Correction of intestinal dysbacteriosis in elderly patients with the use of bifidobacterin introduced by different routes

The results of the correction of disturbances in intestinal microflora in elderly patients with the use of bifidumbacterin in the form of powder or suppositories are presented. The effectiveness of the rectal administration of bifidumbacterin (by microinjections through an enema or in suppositories) is shown in comparison with the oral administration of the preparation. The administration of bifidumbacterin in suppositories for 15 days resulted in decreased content of hemolytic Escherichia below the threshold of determination in all examined patients.     

Immunoglobulin efficacy for intravenous administration in the therapy of newborn infants with a suppurative infection

The data on the results of clinico-immunological examination of 46 infants having purulent inflammatory infections in the first month of their life and treated with (a) immunoglobulin for intravenous injection, (b) with hyperimmune antistaphylococcal plasma and immunoglobulin for intravenous injection and (c) without the use of specific hyperimmune preparations are presented. The clinico-laboratory data thus obtained (the levels of serum immunoglobulins and the content of T-rosette-forming lymphocytes) are indicative of the expediency of including the intravenous injection of donor immunoglobulin into the complex therapy of newborn infants with severe and moderate forms of purulent inflammatory infections at an early period of the disease irrespective of its etiology.     

Therapeutic form of doxycycline hydrochloride for intravenous administration in the treatment of suppurative-septic diseases]

Efficacy of doxycycline hydrochloride administered intravenously was studied in treatment of severe purulent inflammatory diseases such as pneumonia, lung abscesses, pyothorax, skin and soft tissue infections, peritonitis, purulent cholangitis, etc.. Doxycycline showed significant advantages over tetracyclines: prolonged action, higher efficacy and good tolerance. Favourable results were observed in 85 per cent of the cases.     

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.     

Immunobiological properties and therapeutic effectiveness of preparations from Klebsiella bacteriophages]

The purified preparations of Klebsiella bacteriophages, viz. the monovalent preparation of K. pneumoniae bacteriophage and the polyvalent bacteriophage preparation for the treatment of infections caused by K. ozaenae, K. rhinoscleromatis scleromatis and K. pneumoniae sensu lato, have been obtained. The bacteriophage preparations have proved to be nontoxic and safe for laboratory animals after the intraperitoneal injection of these preparations followed by the pathomorphological study of the internal organs of the animals. The clinical study of the newly developed bacteriophage preparations in the course of the treatment of purulent inflammatory diseases in 109 patients has revealed that the preparations are not reactogenic and exhibit sufficient effectiveness in the therapy of ozena, rhinoscleroma and Klebsiella infections with different localization of the infectious process.     

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.     

Resistance of hospital Staphylococci to beta-lactam antibiotics]

Resistance of hospital Staphylococci to beta-lactam antibiotics was studied. The strains were isolated in two obstetric hospitals during an outbreak of purulent inflammatory infections in them. A modification of the "clover leaf" procedure providing elucidation of the resistance mechanism was used in the study. Development of the resistance to the beta-lactam antibiotics was shown to be mainly due the activity of beta-lactamases which makes it possible to discuss their role in the mechanism of resistance development.     

The detection of a choleriform thermolabile enterotoxin in clinical strains of Proteus isolated in different infections

The capacity of Proteus strains, isolated from patients with purulent inflammatory, urological and enteric infections, for the production of choleriform thermolabile enterotoxin was studied by means of the enzyme immunoassay (EIA) with the use of antitoxic serum to Escherichia coli enterotoxin. Out of 125 strains, 27 (21.6%) showed the capacity for producing choleriform thermolabile enterotoxin in EIA experiments. The results thus obtained indicate that EIA techniques can be used, in principle, for detecting the capacity of Proteus for the production of choleriform thermolabile enterotoxin.     

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.     

Use of cefoperazone in clinical practice]

The bacteriological and clinical efficacy and side effects of cefoperazone were studied in 45 patients with severe and moderate purulent inflammatory diseases. The study showed that its bacteriological and clinical efficacy was high in cases with peritonitis, cholecystitis, respiratory and urinary infections, as well as those of the eye and soft tissues. The general clinical efficacy amounted to 95.6 per cent. The number of the side effects was insignificant. This made it possible to recommend the use of cefoperazone in the therapy of many purulent inflammatory diseases, as well as in empirical therapy.     

Pseudomonas aeruginosa and Proteus antigenemia and antibody formation in mono- and mixed infections in patients with suppurative inflammatory diseases

P. aeruginosa and Proteus antigenemia and antibody production have been studied in 335 patients with purulent inflammatory diseases. The study has revealed that in the association of P. aeruginosa and Proteus with staphylococci and representatives of the family Enterobacteriaceae the level of antigenemia is considerably lower than in monoinfections or in the association of these microorganisms with streptococci. In mixed infections humoral immune response develops later than in cases of monoinfection. An important role of ecological and physiological relationships between microorganisms in the course of purulent processes and in their influence on the host has been confirmed. The use of the enzyme immunoassay in the clinical practice has made it possible to determine the etiological role of P. aeruginosa and Proteus in the development of suppurative-inflammatory diseases, to select adequate immunotherapy, including the use of anti-P. aeruginosa and anti-Proteus plasmas, and to evaluate the effectiveness of treatment.     

Antibiotic sensitivity of the main opportunistic pathogenic aerobic bacteria

Antibiotic sensitivity of 1421 strains of Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa and Klebsiella spp. was studied. Gentamicin, levomycetin (chloramphenicol) and ristomycin proved to be the antibiotics of choice in treatment of purulent inflammatory diseases caused by S. epidermidis and S. aureus. For antibiotic therapy of infections caused by gram-negative organisms gentamicin and polymixin might be recommended.     

Ciprofloxacin in the treatment of infections in oncology patients

Treatment of infectious complications with ciprofloxacin in 65 patients provided good and satisfactory results in 67.7 and 20.0 per cent of the cases, respectively. The drug was efficient in sepsis, urogenital infections, respiratory infections and postoperative purulent complications. Ciprofloxacin showed a broad antibacterial spectrum. 96.3 per cent of the isolates belonging to aerobic organisms causing purulent inflammatory processes, including those with high antibiotic resistance levels, such as Pseudomonas spp., Proteus spp., Klebsiella tribe and Staphylococcus aureus were sensitive to the drug. In its antibacterial spectrum ciprofloxacin was similar to ofloxacin. The advantage of ciprofloxacin is its possible use not only orally but also intravenously. Adverse reactions to ciprofloxacin were observed in 5 (7.7 per cent) out of the 65 patients. In two cases discontinuation of the drug use was required. The use of ciprofloxacin in treatment of infectious complications in oncological patients is promising.     

Spiral computed tomography in the diagnosis of inflammatory diseases of the vertebral column

A Somatom Plus 4 spiral computed tomograph was used to examine 40 patients with purulent spondylitis and 8 patients with tuberculous spondylitis. Analysis of the primary examination, postoperative status, and follow-up of patients on medical therapy identified the main signs of an inflammatory process from a great variety of the computed tomographic (CT) signs of a lesion. They made it possible not only to reveal the inflammatory nature of a lesion, but also to differentiate purulent and tuberculous spondylitis. The main CT signs that allow a purulent spondylitis to be differentiated from tuberculous one are as follows: the location of involved veterbrae, the number of and the pattern of destruction of trabecular and cortical layers, the extent of and the form of paravertebral tissue lesion.     

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.     

Chemotherapy of newborns with intestinal infections caused by opportunistic gram-negative aerobic bacteria]

A clinical bacteriological examination was applied to 100 newborns with intestinal infections caused by opportunistic gram-negative aerobes. There was a correlation between the decrease in the quantity of the bifidobacteria and the predominance of various species of opportunistic gram-negative aerobes and their associations, as well as high sensitivity of clinical isolates of the opportunistic bacteria to phosphocin, gentamicin, polymyxin and specific bacteriophages. The study showed that the combined use of antibiotics with the biopreparations (the specific bacteriophages and bifidumbacterin) was effective in treating the newborns with the above mentioned infections.     

Hospital infections: the problems and ways to resolve them]

The authors present the critical analysis of the existing situation in the spread of purulent septic infections in surgical hospitals of the USSR and the state of epidemiological surveillance. Considering this situation to be highly unfavorable, the authors propose a number of urgent organizational measures (the inclusion of hospital epidemiologists into the medical staff of large clinics, the system of training in this problem). The article deals with the specific features of the epidemiological process in purulent septic infections and the main principles of the organization of the epidemiological surveillance system for this group of infections.     

Experimental grounds for the effectiveness of ciprofloxacin and oxytocin combined use

In order to determine the influence of combined use of ciprofloxacin and oxytocin on susceptibility of microflora to antibiotics as well as level of microbial anti-lysozyme (ALA) and anti-complement activity (ACA) 148 anaerobic and aerobic microorganisms were isolated from 80 patients with purulent infections of soft tissues. Susceptibility of staphylococci, streptococci, and enterobacteria to the most commonly used antibiotics was assessed by agar-diffusion method with standard disks. ALA and ACA of the isolated strains were defined by routine methods. Minimal inhibitory concentration (MIC) of ciprofloxacin and oxytocin for isolated pathogens were determined according to standards of NCCLS. Influence of oxytocin on MIC of ciprofloxacin was determined as well as inhibitory effect of the latter on factors of bacterial persistence. Decrease of MIC of ciprofloxacin as well as increase of its inhibitory effect on pathogens' ALA and ACA when it used in combination with oxytocin were noted. Usefulness of combined use of ciprofloxacin and oxytocin for treatment of different infections has been proposed.     

Amikacin in the treatment of infectious-inflammatory diseases in patients at a therapeutic hospital

Amikacin sensitivity of 157 strains which caused infectious inflammatory diseases in patients of a therapeutic hospital was studied. It was shown that 52 and 42.9% of the isolates from patients with bronchopulmonary infections were highly and moderately sensitive to amikacin, respectively. 5 pneumococcal strains were resistant to amikacin. Among the isolates from urine of the patients with urinary infections there were no strains resistant to amikacin. Study of amikacin pharmacokinetics demonstrated expediency of antibiotic endobronchial administration to patients with bronchopulmonary diseases and aggravation of chronic purulent inflammatory processes. A favourable clinical effect of amikacin after its intramuscular or endobronchial administration was observed in 53.3% of the patients. In 30% of the patients the effect was satisfactory. In 16.7% of the patients the treatment failed. Satisfactory antibiotic tolerance in the majority of the patients was stated.