MODERN ANTICEPTIC HYDROGEL IN TREATMENT OF INFECTIOUS COMPLICATIONS OF WOUNDS IN SURGERY.

Treatment and prevention of infectious complications remain the actual problems of surgery. Purulent complications very often arise in operative interventions with an application of various fixing devices. A study of the adhesive surgical antiseptic (ASA) «ARGAKOL¼ (Registration certificate № FS 012б2005/1878-05) was completed. The results of the preliminary antimicrobial activity of the developed composition showed that ASA «ARGAKOL¼ had a broad spectrum of antimicrobial action. There was used the method of twofold serial dilutions in a liquid medium and Cup-suspension. The study of the influence of the ASA «ARGAKOL¼ on the wound healing was made in the experiment on white outbred rats. There were carried out two series of experiments with 10 rats in each group: on the model of just contaminated wound (the first series) and on the model of infected wound with delayed application of the glue (after 3 days) after trauma (the second series).

[Substantiation of clinical application for hernioplasty of reticulate prosthesis with antimicrobial properties].

A new reticulate hernioprosthesis has been developed and proposed for clinical use. The adhesive high molecular polymer coating containing silver nanoclusters was applied on the lavsan network. After implantation the polymer was dissolved in the tissue fluid and formed the hollows between the threads facilitating invasion of the connective tissue into the network. The prolonged antimicrobial effect was proved to stay in the wound tissue as long as 5 days. Silver nanoclusters prevent the formation of microbial biofilms and development of suppuration around the prosthesis. Its unique properties are confirmed by positive results of its clinical use.

Antimicrobial resistance of nosocomial strains of Staphylococcus aureus in Russia: results of a prospective study.

A total of 879 Staphylococcus aureus clinical isolates from 17 medical institutions in different regions of Russia were tested. Susceptibility to 18 antimicrobials was determined by agar dilution in accordance with the NCCLS recommendations. The most potent antimicrobials were glycopeptides, linezolid, and fusidic acid, to which no resistance was found. Other antimicrobials with low frequency of non-susceptibility were mupirocin (0.3%), trimethoprim/sulfamethoxazole (0.8%), quinupristin/dalfopristin (1.8%) and rifampicin (7.0%). Fluoroquinolones displayed moderate activity (5.8% of non-susceptible strains to moxifloxacin, 9.1% to levofloxacin, 13.1% to ciprofloxacin). High rates of non-susceptibility were found to clindamycin (27.1%), gentamicin (30.7%), tetracycline (37.1%), erythromycin (39.6%) and chloramphenicol (43.1%). The prevalence of oxacillin-resistant S. aureus (ORSA) was 33.5% and varied from 0% to 89.5% in different hospitals. ORSA were isolated most frequently in the burn units (77.5%), intensive care units (54.8%), trauma and orthopedics units (42.1%). This is the first multicenter study published of antimicrobial resistance of S. aureus in Russia which meets international standards.

[The antimicrobial activity and cytotoxicity of anti-infective preparations in a human cell-culture model]. / Issledovanie protivomikrobnoi aktivnosti i tsitotoksichnosti antiinfektsionnykh preparatov na modeli kul'tury kletok cheloveka.

The complex evaluation of Polysept, a new antiseptic, by its antimicrobial activity with the determination of the minimal inhibiting concentration, its antiadhesive effect and its cytotoxic action with the determination of the minimal toxic dose is presented after preclinical trial, carried out on the culture of skin and lung fibroblasts of human embryo used as an experimental model. The presence of 50% human blood serum enhances the antimicrobial and antiadhesive effects and decreases the cytotoxic action of the antiseptic with respect to fibroblasts, which makes it a promising preparation not only for the treatment, but also for prophylaxis of wound infection.

[The effect of individual serum proteins and native blood serum on the adhesion of Staphylococcus aureus to cells in vitro]. / Vliianie otdel'nykh syvorotochnykh belkov i nativnoi syvorotki krovi na adgeziiu Staphylococcus aureus k kletkam in vitro.

Blood serum and its components were found to produce an antiadhesive effect which inhibited the attachment of S.aureus to cells HEp-2 and immortalized astrocytes. Normal and antistaphylococcal immunoglobulins exhibited the highest activity, inhibiting the process of bacterial adhesion in a serum-free medium. The antiadhesive activity level of native serum was considerably lower and constituted 4% of that of normal immunoglobulin and 85% of that of albumin. In spite of pronounced inhibiting action of normal immunoglobulin and albumin, their dissolution in serum did not increase its antiadhesive activity.

[Some biochemical indicators of the cytotoxic response of human fibroblasts cultured with natural and synthetic polycations]. / Nekotorye biokhimicheskie pokazateli tsitotoksicheskogo otveta fibroblastov cheloveka v kul'ture pod deistviem prirodnykh i sinteticheskikh polikationov.

Cationic antiseptics--catamine AB, polysept (polymeric derivative of chlorhexidine) as well as cationic protein protamine exhibited a pronounced cytotoxic effect on human skin and lung fibroblasts in cell culture. Their effect was accompanied by augmentation of lipid peroxidation products and by inhibition of DT-diaphorase, LDH, ATPase and glutathione reductase. Introduction of alpha-tocopherol into the cultural medium normalized the rate of lipid peroxidation but did not remove the inhibitory effect on activity of oxidoreductase studied. Blood serum proteins immunoglobulins and albumin diminished significantly the cytotoxic effect of cationic preparations contributing to restoration of all the parameters studied to control values; this phenomenon appears to occur due to nonspecific membrane protective and antioxidation effects of the blood serum proteins.

[Use of siloxane films in the treatment of contracture of the knee joint]. / Primenenie siloksanovykh plenok pri lechenii kontraktur kolennogo sustava.

The siloxan film with programmed physiochemical characteristics possessing antimicrobial properties is proposed for the prevention of cicatrization in the knee joint area. Using this film as a pad after mobilizing operations on the knee joint has shown its high efficiency and considerably improved results of treatment.

[Characteristics of the sources and routes of spread of a Pseudomonas aeruginosa infection in a trauma department]. / Kharakteristika istochnikov i putei rasprostraneniia sinegnoinoi infektsii v travmatologicheskom otdelenii.

In the study of the epidemic process of P. aeruginosa infection in a traumatological hospital the leading role of patients with hospital septic infections as the sources of infection has been epidemiologically proved. Contamination has been shown to occur mostly in the pus dressing room.

[Epidemiological analysis of the morbidity from suppurative-septic infections in a trauma center and orthopedic hospital]. / Epidemiologicheskii analiz zabolevaemosti gnoino-septicheskimi infektsiiami v travmatologoortopedicheskom statsionare.

Organizational measures, surgical techniques and surgical activity have proved to affect the morbidity rate of suppurative septic infections. Gram-negative bacilli have been shown to cause suppurative septic infections mostly as the result of superinfection.

[Prevention of the formation of drug resistance in bacterial populations by using biologically active substances]. / Preduprezhdenie formirovaniia lekarstvennoi ustoichivosti populiatsii bakterii primeneniem biologicheski aktivnykh veshchestv.

The patients with infected wounds of the extremities were treated with kanamycin electrophoresis in combination with chlorhexidine bigluconate, an antiseptic. As compared to the patients treated with kanamycin alone, the rate of the wound size decrease in such patients was 2 times higher. The levels of microbial contamination in these patients were much lower. The contamination level with the aerobic flora was 4.8 times lower, including staphylococci, the level of contamination with which was 5.9 times lower. The contamination level with the kanamycin-resistant bacteria was 22 times lower. The treatment with kanamycin alone resulted in a 2.6-fold increase in the number of the antibiotic-resistant variants in the microbial populations of the wounds. In 48.2 per cent of the patients, this was accompanied by development of resistance to kanamycin in the whole microbial population of the wound. The development of the kanamycin resistance in the staphylococcal populations of 18.1 per cent of the patients was associated with changed sensitivity of the initial strains and in 81.9 per cent of the patients, with superinfection by the resistant strains. No changes in the kanamycin sensitivity of the initial gram-negative organisms during the treatment were observed. The use of chlorhexidine bigluconate, as a biologically active substance in combination with kanamycin potentiated the action of the antibiotic, prevented development and accumulation of the antibiotic-resistant variants in the microbial populations of the wounds and development of the drug resistance in these populations.

[Effect of detergents on the chloramphenicol inactivation process by resistent bacteria]. / Vliianie detergentov na protsess inaktivatsii khloramfenikola rezistentnymi bakteriiami.

The effect of detergents, i. e. cationic, anionic, nonionic and polyelectrolytes of the cationic type on the efficacy of chloramphenicol against resistant strains of E. coli and Staph. aureus was studied. It was found that the detergent effect on inactivation of chloramphenicol by the bacterial resistant strains was inconsistent. The cationic detergents and in particular chlorhexidine had the most pronounced inhibitory effect. In subbacteriostatic concentrations they significantly suppressed inactivation of chloramphenicol in the cells of E. coli and Staph. aureus. The anionic detergents and polyelectrolytes of the cationic type in the above concentrations were effective only with respect to Staph. aureus. It is noted that the detergents increased the activity of chloramphenicol against E. coli and Staph. aureus.

[Effect of surface-active antiseptics on plasmid transduction of drug resistance and the transducing bacteriophages of staphylococci]. / Vliianie poverkhnostno-aktivnykh antiseptikov na transduktsiiu plazmid lekarstvennoi ustoichivosti i transdutsiruiushchie bakteriofagi u stafilokokkov.

Anionic surface active substances (SAS), such as sodium alkylsulfates, iodonate, sulfanol NP-3 used in subbacteriostatic concentrations lowered at least 100 times the intensity of the erythromycin resistance plasmid in vitro on mixed cultivation of the staphylococcal cells of the donor (strain 8325/11 de) and the recipient (strain 825-1). The cationic SAS, i. e. roc cal, chlorhexidine had no such capacity. The above anionic and cationic SAS had an antiphage effect with respect to the transducing staphylococcal bacteriophages of the serological group B (80, 85, 52A, 53). Such an effect (on the example of sodium alkylsulfates) increased with prolongation of the alkyl radical from C8 to C14. A decrease in the transduction intensity of the erythromycin resistant plasmid in staphylococci was observed in the presence of the anionic SAS either possessing (alkylsulfates, iodonate) or not (sulfonol NP-3) the antiphage activity.

[Increase in tetracycline activity by using surface-active substances]. / Povyshenie aktivnosti tetratsiklinov s pomoshch'iu nekotorykh poverkhnostno-aktivnykh veshchestv.

The antimicrobial effect of cationic and anionic surface-active substances, i.e. catamine AB and sulphonol NP-3 respectively was studied in vitro with respect to gramnegative bacteria. In non-bactericidal concentrations catamine AB significantly increased the efficacy of tetracyclines, while the anionic compound had no such effect. The increase in the tetracycline activity was due to the antibiotic increased absorption (14C-oxytetracycline as an example) on the treatment of gramnegative bacteria with catamine AB and staphylococci with catamine AB and sulphonol NP-3, which was mainly associated with impairement of the cell membrane permeability by the surface-active substances.

[Effect of polymer complexons based on vinylpyrrolidone copolymers with vinyliminodiacetic acid and methacrtloylacetone on the antibiotic sensitivity of antibiotic-resistant bacterial strains]. / Vliianie polimernykh kompleksonov na osnove sopolimerov vinilpirrolidona s vinilimodiuksusnoi kislotoi i metakriloilatsetonom na chuvstvitel'nost'k antibiotikam antibiotikoustoichivykh shtammov bakterii.

Polymer complexons, such as copolymers of vinylpyrrolidone with vinyliminodiacetic acid and metacryloilacetone changed the permeability of the bacterial cell wall due to chelating of the metalic ions contained in the cell wall. An increase in the bacterial sensitivity to chloretracycline, methicillin, ampicillin and methicillin was observed in the presence of the above complexons.