitivity of pathogenic microbes isolated from purulent wounds of the soft tissues of patients treated in the Institute clinic in 1977-1980 are presented. The frequency of secondary infection of the purulent wounds was estimated. During this period the percentage of gram-negative bacteria isolated from opened purulent foci increased. In some cases investigation of the time course of the purulent processes revealed new microbial strains, such as pathogenic staphylococci or opportunistic gram-negative bacteria. Sometimes replacement of the causative agent by new organisms was observed. The new strains were high- and multiple-resistant to the antibiotics.     

Antioxidant therapy of purulent wounds in animal experiments

A new complex method for treating purulent wounds has been elaborated in the experiment on 22 mature chinchilla rabbits with a simulated abscess. It has been established that a combined use of a 2% alcohol solution of ionol, a 10% aqueous solution of urotropin for irrigation of the wound cavity and a single administration of nialamide cuts down the time two-fold for cleaning wounds and development of granulations and by 40% for the wound complete healing.     

Experimental study of photodynamic effect on bacterial wound microflora

The in vitro study of the influence of photodynamic action (with the use of photosensitizer "Photosens", laser and non-laser irradiation) on the strains of the main representatives purulent wound microflora was carried out. Staphylococcus aureus, S. epidermidis, Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis cultures have been isolated from wound secretions and identified. The photosensitizer was shown to produce no bactericidal effect by itself. Irradiation with laser and non-laser light sources induced a sharp decrease in the number of viable cells in the cultures under study. The irradiation of the photosensitizer led to its activation, manifested in bactericidal action. The results thus obtained confirm good prospect of using photodynamic therapy for the treatment of purulent wounds.     

The clinical laboratory assessment of vancomycin (Edicin) efficacy in treating suppurative wounds of the skin and soft tissues, burn wounds and the infectious complications of burns]

Clinical and bacteriological efficacies of vancomycin (Edicin, LEK) in the treatment of 17 patients with wound infection and 13 patients with thermal affections were studied. The clinical efficacy in the group of the patients with purulent wounds of the soft tissues amounted to 94.1 per cent and that in the patients with thermal affections was 92.3 per cent. The bacteriological effect was recorded in 86.6 per cent of the patients with purulent wounds of the soft tissues and in 69.3 per cent of the patients with burn infections. The drug intolerability was observed in two cases.     

Use of pefloxacin in the treatment of patients with purulent wounds of soft tissues]

Pefloxacin was used in the treatment of 25 patients with wound infection in a dose of 400 mg orally twice a day for 10-12 days. As the monotherapy it was applied to 15 patients. 7 patients with clinical signs of non-clostridial anaerobic infection were treated with pefloxacin in combination with intravenous metronidazole. Pefloxacin was highly efficient in 96 per cent of the cases with extensive posttraumatic purulent wounds with and without bone affection, acute purulent wounds of the soft tissue, purulent wounds of the soft tissues in diabetic patients, trophic or decubitus ulcer. 266 clinical isolates of Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus mirabilis, Enterobacter spp. and Acinetobacter spp, were tested and 75 to 100 per cent of them was shown to be susceptible to pefloxacin and ciprofloxacin. At the same time the isolates of Pseudomonas aeruginosa and Klebsiella spp. were more susceptible to ciprofloxacin. The pathogen eradication and eradication with superinfection in the cases treated with pefloxacin amounted to 92 per cent. The drug tolerance was good. No clinically significant adverse events were recorded.     

Immunoreactive systems in the healing of aseptic and infected wounds in an experiment

Main parameters of systemic immune reactivity were studied in 240 mature Wistar male rats with simulated aseptic and infected surface wounds before surgical intervention, and 1-10, 12 and 15 days after it. It was stated that aseptic wounds were responsible for nonspecific systemic response to the stress, whereas the presence of bacterial flora in the wound inhibited the development of humoral immune response in the presence of T-cell activation thus causing the dysfunction of the immune system and therefore affecting the course of wound progress. The consideration of all factors mentioned permits averting wound purulent complications in postsurgical period.     

Optimal control of the microflora environment in suppurative foci

The informative capacity of various statistic parameters characterizing the ecology of pathogens of purulent processes was studied. Many-years' results of the routine bacteriological tests of the materials from purulent wounds in patients from surgical, traumatological and burn departments served as the study subjects. The frequency, persistence and contamination capacity of the pathogens were investigated. Data on the changes in the frequency parameter with respect to the main pathogens of wound infections in various contingents of patients were collected. In relation to the observation period and contingent of the patients, various microorganisms were found to be permanent, supplementary and casual. The use of the ecological parameters was shown to provide integrated information on the etiological role of the pathogens in the development of purulent processes. The information characterized the microbial properties which should be considered in planning the use of antibacterial drugs and estimating the efficacy of the epidemiological control.     

Preparation of lysozyme immobilized on textile carriers and its use in treating suppurative wounds

Immobilized forms of lysozyme were prepared by its covalent binding on dialdehyde cellulose and polycaproamide fibres as woven and knitted fabrics respectively. The preparations were estimated by the content of protein and bacteriolytic activity. The lysozyme activity per 1 g of the carrier and the protein content on dialdehyde cellulose were several times higher than those on polycaproamide while the specific activity of lysozyme on the polycaproamide carrier was somewhat higher than that on dialdehyde cellulose. The effect of the immobilized lysozyme in treatment of purulent wounds was studied on albino rats. It was shown that the periods of the wound healing with the use of the immobilized lysozyme were shorter than those with the use of native lysozyme. Cytological and morphological investigation of the wound wall confirmed the higher efficacy of the lysozyme immobilized forms in treatment of purulent wounds as compared to the use of the native enzyme.     

Laboratory and clinical study of nitazole]

Nitazole, a drug from the nitrotiazole group, was shown to be active in vitro against bacteroides, peptococci, peptostreptococci, clostridia, staphylococci, colibacilli and streptococci. By its activity and antibacterial spectrum nitazole had some advantages over metronidazole, a drug from the nitroimidazole group. Experimental study of nitazole aerosole formulation in 4 models of purulent wounds of rabbits infected by Bacteroides fragilis, B. melaninogenicus, Clostridium perfringens 27 and Staphylococcus aureus 209P revealed its high therapeutic efficacy. In the treatment of 37 patients with purulent wounds of the soft tissues including 12 cases isolating anaerobic microbes, the clinical process of the acute suppuration in all the patients at the average reduced to the 5th-7th day. By the data of the bacteriological and cytological examinations the wound surface was ready for putting in stitches or free perforated cutaneous graft by the 10th-12th day. The drug tolerance was good. No adverse reaction were observed under the nitazole dressing in any case during the treatment of the wounds.     

Clinico-laboratory effectiveness of modern ointments with a polyethylene glycol base in the treatment of purulent wounds]

The 25-year experience with the underbandage treatment of soft tissue purulent wounds of various location and genesis with modern ointments with polyethylene glycol as the basis was analyzed. Levocin, levomecole, dioxycole, 5-percent dioxydinic, 1-percent iodopyronic, 0.5-percent quinifuryl and furagel ointments proved to preserve their high activity against aerobic grampositive and gramnegative flora. 10-percent mafenide acetate ointment had a high selective effect on Pseudomonas aeruginosa. The new ointments nitacid and streptonitole containing nitazole and white streptocide were highly active against both aerobic and anaerobic infections. The use of the ointments with the polyethylene glycol as the basis made it possible to decrease 2 times the period of the patient hospitalization in surgical units and to shorten the terms of the systemic antibacterial therapy. The marked therapeutic effect of such ointments due to their high dehydrating capacity and broad antibacterial spectrum enabled to consider them as the drugs of choice in the local treatment of purulent wounds during the 1st phase of the wound process, trophic and decubic ulcers, infected burns, diabetic and atherosclerotic gangrene, furuncles, carbuncles, mastitis, etc. The ointments in the water soluble vehicle can be as well used with success for the prophylactic treatment of infected wounds after the suture. The multitarget effect of the ointments in the water soluble vehicle and their ability to prevent severe purulent complications permitted to consider them as the 1st order drugs in cases of emergency.     

The significance of tuber damage and inoculum concentration of Phoma exigua var. foveata in the development of gangrene in stored potato tubers

The susceptibility to gangrene infection of wounds of various shapes and depths on potato tubers was studied by inflicting wounds using differently-shaped brass teeth and rods of different diameters. Inoculating wounds with spore suspensions or damaging tubers which had been previously contaminated with Phoma exigua var. foveata or which had been recently lifted from plots of field experiments showed that wounds in which tissue was crushed were most susceptible to infection. Over a wide range of inoculum concentrations and in experiments using several different cultivars the incidence of infection of any wound type was compared to that of the standard severe cut and crush wound. Using a probit transformation a linear relationship was established, the slope of the line indicating the relative susceptibility of the wound. In 1977 and 1978, crops of cv. Pentland Dell were surveyed for damage incidence, inoculum and inoculum potential on arrival at a commercial bulk store. Nets of tubers buried among the tuber bulk were recovered after storage and gangrene incidence compared with damage and inoculum assessments. Inoculum potential and incidence of severe damage both influenced disease development but damage incidence was of greater importance, showing that priority should be given to decreasing damage and to curing to promote rapid wound healing in endeavours to control the disease.     

清得佳凝胶治疗烧伤创面的生物学作用

目的探讨清得佳凝胶治疗烧伤创面的效果及其意义。方法采用家兔皮肤创伤模型,将每只家兔的背部烧伤区域用2种不同颜色的记号笔分成二组:A组(n=9):为实验组(6个部位):常规方法清洁、消毒创口,使用清得佳凝胶涂抹;B组(n=9):为对照组(6个部位):使用常规的无菌敷料覆盖包扎创口。实验于第3、5、7、9天分别取各组皮肤组织进行切片,作组织病理学及免疫组织化学观察。结果1.HE观察结果:烧伤后第3天,A组与B组皮肤烧伤创面结构变化不明显;烧伤后第5天,A组表皮细胞变性坏死程度减轻,成纤维细胞增生,水肿减轻,而B组表皮细胞变性坏死减轻程度不明显,结缔组织胶原纤维变性坏死程度没有得到明显的改善;烧伤后第7天,A组表皮细胞生长良好,真皮组织水肿基本消失;而B组表皮细胞变性坏死程度开始出现减轻,可见部分上皮增生;烧伤后第9天,A组上皮及结缔组织结构基本接近正常,创面愈合情况较好。而B组以上结构出现改变,但愈合状况不是很理想,真皮组织轻、中度水肿,有少量的炎性细胞浸润。2.转化生长因子β1(transforming growth factor β1,TGF-β1)的表达:烧伤后第3天和第5天,A组成纤维细胞胞浆中可见一些棕黄色颗粒,TGF-β1表达较强;B组成纤维细胞胞浆中未见或少见棕黄色颗粒,TGF-β1无表达或表达很弱。烧伤后第7天和第9天,A组成纤维细胞胞浆中可见密集分布的棕黄色颗粒,TGF-β1表达强;B组成纤维细胞胞浆中可见少量的棕黄色颗粒,TGF-β1表达弱。结论清得佳凝胶是一种烧伤创面良好的外用药,能清除创面坏死组织,有利于烧伤创面愈合。     

Effectiveness of gentamicin sulfate in suppurative-inflammatory processes of varying localization]

Antibiotic sensitivity of 486 strains of grampositive and gramnegative organisms isolated from patients with purulent infections was studied in vitro. Gentamicin was shown to be highly active as compared to kanamycin and other antibiotics against the main causative agents of purulent inflammatory infections including multiresistant E. coli, Proteus, Ps. aeruginosa, Staphylococcus. High efficiency of gentamicin in therapy of peritonitis, septic conditions, purulent postoperative wounds, infections of the urinary tract, pneumonia, etc. (197 patients) was shown. Positive results were obtained in 87.4 per cent of the cases. Side effects, such as albuminuria, hyperthermic reaction, rash, pruritis were registered in 3 per cent of the patients.     

Different products for biological control of Botrytis cinerea examined on wounded stem tissue of tomato plants

For the moment the agents that are used against Botrytis cinerea, in glasshouses were tomatoes are cultivated, are from chemical origin. For reducing the use of chemical agents in the future it is important to search for effective biological control agents against the fight of Botrytis cinerae. The following biological products Vital pasta, Vital gel and Elot-Vis were examined in there possibility to control Botrytis cinerea. Elot Vis was tested out in experiments that were carried out in climate chambers were leafs of 3 week old tomato plants were artificially infected with Botrytis cinerea spores. Also the biological products of Vital were first investigated in experiments that were carried out in climate chambers. In stead off leafs of tomato plants it were stem wounds of tomato plants who were treated with the pasta or the gel that was spread over the wounded surface after this has been inoculated with a suspension of conidia of Botrytis cinerae. The results of these first tests that were executed in the climate chambers were the circumstances for Botrytis cinerea were ideal seemed promising. In the next step these products were tested out on large scale in glasshouses. For each plant 5 wounds were created by removing the leafs, these wounds were or first treated with the Biological product and thereafter artificially infected with Botrytis cinerea spores to check out if these products can be used as a preventive agent or the wounds were first inoculated with a suspension of Botrytis cinerea spores and thereafter treated with the product. For the product Elot-Vis a few plants were totally sprayed with an Elot-Vis suspension before leafs were removed and the wounds were inoculated with conidia of Botrytis cinerea to check out if this product was able to activated the induced systemic resistance pathway. The experiments that were executed in glasshouses showed different percentages of succeeded Botrytis cinerea infections. This is probable due to the different weather conditions during both days that the experiments were executed. For the wounds that were treated with pasta it was difficult to distinguish wounds were Botrytis cinerea succeeded to infect the plant, because these wounds frequently didn't show any sign of infection on the surface but when the wounds with the pasta were cut open it was possible to see Botrytis cinerea infections inside the stem.     

Promotion of wound healing using adipose-derived stem cells in radiation ulcer of a rat model

Background

Wound healing is a complex biologic process that involves the integration of inflammation, mitosis, angiogenesis, synthesis, and remodeling of the extracellular matrix. However, some wounds fail to heal properly and become chronic. Although some simulated chronic wound models have been established, an efficient approach to treat chronic wounds in animal models has not been determined. The aim of this study was to develop a modified rat model simulating the chronic wounds caused by clinical radiation ulcers and examine the treatment of chronic wounds with adipose-derived stem cells.

Results

Sprague–Dawley rats were irradiated with an electron beam, and wounds were created. The rats received treatment with adipose-derived stem cells (ASCs), and a wound-healing assay was performed. The wound sizes after ASC treatment for 3 weeks were significantly smaller compared with the control condition (p < 0.01). Histological observations of the wound edge and immunoblot analysis of the re-epithelialization region both indicated that the treatment with ASCs was associated with the development of new blood vessels. Cell-tracking experiments showed that ASCs were colocalized with endothelial cell markers in ulcerated tissues.

Conclusions

We established a modified rat model of radiation-induced wounds and demonstrated that ASCs accelerate wound-healing.     

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.     

Antibacterial treatment of infectious-toxic shock

The studies enabled one to identify six leading clinicophysiological syndromes developing in patients with infective toxic shock (ITS). They include signs of purulent inflammatory processes, organ disorders and systems disturbances. Despite the clinical picture polymorphism, ITS has a clearly defined stage-by-stage process which makes it possible to determine hyperdynamic and hypodynamic phases of the pathological process within each stage. An absolute condition for antimicrobial drugs includes the following: drainage of the purulent inflammatory focus, arresting of pathogen discharge into the blood flow, recovery of host impaired functions and their maintenance. It was shown that a wrong choice of the drugs and antibacterial therapy regimens resulted in a 2-fold increase in fatal cases with ITS. Disorders in systemic and organ blood flows and microcirculation and coagulation disturbances played a particular role in decreasing antibacterial therapy efficacy. Further ways for optimizing antibacterial therapy are mainly connected with availability of efficient antibacterial drugs for practitioners and introduction of microbiological and pharmacokinetic monitoring of antibacterial therapy providing conditions for their rational and safe use.     

The possibility of using the data on the content of volatile fatty acids for the indirect demonstration of the causative agents of suppurative-inflammatory diseases in the pathological material

The use of the quantitative content of volatile fatty acids as marker for the indication of the causative agents of pyo-inflammatory diseases in material taken from wounds is proposed. Thus, in 71% of cases the detection of acetic acid in a purulent wound coincided with the bacteriological isolation of monocultures, as well as associations, of facultative anaerobic bacteria. The analysis of isobutyric, butyric, isovaleric, valeric and acetic acids permitted the rapid detection of associations of obligate and facultative anaerobic bacteria in an individual patient. Changes in the quantitative content of volatile fatty acids in pathological material integrally reflected the dynamics of the causative agents of purulent infections and the effectiveness of the prescribed therapy.     

Preparation of porous material based on alginic acid, containing immobilized terrilytin

A comparative study was conducted on immobilization of terrilytin on alginic acid by attaching the enzyme by ionic or covalent bonds and possible use of such compounds in preparing porous coatings for wound treatment. It was shown possible to prepare a coating with the enzyme activity after radiation sterilization equal to 80-85 per cent of the initial level. Medico-biological investigations proved that the use of the coating in treatment of purulent wounds was efficient.