Effects of interferon preparations on the course of Salmonella infection (experimental and clinical studies)]

The effect of type I interferons on the process of experimental salmonellosis in mice and rabbits, as well as their effect on salmonellosis in patients was studied. It was shown that homologous interferon increased the animal survival rate, activated bactericidal activity of the phagocytic cells and increased elimination of the infectious agents from the host. The complex of the etiotropic and pathogenetic treatment of 32 patients with salmonellosis included human leukocytic interferon, leukinferon. It was administered intramuscularly in a dose of 1 x 10(4)-2 x 10(4) IU: three injections at intervals of 48 to 72 hours (the treatment course). The course was repeated 10 days after the last injection of the first course. Addition of leukinferon to the routine scheme of the medicinal treatment of salmonellosis provided recovery of all the patients without complications or appearance of the bacteria carriers (the observation period of more than 3 years).     

Characteristics of sources and means of spread of Pseudomonas aeruginosa infections in urology wards

Patients with purulent septic infections form the main source of infection in urological departments. The spread of infection from these patients occurs mainly by contact in dressing and cystoscopy rooms. The complex of measures, planned in accordance with the results of diagnosis, makes it possible to decrease morbidity rate in the purulent septic infections of the urinary tract.     

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.     

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.     

Epidemiological aspects of antibiotic resistance in hospital microorganisms

A total of 37490 medical histories of patients with "pure" and conditionally "pure" operations were analysed with a purpose of studying the scales of hospital infections in surgical inpatients and the effect of the prophylactic use of antibiotics on the frequency of postoperative complications. It was found that postoperative purulent complications developed in 10-25 per cent of patients. Antibiotics and mainly penicillin and streptomycin were used in the treatment of 75 per cent of patients before, during and after operations. The prophylactic use of the antibiotics in mass operations did not prevent the development of infections. Infiltrates and purulent wounds were more frequent (P less than 0.001) in patients subjected to the antibiotic prophylaxis. This indicates that the use of the antibiotics for preventing possible complications in patients with the "pure" operations and in the majority of patients with the conditionally "pure" operations is not advisable. The strategy of the rational use of antibiotics requires that the staff of the large hospitals should include a chemotherapeutist for defining the tactics of chemotherapy and controlling the use of antibiotics which should promote a decrease in the incidence of hospital infections and in the rate of lethality.     

The effect of leukinferon on the activity of phagocytosing cells in human salmonellosis]

The functional activity of phagocytic cells in 52 salmonellosis patients was studied with regard to the following characteristics: percent share of phagocytosis, phagocytic index, nitro blue tetrazolium test results, digestive activity. In patients with the unfavorable course of salmonellosis (the formation of carrier state) disturbances in the bactericidal activity of neutrophils and monocytes were established. For 32 patients leukinferon was included in the complex of etiotropic and pathogenetic treatment. The preparation was introduced in 3 intramuscular injections of 10,000 I. U. at intervals of 48 hours (the course of treatment); 10 days after the last injection this course was repeated. The use of leukinferon restored the normal functioning of phagocytes and the number of T-lymphocytes.     

State of the nonspecific humoral factors of the body's natural resistance in patients with suppurative and septic infections having various ABO system blood groups]

The results of surveying 140 patients with severe purulent and septic infections of staphylococcal etiology, when compared with the distribution of the blood groups (as classified according to the ABO system) in 180 healthy donors, revealed that generalized purulent infections occurred most frequently in patients with blood groups A (II) and AB (IV), and more seldom in patients with blood groups O (I) and B (III). The average content of lysozyme, complement and normal antibodies to E. coli, as well as the average level of general bactericidal activity in the blood sera of the patients were considerably lower than in the blood sera of healthy donors; at the same time content of lysozyme, complement and normal antibodies in the blood sera of patients having different groups of blood did not reflect the degree of their predisposition or resistance to staphylococcal infections. The general bactericidal activity of the blood serum was found to correlate with the degree of predisposition or resistance to purulent septic infections of staphylococcal etiology to a greater extent than other characteristics.     

Results of 10 years of use of lincomycin (1966-1976) in the clinics of the N. N. Priorov Central Research Institute of Traumatology and Orthopedics]

During 10 years 1063 patients were treated with lincomycin used parentally or orally at the N. N. Priorov Central Research Institute of Traumatology and Orthopedy. The doses and the rate of its use depended on the state of the patient, its age and weight. Lincomycin was used for the treatment of patients with osteomyelitis or purulent wound infection, as well as for prophylaxis of suppuration. The drug was used for a long period of time under conditions of the same hospital, and it was shown that it remained up to the present days highly effective in therapy of infections and especially bone infections caused by staphylococci sensitive to it. The 10-year study of staphylococcal sensitivity to lincomycin revealed an insignificant increase in the development of resistance to it. The paper presents data on the importance of adequate surgical interventions in addition to the antibiotic therapy in cases with bone infections. A possibility of lincomycin combined use with other antibiotics and gentamicin or kanamycin in particular was shown. Complications, such as diarrhea and urticaria were registered in 11 patients.     

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.     

The action of interferon preparations on strains of Legionella of various serogroups and species

The action of different preparations of interferon on Legionella strains has been studied in vivo and in vitro. The preparations of leukinferon at a concentration of 500 international units (I.U.) and reaferon at a concentration of 10,000 I.U. have been found to produce an inhibiting effect on Legionella strains in vitro, in a medium with carbon-yeast agar. Leukinferon at a concentration of 125 I.U. suppresses the growth of L. pneumophila also in a liquid medium. The preparation of leukinferon at a minimal concentration of 100 I.U. has been found to suppress the development of lethal infection in chick embryos infected with L. pneumophila strain Philadelphia 1.     

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.     

Epidemiological features of hospital purulent-septic infections in otolaryngological wards]

Prospective epidemiological observation in an otorhinolaryngological hospital has made it possible to distinguish the specific features of pyoseptic nosocomial infections. Such infections, appearing as cross re- and superinfections, are most frequently induced by staphylococci, as well as by Proteus and Pseudomonas aeruginosa. High risk groups include patients with purulent otitis and sinusitis, who have contacted infection through instruments in examination and dressing rooms. The main sources of infection are patients with pyoseptic infections of the ear and sinuses.     

Changes in the immune status parameters and their correction in various forms of tick-borne encephalitis]

Comparative investigation of immune status indices in patients with fever form of vernal encephalitis (group 1), with inapparent form with prolonged antigenemia (group III) and with short-term antigenemia (group II) was performed for the first time. Total 99 patients were under investigation. It was shown that in group I selective damage of immune system at T-level took place. In patients of group III immune system at all levels was less involved and humoral factor were changes. In patients in group II no significant change in immune system were registered. Activity of different immune correctors (thimalin, 4-iodoantipirine, leukinferon) was investigated in vitro. This preparations had stimulating effect in blood samples of patients with decreased immune status. In the patients with unchanged immune status no effect was demonstrated. The most prominent effect was revealed in the case of 4-iodoantipirine--interferon inducer.     

Epidemiological characteristics of postoperative wound infections in a trauma center hospital

The occurrence of cross infections in osteomyelitis patients has been proved by clinical, microbiological, and epidemiological methods. The patients are infected mainly in the dressing room for patients with purulent processes; the working conditions in this dressing room do not preclude the possibility of cross infections.     

Combined antibiotic therapy following heart surgery

In vitro efficacy of combinations of broad and narrow spectrum semi-synthetic penicillins, broad spectrum semi-synthetic penicillins with macrolides or aminoglycosides and tetracyclines with other biosynthetic antibiotics was studied with respect to the causative agents of surgical infections. Correlation between the sensitivity of the isolates and the antibiotics levels in the organism of the surgical patients was shown. The role of the etiological factor in the development of the post-operative complications in the patients after surgical operations on the heart was elucidated. The most rational schemes of the antibiotic use in therapy of the patients with purulent complications after operations on the open heart were developed and the maximum doses of different semi-synthetic penicillins for the treatment of patients with purulent processes after operations under conditions of artificial blood circulation were determined.     

Cardiodepressive effect of blood serum in severe forms of purulent infection

The effect of human blood serum from patients with purulent infections (sepsis, purulent resorptive fever) has been studied on the electrical and mechanical activities of isolated auricles of guinea pig. The intracellular resting potentials (RP), action potentials (AP) and isometric contractions elicited by electrical stimulation (1 Hz) were measured. The patient serum diluted by Tyrode solution (1:1) didn't change RP values and AP amplitude but caused a decrease in the AP plateau phase duration (P less than less than 0.05). In 75% cases a replacement of the healthy donor serum by the serum from patients caused a decrease in the contraction amplitude. This cardiodepressive effect was reversible: washing of the preparation by the control Tyrode solution or by the donor serum restored the normal contractility. These data were compared with those obtained in studying the action of staphylococcus alpha-toxin on a preparation of guinea pig myocardium]     

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 bacteroides infection under clinical and experimental conditions

Bacteroides were detected in pus and bioptates of the majority of 125 patients with purulent and purulent septic infections of various localization. In 90 per cent of the subjects the bacteroides were detected in association with aerobes, facultative and obligate anaerobic bacteria. The species of the bacteroides and concomitant microflora isolated from the cases with different diseases were defined by endogenic sources of the microbial contamination. Sensitivity of 112 bacteroide strains to antimicrobial agents was tested. Chloramphenicol, clindamycin, metronidazole, cefotaxime and heliomycin proved to be the most efficient. Efficacy of heliomycin was detected in hamsters with experimental bacteroide infection in the buccal sac. Thorough bacteriological examination is required for rational chemotherapy of bacteroide infections.     

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.     

Randomised controlled trial of antibiotics in patients with cough and purulent sputum.

Two hundred and twelve adults with cough and purulent sputum of up to one week''s duration were allocated randomly to treatment with doxycycline or placebo capsules for up to 10 days. Cough, purulent sputum, feeling "off colour," and time off work lasted as long in treatment and control groups, but running nose persisted for a shorter time in the doxycycline group. The number of new episodes of lower respiratory tract infections, vaginal infections, gastrointestinal upsets, and otitis media over the next six months were the same in both groups, but fewer new upper respiratory infections were experienced by the doxycycline-treated patients. There is no consensus among doctors about using antibiotics in patients with cough and purulent sputum, and these results indicate that otherwise healthy people with these symptoms will usually get better without antibiotic treatment.