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.     

Antibiotic sensitivity of gram-negative opportunistic bacteria isolated from the feces of newborn infants with intestinal infections

Antibiotic sensitivity of 136 pure cultures of gram negative aerobic potentially pathogenic bacteria was assayed. The bacteria were isolated from feces of newborns with intestinal infections. It was shown that the majority of the strains were resistant to 4-5 antibiotics widely used in treatment of patients. However, they were sensitive to gentamicin and polymyxin M.     

Host-parasite interaction in serious infections due to gram-negative bacteria

Gram-negative rods such as Enterobacteriaceae and Pseudomonadaceae are normal habitants of the digestive tract. However, if defense mechanisms of the host are compromised by underlying diseases such as malignant neoplasms, renal insufficiency, extensive traumata, or immunosuppressive therapy, invasion of the blood-stream can occur. Gram-negative septicaemia is associated with high morbidity and mortality, despite intensive care and administration of potent antibiotics. A central role in the pathophysiology of life-threatening bacteraemia is attributed to endotoxin, a constituent of the gram-negative cell wall. This paper reviews current concepts of septic shock, the acquisition of gram-negative bacteraemia and the role of endotoxin. It also deals with a new approach to prevention and control of severe gram-negative infections using serotherapy based on the structure of endotoxin.     

Etiological structure of acute intestinal infections caused by opportunistic bacteria in young children

Altogether 587 children with diagnosed acute enteric infections were examined. In 26.4% of them pathogenic enterobacteria were detected, and in 59%, opportunistic enterobacteria. In 38.2% of children these bacteria were found to be the etiological factor of the disease. A reverse relationship between the contamination of feces with pathogenic enterobacteria and the age of children was established.     

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.     

Formation of intestinal microflora in children during the first year of their life

In 525 young children the state of intestinal microbiocenosis was studied every month of the first year their life. The study revealed that the process of the microflora formation lasted throughout the first year of their life and was characterized by dysbiotic disturbances. During this period the aggravation of dysbiotic changes in the intestine of these children on months 3, 6-7 and 11-12 was of particular importance. The formation of stable dysbacteriosis led to a decrease in the immunological status of the child, which was manifested by the increased content of such microorganisms as hemolytic cocci, Proteus and a decrease in the quantitative level of bifidobacteria in the total intestinal microbiocenosis by the end of the first year of child's life.     

Antibiotic therapy of Salmonella infection in infants during the first year of life and methods if its correction]

The efficacy of antibiotic therapy of salmonellosis was studied and functional activity of peripheral blood leukocytes from electron microscopic data was estimated in 200 infants. It was shown that the use of antibiotics in combination with immunostimulants such as leukocyte mass, lysozyme and prodigiozan in complex therapy of salmonellosis in infants had a favourable effect on both the time course of the clinical signs and the functional state of the neutrophil leukocytes. The duration of the treatment decreased by 6.14 +/- 0.34 days and repeated isolation of the pathogen from the host appeared to be less frequent.     

Detection of alternative nitrogenases in aerobic gram-negative nitrogen-fixing bacteria.

Strains of aerobic, microaerobic, nonsymbiotic, and symbiotic dinitrogen-fixing bacteria were screened for the presence of alternative nitrogenase (N2ase) genes by DNA hybridization between genomic DNA and DNA encoding structural genes for components 1 of three different enzymes. A nifDK gene probe was used as a control to test for the presence of the commonly occurring Mo-Fe N2ase, a vnfDGK gene probe was used to show the presence of V-Fe N2ase, and an anfDGK probe was used to detect Fe N2ase. Hitherto, all three enzymes have been identified in Azotobacter vinelandii OP, and all but the Fe N2ase are present in Azotobacter chroococcum ATCC 4412 (MCD1). Mo-Fe N2ase and V-Fe N2ase structural genes only were confirmed in this strain and in two other strains of A. chroococcum (ATCC 480 and ATCC 9043). A similar pattern was observed with Azotobacter beijerinckii ATCC 19360 and Azotobacter nigricans ATCC 35009. Genes for all three systems are apparently present in two strains of Azotobacter paspali (ATCC 23367 and ATCC 23833) and also in Azomonas agilis ATCC 7494. There was no good evidence for the existence of any genes other than Mo-Fe N2ase structural genes in several Rhizobium meliloti strains, cowpea Rhizobium strain 32H1, or Bradyrhizobium japonicum. Nitrogenase and nitrogenase genes in Azorhizobium caulinodans behaved in an intermediate fashion, showing (i) the formation of ethane from acetylene under Mo starvation, a characteristic of alternative nitrogenases, and (ii) a surprising degree of cross-hybridization to the vnfDGK, but not the anfDGK, probe. vnfDGK- and anfDGK-like sequences were not detected in two saccharolytic Pseudomonas species or Azospirillum brasilense Sp7. The occurrence of alternative N2ases seems restricted to members of the family Azotobacteraceae among the aerobic and microaerobic diazotrophs tested, suggesting that an ability to cope with O2 when fixing N2 may be an important factor influencing the distribution of alternative nitrogenases.     

Immunologic correction with immunoglobulin of toxemia with exicosis in infants with acute intestinal infections]

The clinical course of acute intestinal infections complicated by toxicosis and exicosis was studied in 150 infants undergoing multimodality therapy, including natural human immunoglobulin for intravenous injections. The use of the new complex in the treatment of intestinal toxicoses was accompanied by increasing host immunological reactivity within short periods and decreasing of the treatment duration by 5.0 +/- 1.3 days; there were no persisting and chronic forms of the diseases and fatal outcomes. It was concluded that the use of the immunoglobulin for intravenous injections in the multimodality therapy of intestinal toxicoses in infants made it possible to prevent death in complicated intestinal infections and at the same time to accelerate their recovery.     

Transplacental measles immunity in infants in the 1st year of life]

A total of 187 parturients (66 with a history of measles and 121 immunized with live measles vaccine, or LMV, in childhood) and their 187 newborn infants, as well as 195 children aged up to 1 year, were examined. Antimeasles antibodies in blood sera were detected in the hemagglutination inhibition test. In all mothers with a history of measles and in their newborn infants antimeasles antibodies in different titers were detected. In mothers, formerly immunized with LMV, antimeasles antibodies were absent in 5.8% and in their newborn infants, in 6.6% of the examinees. Among children aged up to 1 year, born of formerly immunized mothers, more rapid disappearance of passive antimeasles immunity was observed. In cases of contact with measles, the serological examinations of all children born of mothers immunized with LMV should be carried out in order to protect seronegative children by passive or active immunization.     

Histological characteristics of the intestinal mucosa of the rat during the first year of life

In spite of the widespread use of rats in gastrointestinal research, there is a lack of information on the qualitative and quantitative histological characteristics. Therefore, a study was performed in 69 male Wistar rats with ages ranging from one day to one year old. The features studied included: height and number of villi in the duodenum, jejunum and ileum, and depth and number of crypts in the duodenum, jejunum, ileum, colon and rectum. Morphometric observations were expressed in a mathematical logarithmic curve that showed a normal, pattern of intestinal growth for each intestinal level. The number of villi in the small intestine decreased from 1 to 35 days of age, whereas the other intestinal parameters all increased during the same period. After 35 days the rates of increase or decrease were lower. The quantification of these intestinal changes provides a new complementary pattern as a reference for research as indicators of normality or malfunction in the rat intestine.     

Plasma levels of DSIP in infants in the first year of life and SIDS risk.

In searching for abnormalities related to the sudden infant death syndrome (SIDS), delta sleep-inducing peptide (DSIP), a regulatory peptide with sleep promoting actions, was investigated in the first year of life in four groups of children: (1) preterm infants (n = 28), (2) infants with a high mean apnea duration evaluated polysomnographically (n = 26), (3) healthy full-term infants (n = 37) and (4) siblings of SIDS-victims (n = 26). DSIP was radioimmunoassayed in plasma. Half of the infants were also investigated polygraphically during sleep. The ratio between quiet sleep and active sleep was determined. There was no age dependence of the plasma level of DSIP in the first year of life but there was an increase in the ratio of quiet/active sleep depending of maturity. The level of DSIP in healthy full-term infants was significantly higher (P less than 0.05) (median: 1885 pmol/l, interquartile range: 757 pmol/l) than in preterms (1595; 385) and in infants with a high mean apnea duration (1542; 373). There was no significant difference in DSIP concentrations between healthy full-term infants and SIDS-siblings (1605; 271).     

Respiratory infections in the first year of life in children at risk of developing atopy.

Ninety-two infants, each of whom had one parent with asthma or hay fever, were followed up from birth to age of 1 year and 72 to the age of three years. During the first year of life respiratory symptoms, eczema, and respiratory viral infections were all reported. Within the first year 24 babies developed eczema; 28 had a wheal of 1 mm in diameter or more on prick skin testing with cutaneous allergens. Forty-three children had one or both of these characteristics and formed an atopic subgroup; by the same criteria, 49 children were non-atopic. The number of respiratory infections in the two groups was not significantly different; similar viruses were isolated from both groups. These viruses were associated with both upper and lower respiratory tract infections. Wheezing was a clinical feature in 12 children during lower respiratory tract infections. Of these babies six were atopic in the first year of life. Of the six non-atopic babies, one had eczema in the second year and five children developed raised total serum IgE values within the 3 years.     

A neurophysiologic study of sleep in children during the first year of life]

Polygraphic investigation of day sleep has been carried out in thirty suckling infants (aged from 25 days to 12 months). EEG, OCG, SGR, respiration ECG, muscular activity, and in some infants, also rheographic parameters (REG and RG of the shin) have shown that already at an early nursing age, states of drowsiness, falling asleep, light and medium depth and deep slow sleep set in, as well as the so-called rapid sleep which occurs only after slow sleep. The denotation of the slow sleep stages is based on the classification by Loomis et al., though their electroenecepholographic expression in the infant is in many ways peculiar and undergoes certain dynamics during the first year of life. Peculiarities of the central area EEG have been exhibited in all the age groups, and it has been assumed that the central parts of the cortex of a suckling infant are a kind of "window" into the subcortical parts. While EEG, displaying new forms of activity at certain stages of sleep undergo distinct age changes, vegetative sleep manifestations display only some age depending quantitative differences. Thus, at the nursing age the mechanisms of electroencephalographic and vegetative sleep manifestations are of different degree of maturity: they possess a considerable autonomy, although they function in concord.     

Brain CT diagnosis in infants of the first year of life who have congenital heart diseases

Computed tomography (CT) was used to study the brain in 73 infants of the first year of life who had different congenital heart diseases (CHD). CT was performed on a HiSpeed CT/i spiral computer tomograph (the firm "CE") and a C-150 XP electronic radiation tomograph (the firm "Imatron"). The capacities of the technique in the diagnosis of brain lesion were explored in CHD infants of the first year of life. The studies indicated that the commonest abnormalities in CHD infants of this age were hydrocephalus frequently concurrent with congenital malformations, as well as diffuse and focal changes in the brain.