[Emergence of the integron-positive multi-drug resistant strain of Acinetobacter baumanii in Russian hospitals].

AIM: To detect the integron-positive strains among nosocomial Acinetobacter spp. and to determine their relationship on the genotype level. MATERIALS AND METHODS: Amplification by polymerase chain reaction using primers specific to sequences of the class 1 and 2 intergrons on the genomic DNA template followed by restriction fragments length polymorphism analysis as well as RAPD-genotyping of the integron-positive strains were performed. RESULTS: Fact of spreading of Acinetobacter baumanii strain containing class 1 integron in medical centers was established. The composition of the integron's gene cassettes was analogous to worldwide (including epidemic) types. CONCLUSION: Molecular genetic analysis of the mobilized structures (integrons) under the standardization of used approaches are suitable for the surveillance for circulation of epidemic strains of nosocomial pathogens.

[Genetic variety of Acinetobacter baumannii in an intensive care unit for burn patients].

The genetic structure of A. baumannii hospital isolates, formed in the course of 2002 - 2004 in an intensive care unit for burn patients (St. Petersburg) was studied. The prolonged circulation of only some clonal strains was shown, 35% of the isolates belonged to dominating strains. Phenotypically, all cultures were characterized by resistance to the preparations of the cephalosporin row and gentamicin. The presence of class 1 integron with variable segment sized 2.5 kbp was found in the genotype of four isolates with the use the polymerase chain reaction. The restriction analysis revealed its similarity with integron, detected earlier (in 1989 - 2001 ) in A. baumannii in European hospitals abroad.

[The effect of silver sulfadiazine on Acinetobacter baumannii strains isolated in burn units].

The genotype structure and silver sulfadiazine (SDS) resistance of a number of Acinetobacter baumanii strains that circulated for a prolonged period of time in burn UCUs were studied. The most resistant strain (SDS MIC 50 mcg/ml) contained a class 1 integron with the gene of sulfonamides resistance (sul1) in its genome. Possible reasons for selection of the multiple resistance among Acinetobacter spp. in burn units are discussed.

[Mode of the rational use of Pseudomonas aeruginosa bacteriophages in therapeutic and epidemic control practice]. / Puti ratsional'nogo ispol'zovaniia sinegnoinykh bakteriofagov v lechebnoi i protivoépidemicheskoi praktike.

Ecological aspects of the circulation of P. aeruginosa and P. aeruginosa bacteriophages under hospital conditions were under study. The statement concerning the formation of triple parasitic systems was put forward. The influence of these systems on the formation of phage and antibiotic resistance in P. aeruginosa hospital strains was studied. Spontaneous circulation of faintly virulent phages taking part in the formation of triple parasitic systems was shown not to ensure the elimination of P. aeruginosa hospital strains in clinics. Construction of highly virulent phages adapted to local P. aeruginosa strains was the only way of ensuring the protection of patients. Theoretical and practical approaches to the use of highly active bacteriophages for controlling P. aeruginosa infection were substantiated. The realization of these approaches resulted in achieving not only a clinical, but also essential epidemic control effect in cases of purulent septic infections caused by P. aeruginosa (a decreased frequentcy of hospital infections from 40.8% to 8.93%).

[Some unsolved aspects of the parasitism problem]. / Nekotorye nereshennye aspekty problemy parazitizma.

Various interpretations of the parasitism phenomenon exist. In this work data supporting the ecological understanding of its nature are presented. For parasitic species formed in the process of evolution the host organism has become the habitat (nutrition, multiplication), i.e., the environment, where interactions between the host and parasites are governed by ecological regularities. The consequences of this interactions are different (disease, asymptomatic infection), being secondary they reflect the result of concrete interactions. For this reason parasitism should not be identified in terms of only one consequence of such interaction--the development of pathologic processes.

[Means for improving the teaching of parasitology in higher medical academic institutions]. / Puti uluchsheniia prepodavaniia parazitologii v meditsinskikh vysshikh uchebnykh zavedeniiakh.

In our country's population, the high incidence of parasitoses of various origin is largely due to physicians' poor knowledge of parasitology. Information on major parasitic diseases, provided to students at all higher medical educational establishments, is fragmentary and scarce. For effective preparation of some graduates, the Medical Prevention Faculty, Department of Epidemiology, Saint Petersburg State Medical Academy, has elaborated a model programme for subsequent 3-year postgraduate training both of professionally qualified epidemiologists and parasitologists (1 year for medical postgraduates and 2 years for junior doctors who will specialize in a particular field). This programme provides a comprehensive theoretical background, practical skills, and preparation for making researches, investigations, and practical work.

[Epidemiological features of hospital purulent-septic infections in otolaryngological wards]. / Epiemiologicheskie osobennosti gospital'nykh gnoi-septicheskikh infektsii v otolaringologicheskikh otdeleniiakh.

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.

[Characteristics of sources and means of spread of Pseudomonas aeruginosa infections in urology wards]. / Kharakteristika istochnikov i putei rasprostraneniia sinegnoinoi infektsii v urologicheskom otdelenii.

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.

[Epidemiological characteristics of postoperative wound infections in a trauma center hospital]. / Epidemiologicheskaia kharakteristika posleoperatsionnykh ranevykh infektsii v travmatologicheskom statsionare.

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.

[Modelling of the epidemic process of suppurative septic infections using a Pseudomonas aeruginosa bacteriophage]. / Modelirovanie épidemicheskogo protsessa gnoino-septicheskikh infektsii s pomoshch'iu bakteriofaga k Pseudomonas aeruginosa.

The method for modeling the epidemic process of pyoseptic infections with the use of P. aeruginosa bacteriophage is proposed. The application of this method in urological and traumatological wards has made it possible to confirm the role of patients as the sources of infection and the part played by instruments and the hands of the medical personnel in its transfer.

[Current aspects of the short-term prognosis of meningococcal infection morbidity for the sake of epidemiological surveillance]. / Sovremennye aspekty kratkosrochnogo prognoza zabolevaemosti meningokokkovoi infektsii v interesakh épidemiologicheskogo nadzora.

The short-term prognosis of the epidemic situation requires the establishment of the system of constant surveillance, which takes into account the data on morbidity rates for several years, both total and in various age groups, the data on the morbidity level and its changes, induced by meningococci of the epidemic group, in the IV quarter of the year, the data on the level of carriership among the indicator groups of the population in this period, as well as the data on changes in antibody titers in the sera of donor blood samples taken in summer and in December.

[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.