Quantitative method for the determination of antibiotic-resistant gut bacterial strains for the early diagnosis of chronic arthritis.

Based on the clinical and microbiological monitoring of two groups of children aged 3 to 17 years with acute (n=78) and chronic (n=46) course of reactive arthritis (ReA), a method for early diagnosis of chronic arthritis was developed by determining the number of antibiotic-resistant coprostrains in patients with ReA, characterized by the absence of the need to isolate a pure culture of the pathogen and its identification; inoculation of faeces at a dilution of 10-5 on solid 1.5% GRM-agar with an antibacterial agents used in the treatment of a particular patient, at a minimum inhibitory concentration in the resistance range, followed by incubation and counting of the colonies of microorganisms grown on the plate. A significant relationship between the number of antibiotic-resistant gut bacterial strains and the course of arthritis (acute, chronic) was revealed, and the borderline value of the number of antibiotic-resistant gut bacterial strains was determined - 5×103 CFU/g, which allows differentiating the acute course from the chronic one: in the acute course< 5×103 CFU/g, with chronic - ≥ 5×103 CFU/g. The method allows, at the stage of completion of anti-inflammatory therapy in the active phase of the disease, to identify a risk group for the development of a chronic course of arthritis among patients with ReA, which can contribute to timely therapeutic measures aimed at preventing recurrence of the disease and making the patient disabled.

[Treatment of contusion of moderate severity in children in outpatient clinics]. / Lechenie detei s ushibom golovnogo mozga srednei stepeni tyazhesti v ambulatornykh usloviyakh.

OBJECTIVE: To determine the efficacy of cortexin in treatment of traumatic brain injuries with contusion of moderate severity in children in an outpatient clinics. MATERIALS AND METHODS: Seventy-four patients, aged 6-13 years, with a traumatic brain injury and a moderate brain contusion were examined. A comprehensive clinical examination, including neurological and ophthalmological examinations, EEG, brain CT scan, testing using a set of experimental psychological techniques, was performed. Children of the main group received standard therapy and cortexin. Children of the control group received similar treatment without cortexin. Re-examination was carried out 30 days after the start of treatment. RESULTS: After the treatment, a positive dynamics was noted in both groups. There were a decrease in the severity of subjective symptoms (p<0,01) and focal neurological symptoms (p <0,001) as well as absence of acute waves to physical activity according to EEG results in the main group compared with the control group. Also, EEG showed that cortical electrogenesis corresponded to the age of the patient, hypertensive/hydrocephalic signs were stopped (p <0,05), positive changes in cognitive functions occurred. CONCLUSION: The study showed the positive dynamics in the recovery of cognitive functions, the normalization of EEG parameters and stopping of hypertension-hydrocephalic symptoms in children with traumatic brain injuries with contusion of moderate severity a month after the start of treatment with cortexin.

[GUT MICROSYMBIOCENOSIS IN CHILDREN WITH REACTIVE ARTHRITIS].

AIM: To study the state of gut microsymbiocenosis in children with reactive arthritis (RA), with the assessment of biofilm formation (BFF) of microsymbionts and the ability to change cytokine levels (their anticyokine activity) in vitro. MATERIALS AND METHODS: The investigation of gut microsymbiocenosis by means of bacteriological method was conducted in 34 children with RA and 25 relatively healthy 3 - 16 year- old children. Microorganisms were identified with the help of MALDI-TOF mass-spectrometry, anticytokine activity (ACA) of microsymbionts - according to Bukharin O.V et al. (2011), biofilm formation - according to O'Toole G.A., Kolter R. (1998). RESULTS: On the ground of species composition differences of gut microbiota discrimination model was created which allowed to separate the group of children with RA from healthy individuals. Microsymbiocenosis of patients with RA was characterized by increasing number of opportunistic microorganisms (OM) (enterobacteria, clostridia, bacteroides, and Candida), BFF and ACA level. CONCLUSION: The obtained data greatly contribute.to the deciphering of spondylo- arthritis and disclose the role of microbial factor under given pathology. Hypercolonisation of human gut with OM, having pronounced ability to BFF and regulating cytokine level, promotes strengthening of arthritogenic potential and serves as additional marker of arthritis development risk in children.

[Effect of medicinal plants on the antilysozyme activity of microorganisms]. / Vliianie lekarstvennykh rastenii na antilizotsimnuiu aktivnost' mikroorganizmov.

Medicinal plants effect on antilysozyme activity of E. coli, Klebsiella, S. aureus, Candida, Bifidobacterium, Bacteroides, Clostridium was evaluated in vitro. It was demonstrated that the effects differed substancially according to the microorganism taxonomy. The experimental data on the plants inhibitory activity may be used for elaboration of effective regimes of infections and disbiosis treatment.

[Effect of a polyoxydonium immunoregulator on the biological properties of microorganisms]. / Vliianie immunomoduliatora polioksidoniia na biologicheskie svoistva mikroorganizmov.

The effect of the synthetic immunomodulator polyoxydonium (PO) on some biological properties of pathogenic bacteria (Shigella flexneri, Salmonella enteritidis), opportunistic bacteria (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacteroides fragilis, Peptostreptococcus anaerobius, Prevotella melaninogenica, Propionibacterium propionicum, Clostridium difficile) and fungi (Candida albicans), isolated during enteric infections, enteric dysbiosis, pyoinflammatory diseases, was evaluated in a number of in vitro experiments. The study revealed that the recommended therapeutic concentration of PO decreased antilysozyme activity (ALA) and the anticomplement activity in Klebsiella, Shigella, Propionibacterium, Clostridium, bacteroids, fungi of the genus Candida, but increased ALA in nonhemolytic Escherichia. Under the action of PO an increased sensitivity of the microorganisms under study to definite antibiotics of the lincosamide, fluoroquinolon, carbapenem and cephalosporin groups was noted. The data obtained in this study reveal one of the possible mechanisms of the corrective action of PO on the microbiocenosis of the intestine in dysbiosis, enteric infections and pyoinflammatory diseases.

[Microflora of the large intestine in patients with connective tissue dysplasia]. / Mikroflora tolstoi kishki u patsientov s displaziei soedinitel'noi tkani.

The specific features of intestinal aerobic and anaerobic intestinal microflora in children with nondifferentiated connective tissue dysplasia were under study. A high rate of dysbiotic disturbances was noted in patients with connective tissue dysplasia in comparison with healthy persons. Profound quantitative and qualitative changes in the biocenosis of the intestine were detected in patients with the pathology of the gastrointestinal tract as well as that of the locomotor system. Changes in the species composition and the persistence properties of the intestinal microflora may serve as pathogenetic factors in the development of connective tissue dysplasia.

[Colicinogenic activity of intestinal microflora as a sign of dysbacteriosis of the gastrointestinal tract]. / Kolitsinogennaia aktivnost' kishechnoi mikroflory kak pokazatel' disbioticheskogo sostoianiia zheludochno-kishechnogo trakta.

Clinical and bacteriological studies have revealed that the production of colicin by Escherichia coli forming a part of intestinal microbiocenosis is related to the clinical manifestations of inflammatory diseases of the gastrointestinal tract. During the exacerbation of chronic inflammatory processes of the digestive system the proportion of colicin producing E. coli increases (more than 45%) in comparison with that of E. coli fecal strains isolated in children and adolescents regarded as healthy (less than 15%). The possibility of using the colicin producing activity of intestinal microflora for the evaluation of the dysbiotic states of gastrointestinal tract is discussed.

[Modifying action of Saccharomyces boulardii on the biological properties of enterobacteria]. / Modifitsiruiushchee deistvie Saccharomyces boulardii na biologicheskie svoistva énterobakterii.

The influence of the exometabolites of the fungus S. boulardii, contained in the probiotic preparation "Enterol", on the biological properties of opportunistic and pathogenic enterobacteria of fecal microflora (inactivation of lysozyme, colicin production, hemolytic activity, antibiotic resistance) was studied. The study revealed that the supernatants of S. boulardii decreased antilysozyme activity (ALA) in lactose positive (lac+) and lactose negative (lac-) Escherichia coli and Klebsiella strains, but produced no influence on ALA in Salmonella. In response to the action of S. boulardii exometabolites colicin production in E. coli (lac+) was found to increase, while in E. coli (lac-) colicin production was suppressed. An increase in the sensitivity of lactose negative E. coli to cefazolin and cefotaxime under the action of S. boulardii supenatants was noted. The results obtained in this study show the probable mechanism of the corrective action of "Enterol" on intestinal biocenosis, which should be taken into consideration in the differentiated selection of probiotics for the treatment of intestinal dysbacteriosis.

[Bacterial-fungal associations in the intestine under the conditions of colonization by yeast-like fungi of the genus Candida]. / Bakterial'no-gribkovye assotsiatsii kishechnika v usloviiakh kolonizatsii drozhzhepodobnymi gribami roda Candida.

The composition of the fecal microflora in somatic patients and patients with enteric infections under the conditions of surpluscolonization by yeast-like fungi of the genus Candida was analyzed. The study revealed that the high level of fungal contamination was linked with decreased colonization resistance of the intestine (deficiency in bifidoflora) and with the presence of opportunistic microorganisms: Staphylococcus aureus, hemolytic and lactose-negative Escherichia coli, as well as nonfermenting Gram negative bacteria. The antilysozyme activity of enterobacteria was found to increase in the course of their joint cultivation with fungi of the genus Candida, that may be regarded as one of the mechanisms of the formation and maintenance of pathobiocenosis.

[Health status of children living in rural localities in the area of Totsk nuclear explosion]. / Sostoianie zdorov'ia detei, prozhivaiushchikh v sel'skikh naselennykh punktakh v zone Totskogo iadernogo vzryva.

The paper presents late outcomes of radiation exposure of 3205 children aged 6-17 years from native persons residing in the areas exposed to radiation 40 years ago. The spread of noncommunicable diseases in the children from the polluted area is 92%. Organic abnormalities are prevalent among them. These include thyroid hyperplasia, lymphadenopathy, gastrointestinal, cardiovascular, and other diseases. Thus, the environmental radiological situation in the southern Urals and the Orenburg Region is poor.

[The effect of drug preparations on the expression of the persistence properties of uropathogenic strains of enterobacteria]. / Vliianie lekarstvennykh preparatov na vyrazhenie persistentnykh svoistv uropatogennykh shtammov énterobakterii.

The results of experiments on the study of the influence of antibiotics, agents used in pathogenetic therapy and phytopreparations on the persistence properties of uropathogenic bacteria have demonstrated that medicinal remedies produce different effects on the persistence factors of microorganisms (inhibiting, stimulating, neutral). The method of the selection of optimum medicinal remedies inhibiting the persistence factors of bacteria with the aim of ensuring the effective therapy of pyelonephritis has been developed.

[The microbiological diagnosis of pyelonephritis in children under the control of bacterial persistence factors]. / Mikrobiologicheskaia diagnostika pielonefrita u detei pod kontrolem faktorov bakterial'noi persistentsii.

The study of antilysozyme and anti-interferon activity in 474 urological strains of opportunistic bacteria isolated from the urine of pyelonephritis patients and in 302 strains isolated from the urine of healthy children was made. The occurrence and the average amount of bacterial persistence factors were found to be directly related to the isolation source of cultures. The determination of the antilysozyme and anti-interferon activity of urological strains made it possible to confirm the etiological importance of enterobacteria and Pseudomonas in the development of renal infections and to differentiate the causative agent of pyelonephritis from the concomitant microflora.