Prospective means of decreasing suppurative-septic diseases in puerperae and newborn infants

The comparative analysis of the occurrence of purulent septic diseases in mothers during the puerperal period and in newborns, observed in a maternity hospital before and after the introduction of the system of keeping newborns together with their mothers, showed a considerable decrease in the morbidity rate among newborn infants (6 times) and in occurrence of mastitis among puerperae (30 times). This is attributed to a decrease in the frequency of the colonization of newborns and mothers in the puerperal period by the hospital strains of staphylococci belonging to epidemic phagotypes. The gradual elimination of staphylococci of phagotype 80, which dominated for several years, from the hospital was observed. To decrease the morbidity rate, the introduction of the system of keeping newborn infants with their mothers in all maternity hospitals of the USSR is proposed.     

Microbiological control of drug resistance of causative agents in suppurative-septic infections in newborn infants

Resistance of the main causative agents of purulent septic infections such as pneumonia, meningitis, sepsis, etc. to 11 chemotherapeutic drugs was studied. The pathogens were isolated from autopsies of 203 newborns who died within 1981 to 1987. Among 2978 isolates belonging to Enterobacteriaceae (2466 strains) and Pseudomonadaceae (512 strains) which constituted 88% of all the isolates, strains with multiple resistance predominated: 90% of the strains resistant to 4 or more antibiotics, 77% of the strains resistant to 6 or more antibiotics and 48% of the strains resistant to 8 or more antibiotics. The highest number of the isolates were resistant to 8 and 9 chemotherapeutics (19 and 20%, respectively). 84% of all the isolates belonged to 4 genera: Klebsiella (34%), Escherichia (21%), Serratia (14%) and Pseudomonas (15%). They were characterized by the highest resistance spectra. In all the cases massive colonization of the intestine by the strains with multiple resistance which caused purulent septic infections was observed. The most frequent variants of the drug resistance combination were determined. In the total frequency of the isolate with multiple resistance no significant differences were detected in 1981 and thereafter. In 1986-1987 the frequency of S. marcescens strains increased 3-5 times with simultaneous broadening of their drug resistance spectra. Strains of S. marcescens and K. pneumoniae with multiple drug resistance endemic for definite hospitals were detected.     

Pharmacokinetic characteristics and the effectiveness of using carbenicillin on newborn premature infants with infectious and inflammatory diseases]

The results of the study on the pharmacokinetics peculiar properties of carbenicillin premature infants treated with the drug administered intravenously or intramuscularly are presented. The maximum antibiotic blood levels after intravenous administration exceeded the MIC for most of the causative agents isolated from the children. The schemes for the antibiotic use in treatment of purulent septic processes of children are recommended.     

Properties of Serratia marcescens strains isolated in septic diseases of newborn infants

As the result of the study of blood and liquor samples from 120 newborns, Serratia marcescens was isolated in 21 cases (17.5 %). 8 strains were isolated from the environment of these patients. Almost all strains isolated from both the patients and the environment (with the exception of one environmental strain) belonged to serotype 04. The isolated S. marcescens strains were resistant to penicillin, ampicillin, streptomycin, kanamycin, oxacillin, methicillin, ceporin and moderately sensitive to polymixin. 2 strains from the environment and 9 strains from the patients were mildly sensitive to gentamicin. In one hospital all isolated strains were found to have 2 transmissive R plasmids with the molecular weight 40 and 60 megadaltons. The presence of R plasmids with the same molecular weight in all S. marcescens strains isolated in this hospital, as well as their serological identity, suggest that in all patients infection originated from a common source.     

The microbial colonization of the skin of newborn infants rooming in with the mother in maternity homes]

The formation of skin biocenosis in children under the conditions of a maternity hospital with the joint care of mother and child was studied with the use of commercial bacteriological imprints manufactured in the USSR. The colonization of newborn infants in maternity hospitals with opportunistic, saprophytic and normal microflora was established. In newborn infants aged up to 5 years low skin resistance to colonization and, as a consequence, frequent colonization of the skin with opportunistic and saprophytic microflora was observed.     

The joint variability of the growth-weight characteristics and biochemical gene markers in newborn infants

A relationship between heterozygosity of 6 biochemical loci and variability of 4 anthropometric traits at birth has been studied in 304 boys and girls from Moscow population. All 4 traits in boys are positively correlated with the number of loci for which they are heterozygous. The values of all the traits in girls are highest in homozygous individuals. In order to reduce the number of variables the principal component analysis is applied. Boys and girls with average level of heterozygosity turned out to be closest to the corresponding population averages of morphological traits. The results are discussed in terms of 3 models: Lerner's concept of genetical homeostasis, additive and overdominance polygenic models. It is concluded that an average level of heterozygosity is optimal for a population.