Use of cephalosporins in pediatric practice with the study of the immunoleukolysis (leukocytolysis) reaction

The aim of the study was to determine the value of preliminary assay of hypersensitivity to cephalosporin antibiotics such as cephazolin, cefuroxime and cefotaxime with the immunoleukolysis test (ILT). 130 children at the age of 2 months to 7 years treated with one of the antibiotics for various inflammatory diseases of the bronchopulmonary system were examined. Hypersensitivity (the ILT indices over 30 per cent) was observed in 9.2 per cent of the children with respect to cephazolin (kefzol), in 3.9 per cent of the children with respect to cefuroxime (ketocef) and in 0.8 per cent of the children with respect to cefotaxime (klaforan). The results of the ILT combined with those of the conjunctival test allowed to increase the number of indications to differential use of the cephalosporins in children with various pathological processes in the bronchopulmonary system.     

Comparative study of the antibacterial activity of aminoglycoside antibiotics and their combinations with carbenicillin against Pseudomonas aeruginosa

Antibacterial activity of 7 aminoglycoside antibiotics and combinations of tobramycin or gentamicin with carbenicillin was studied with respect to 33 clinical strains of Ps. aeruginosa. Tobramycin, sisomicin, gentamicin and amicacin showed high levels of antibacterial activity. Tobramycin and sisomicin were 3-4 and 2 times more effective than gentamicin. 100 per cent of the Ps. aeruginosa isolates was sensitive to tobramycin and amicacin. The number of the isolates sensitive to sisomicin and gentamicin amounted to 97 and 94 per cent respectively. The respective numbers for streptomycin and kanamycin were 32 and 11 per cent. No monomycin sensitive isolates were detected. Combination of tobramycin or gentamicin with carbenicillin increased the antibacterial activity of the aminoglycoside antibiotics by 2-16 times and that of carbenicillin by 2-32 times. The synergistic effect of gentamicin or tobramycin with carbenicilin was observed with respect to 50 and 58 per cent of the isolates respectively. No antagonistic effect was detected on the combined use of the antibiotics. The majority of the isolates (96 per cent) were sensitive to combinations of carbenicillin in a concentration of 50 micrograms/ml with tobramycin or gentamicin in concentrations of 0.15 or 0.3 micrograms/ml respectively.     

Action of aureolic acid and dactinomycin group antibiotics on human brain tumors in culture]

The cytotoxic effect of antitumour antibiotics, such as dactinomycin, mithramycin, variamycin and olivomycin on the cells of the human brain tumours (multiform glyoblastoma, arachnoidendotelioma and astrocytoma) grown by the method of the primary plasmic culture was studied. Dactinomycin was superior to the antibiotics of the aureolic acid group in the rate and level of the cytotoxic effect on the tumour cells: 76 per cent of the above tumours were sensitive to dactinomycin, 56 per cent to mithramycin and 52 per cent to variamycin and olivomycin. Among the total number of the tumours sensitive to the drugs the number of the highly sensitive tumours amounted to 57.9 per cent for dactinomycin and 30.8--38.5 per cent for the antibiotics of the aureolic acid group. Definite differences in the efficiency of the antibiotics of the aureolic acid group with respect to different types of the brain tumours were observed.     

Results of testing a new method of using antibiotics in nutrient media for the isolation of Shigella: the 2-streak method]

A new variant of media with antibiotics for isolation of Shigella, i.e. a method of 2 streaks each containing different antibiotics was tested in analysis of excrements from patients with acute dysentery. It was found that the new method is more effective than the well known method of gradient plates (isolation of Shigella in one series of the experiments amounted to 85.2 and 64.7 per cent respectively, and in the other series of the experiments the respective figures were 95.4 and 89.3 per cent). Its efficiency was lower as compared to the procedure of inoculation onto 2 plates, i.e. onto the media with and without an antibiotic (isolation of Shigella was 67.5 and 77.4 per cent respectively). The new method provided a higher frequency of Shigella isolation as compared to inoculation onto the media without an antibiotic, as well as onto any of the media used with one antibiotic. The method of 2 streaks offers wider possibilities for choosing the antibiotics for adding to the nutrient medium, as well as estimation of the antibioticograms and species structures of Shigella distributed in a concrete area.     

Increase in efficacy of antibiotic therapy of anthrax under experimental conditions]

The results of experimental therapy of antraxis infected mice with cefazoline (kefzol) and ampicillin incapsulated into liposomes are presented. Protective activity of the same free antibiotics combinated with amixine and leukinferone was evaluated also. Treatment with liposomal cefazoline enhanced mice survival upto 60 per cent, and life period upto 1.3 +/- 0.3 days. After liposomal ampicillin administration for 3 times the same indices were 60 per cent and 6.5 +/- 0.9 days, after 2 times administration--80 per cent and 14 +/- 1.8 days when compared to the groups of the animals treated with free antibiotics. It was shown that administration of ampicillin with amixine or with leukinferone provided enhanced mice survival upto 20 per cent, administration of cefazoline with leukinferone--upto 30 per cent.     

Methodological procedures for detecting antibiotic producers among cultures of the family Micromonosporaceae]

Data on intensification of the search for active cultures among Micromonospora are presented. It was shown that the frequency of detecting the antibiotic-producing cultures among Micromonospora under conditions of fermentation on the corn-glucose medium inoculated with agar blocks amounted to 35 per cent. The use of nutrient media of different composition for growing submerged inoculum of Micromonospora demonstrated that the rate of its growth reached maximum on the peastarch medium. The use of this medium for growing submerged seed material for fermentation in the corn-glucose medium increased the frequency of detecting active cultures from 35 to 43.1 per cent. The assay of Micromonospora antibiotic activity twice, i.e. in 96 and 240 hours of the fermentation process increased the frequency of detecting active cultures up to 57.1 per cent and revealing greater variety of antibiotics. Fermentation of Micromonospora cultures simultaneously on 6 different nutrient media inoculated with submerged seed mycelium and assay of the activity for 2 times, i. e. in 96 and 240 hours allowed a detection of up to 76.2 per cent of active strains out of the total number of the isolates.     

Use of antibiotics for the prevention of postoperative suppurative complications in planned surgery

Two methods for antibiotic prophylaxis in scheduled surgical treatment were studied comparatively. In the main group antibiotic prophylaxis with respect to 621 operations was started simultaneously with premedication, the duration of the course being defined by the operation type. With respect to 252 pure operations antibiotics were not used in 69.8 per cent of the cases or used for 2-3 days in 27.8 per cent of the cases. With respect to 253 conditionally pure operations shorter courses of antibiotic prophylaxis, i.e. for 2-3 days were used in 50.2 per cent of the cases. In the control group the antibiotics were used after operations in mean therapeutic doses, the duration of the course being defined by the clinical findings. The number of purulent complications in the main group decreased, while the amounts of the antibiotics used were much lower.     

Level and nature of the drug resistance of Shigella flexneri]

Characteristics of antibiotic resistance of 300 strains of Shigella flexner 2a isolated from patients within 1976--1977 in the regions where these bacteria were very rare for a long period of time were studied. It was shown that most of the isolates were resistant to chloramphenicol (88.1 per cent), tetracycline (94.8 per cent), streptomycin (89.1 per cent), polymyxin M (82.4 per cent) and others. 46.5--61.6 per cent of the isolates were resistant to neomycin antibiotics. A high level of the resistance was also noted: the bactericidal effect was registered in 52.0-74.0 per cent of the cultures at a dose of 500--1000 microgram/ml. 91.4 per cent of the strains possessed multiple dug resistance, 78.8 per cent of them being simultaneously resistant to 4--7 drugs. Transmissive R-plasmids were found in 68.8 per cent of the isolates. After exposure to acridine dyes the plasmid nature of the resistance was confirmed in 72.3 per cent of the cultures. Variability of the r-determinant sets in r-plasmids was noted. Strains (64.9 per cent) carrying r-determinants Tc, Cm, Sm and Tc, Cm were more frequent. Strains with one transmissive r-determinant were usually solitary.     

Antibiotic sensitivity and the characteristics of transmissive R plasmids in Shigella belonging to various species]

Sensitivity of 241 Shigella strains isolated from patients at various regions of the USSR in 1975--1978 was tested with respect to 14 antibiotics by the method of serial dilutions. 90.5 per cent of the isolates proved to be resistant to the antibacterial drugs and the greater part of 75.9 per cent of them had multiple resistance. The resistance of the Shigella was most pronounced and frequent with respect to tetracycline, streptomycin, levomycetin, as well as ampicillin and carbenicillin. Gentamicin, cephaloridin, polymyxin M, kanamycin, monomycin, neomycin and rifampicin were highly active against the Shigella. More than 50 per cent of the isolates were sensitive to levomycetin, ampicillin and carbenicillin. Differences in the frequency of the resistant strains and the spectrum of the antibiotic resistance of different Shigella subgroups (species) were observed. The study of 173 multiple resistant Shigella strains showed that about 67 per cent of the strains had a capacity for transduction of the resistance markers into the recipient cells of E. coli. The conjugative R-plasmids were most frequent in Sh. boydii and Sh. sonnei (95 and 95 per cent respectively), less frequent in Sh. flexneri and Sh. newcastle (68 and 53 per cent respectively) and least frequent in the mannitol negative Shigella (25 per cent). The capacity for transduction of R-plasmids in the strains carrying the determinants of resistance to 2 or 3 antibiotics was higher than in the strains carrying the determinant of resistance to one antibiotic. The clinical Shigella strains tested mainly had transmissive R-plasmids of fi--character (79 per cent).     

Study of the activity of a new glycopeptide antibiotic eremomycin combined with tobramycin against Staphylococci in vitro

Eremomycin is an original natural antibiotic with glycopeptide structure isolated at the Institute of New Antibiotics, the USSR Academy of Medical Sciences. Activity of eremomycin alone or in combination with tobramycin was studied with using 25 clinical strains of staphylococci. 56 and 88 per cent of the strains were respectively resistant to gentamicin and kanamycin, two aminoglycoside antibiotics. All the staphylococcal strains were sensitive to eremomycin in concentrations of 0.12 to 1 microgram/ml. The MIC of tobramycin for 10 (40 per cent) sensitive strains ranged within 0.25-2 micrograms/ml. For 60 per cent of the strains the MIC was equal to or higher than 16 micrograms/ml. When eremomycin was used in combination with tobramycin the antibacterial effect with respect to 17 strains (68 per cent) increased. In 32 per cent of the strains the effect was synergistic and in 36 per cent of the strains it was additive. Indifference and antagonism were detected with respect to 7 (28 per cent) and 1 (4% per cent) strains respectively. No significant difference was shown in manifestation of the synergistic-additive nature of eremomycin and tobramycin interaction with respect to the tobramycin sensitive and resistant strains.     

Comparison of the sensitivity of pathogenic staphylococci isolated in 1974 to certain antibiotics and nitrofuran derivatives]

Sensitivity of 267 strains of pathogenic staphylococci isolated in 1974 was studied with respect to some antibiotics and nitrofuran derivatives by the method of serial dilutions on solid media. Sensitivity to penicillin, oxacillin, olemorphocycline, ristomycin and nitrofuran derivatives (furagin and salafur) was observed in 30.7 +/- 2.8, 61.8 +/-3, 29.2 +/-2.8 and 98.9 +/- 0.8 per cent of the cultures respectively.     

Monitoring of uropathogens and their susceptibility to antibiotics]

Samples of urine collected from patients with complicated urology infection and hospitalized to the Moscow Region Research Clinical Institute in 1986, 1991, 1995 and 1999 were analysed. Of 11,444 samples examined, bacteriuria was estimated in 7143 samples. 9786 strains (29 genus) of bacteria were isolated--56.9 per cent as mono culture and 43.1 per cent as associations. Susceptibility to 21 antibiotic was determined by disk diffusion method for 1607 strains; beta-lactamase production was determined in 198 strains, MIC was determined for 41 antibiotics. Gram-negative rods relative amount among pathogens decreased substantially (84.7 per cent in 1986 against 61.6 per cent in 1999), particularly Enterobacteriaceae (74.7 per cent in 1986 against 41.4 per cent in 1999). Nonfermenting Gram-negative rods (NFGNR) relative amount increased (10.8 per cent against 19.2 per cent), along with Gram-positive cocci (19.8 per cent against 64.2 per cent), particularly coagulasenegative staphylococci (CNS) (10.8 per cent against 35.9 per cent) and enterococci (5 per cent against 16.5 per cent) and candida and fungi (0.5 per cent in 1986 against 15.9 per cent in 1999). At the period 1986-1999 the main pathogens in urology infection were E. coli, Enterobacter spp., NFGNR (including P. aeruginosa), Staphylococcus, CNS, Enterococcus spp. The problem pathogens for urological department were the following: E. coli, Klebsiella spp., Enterobacter spp., Proteus spp., NFGNR including P. aeruginosa, CNS, Enterococcus spp., candida and fungi. At the period 1991-1997 Gram-negative pathogens susceptibility to amikacin, ofloxacin, ciprofloxacin, imipenem, ceftazidime, cefotaxime was not changed in general, Gram-positive cocci (staphylococci and enterococci) retained the same susceptibility to vancomicin, cefamandol and amoxyclave. Staphylococci were also susceptible to amikacin, imipenem, rifampicin, oxacillin, ciprofloxacin, and ofloxacin. Production of beta-lactamase was registered for 38.7 per cent of CNS, 26.5 per cent of E. coli, 38.5 per cent of K. pneumoniae, 25 per cent of P. mirabilis and 55.6 per cent of P. aeruginosa strains.     

Antibiotic resistance dynamics of plasma-coagulating staphylococci isolated from patients in 1970-1975]

Resistance of 2345 strains of plasmocoagulating staphylococci isolated from purulent inflammatory foci of surgical patients was studied with respect to the widely used antibiotics by the method of standard paper discs in 1970--1975. It was noted that the cultures resistant to erythromycin and monomycin were more frequent, i.e. from 24.2 +/- 2.5 to 51.4 +/- 3.4 per cent and from 1.0 +/- 0.6 to 28.0 +/- 2.1 per cent respectively, p less than 0.001 in both cases, while the percentage of the strains resistant to benzylpenicillin and tetracycline steadily increased, i.e. from 69.9 +/- 2.4 to 47.0 +/- 2.3 per cent and from 72.8 +/- 2.4 to 28.4 +/- 2.1 per cent respectively, p less than 0.001 in both cases. The number of the resistant cultures to streptomycin and levomycetin slightly changed and was relatively high (about 50 per cent and more). Direct correlation (mean and pronounced) between the amount of levomycetin, tetracycline, erythromycin or monomycin used per citizen of Minsk and the frequency of the strains isolated from the patients to these drugs was noted.     

Sensitivity to antibiotics and the disinfectant chloramine of Staphylococci isolated from healthy and sick persons

Five hundred and twenty seven strains of Staphylococcus aureus with massive contamination of at least 10(3) when estimated quantitatively were tested for their sensitivity to antibiotics and chloramine B. The staphylococcal strains were isolated from patients, air and stock of rooms in medical institutions, from medical personnel and healthy persons having no long-term contacts with hospital media i. e. from pregnant women and workers of confectionery plants. Among the isolates there were strains simultaneously sensitive to antibiotics and chloramine B (16.6 per cent), sensitive to antibiotics but resistant to chloramine B (5.5 per cent), resistant to antibiotics but sensitive to chloramine B (63.1 per cent) and resistant to antibiotics and chloramine B (15.3 per cent). Staphylococci resistant simultaneously to antibiotics and chloramine B were isolated from the persons of all the groups and from the air and stock of the rooms in the medical institutions. This showed the necessity of controlling sensitivity or staphylococci circulating in hospital media not only to antibiotics but also to disinfectants for providing more efficient prophylaxis of intrahospital infections.     

Sensitivity of 56 strains of Streptococcus group B to 12 antibiotics: its determination by dilution and diffusion in agar

Sensitivity of 56 streptococcal strains of group B to 12 antibiotics was studied with the method of dilution in a special solid medium for cultivation of streptococci and with the method of agar diffusion in the same medium. All the strains were found to be sensitive to chloramphenicol, ristomycin and erythromycin. The predominating majority of the strains were sensitive to beta-lactam antibiotics and lincomycin. All the strains were resistant to aminoglycoside antibiotics, such as streptomycin and gentamicin. More than 85 per cent of the strains were resistant to tetracycline. Strains with multiple resistance to 2-7 antibiotics were detected. Satisfactory correlation between the two methods was observed. It was shown to be clinically advisable to determine the sensitivity of streptococci of group B to beta-lactam antibiotics, erythromycin and lincomycin.     

Vibrion variability under the action of antibiotics]

Tetracycline, streptomycin and monomycin resistant variants of the cholera and NAG-vibrios were obtained by means of repeated passages on nutrient media with increasing concentrations of the antibiotics (114 variants V. cholerae asiaticae, 1337 variants of V. cholerae eltor and 299 variants of NAG-vibrios of the 1st Heiberg group). The highest number of the antibiotic resistant variants was obtained under the effect of streptomycin and the resistance level to it was much higher (up to 8000 gamma/ml) than that to tetracycline or monomycin (160 or 320 gamma/ml respectively). The study of the differential-diagnostic properties of the above vibrios showed that 14.8 per cent of the strains of V. cholerae asiaticae and 4.6 per cent of the strains of V. cholerae eltor became non-typical with respect to the colony morphology and fermentative properties. Their agglutinability with the species or type specific cholera sera partially decreased. Nine per cent out of 299 antibiotic resistant NAG-vibrios had changes only in the colony structure. None of them changed their fermentative properties or acquired even minor capacity for agglutination with cholera sera or lysing with specific bacteriophages. The described changes in the properties of the antibiotic resistant cholera and NAG-vibrios were not stable and disappeared after 2- or 3-fold passages on media containing no antibiotics.     

R plasmid distribution in S. typhi isolated on the territory of the left coast of the Ukraine in 1970-1982

A total of 373 strains of S. typhi isolated in 1970-1982 were tested with respect to their sensitivity to 9 antibiotics active against gram-negative bacteria. It was shown that about 1/3 of the isolates were resistant to 1-3 antibiotics. Among the resistant isolates the number of strains resistant to 4-5 and more antibiotics amounted to 12.5 per cent. The plasmid nature of the antibiotic resistance in the isolated strains of S. typhi was shown. Transmissive R plasmids were detected in 13 per cent of the strains studied. Within the last 5 years there was an increase in the proportion of strains with transmissive R plasmids in patients with sporadic typhoid fever or especially in groups of patients with the disease.     

The efficacy of cefepime (Maxipime) in the treatment of abdominal sepsis in surgical patients]

The efficacy of cefepime in the treatment of 46 patients operated for general peritonitis of various genesis and severity (APACHE II not greater than 35) was studied. Cefepime was used in a dose of 2 g administered every 12 hours as slow intravenous infusions in 0.9 per cent sodium chloride solution in combination with metronidazole administered intravenously in a dose of 7.5 mg/kg body weight. The treatment course was 4 to 15 days. 45 patients were given diflucan for the prophylaxis of fungal superinfection, 3 patients were given aminoglycoside antibiotics (netilmicin or amikacin) and 2 patients were given vancomycin per os. The favourable clinical effect of the cefepime therapy was stated in 38 patients (82.6 per cent) including 4 out of 10 patients with initial APACHE II > 15. 101 isolates of aerobic gram-negative and gram-positive microbes from 38 patients treated with cefepime in combination with metronidazole were tested to estimate the bacteriological efficacy of the therapy and it was shown that only 5.9 per cent of them was resistant. The pathogen eradication was stated in 84.2 per cent of the patients.     

Radioprotective and antineoplastic activity of polyene antibiotics combined with dimethyl sulfoxide]

Radioprotective and antineoplastic activity of polyene, its derivatives and combinations with dimethyl sulfoxide (DMSO) was studied. The most potent radioprotective effect was demonstrated by methylated levorin, original levorin and by its isomer--isolevorin. Survival rate of the animals on 12th day after X-ray exposure was 100, 60, 60 per cent, at the control group 33.6, 20 and 0 per cent consequently. Levorin and alkyl derivatives of amphotericin B--methamphocin and buthamphocin inhibited growth of ascites and solid tumors to 46.3-79.0 per cent when compared to control group. Polyen antibiotics combined with DMSO also demonstrated antineoplastic activity at the animals treated with carcinogenic agent--diethyl nitrosoamine (DENA). 5-month survival of the animals was 76 per cent at nystatin and levorin group and 35.7 per cent at the control group (animals treated with DENA only).     

Antibiotic sensitivity of Staphylococci populating the breast skin of nursing women

Sensitivity to penicillins, tetracycline, erythromycin and lincomycin was tested in 1513 staphylococcal strains isolated from the skin of various anatomic areas of the breast of nursing mothers. It was shown that 82.9, 78.4 and 33.9 per cent of the isolated cultures were highly sensitive to lincomycin, erythromycin and methicillin respectively. Sensitivity to tetracycline and benzylpenicillin was detected in 33.1 and 19.8 per cent of the cultures respectively. The study of the resistance spectra of 1343 strains resistant to certain antibiotics revealed that 498 cultures (37.1 per cent) were polyresistant. None of the tested antibiotics could be used for selective decontamination of the breast skin with respect to S. aureus in prophylaxis of lactic mastitis.