Analysis of genetic markers of N. gonorrhoeae resistance to beta-lactam antibiotics.

A complex method for detection of genetic markers of N. gonorrhoeae resistance to penicillin was developed. Mutations in penA and ponA genes were detected by minisequencing reaction with subsequent detection of reaction products by MALDI-TOF mass spectrometry. This approach was tested on 31 clinical strains of N. gonorrhoeae with minimum inhibitory concentration of penicillin from 0.03 to 8 microg/ml and higher. Mutations in penA and ponA genes in moderately resistant strains were shown (minimum inhibitory concentration up to 0.5 microg/ml) and mutations in penA, ponA, and penB genes in resistant strains (minimum inhibitory concentration more than 1.0 microg/ml). beta-Lactamase genes were detected in 4 strains with high resistance (minimum inhibitory concentration 4-8 and more microg/ml). Correlation between microbiological resistance and presence of respective mutations in the studied locuses was detected.

[Relationship between biological variants of U. urealyticum and clinico-morphological manifestations of urogenital inflammation in experimental animals]. / Sviaz' biologicheskikh variantov U. urealyticum s kliniko-morfologicheskimi proiavleniiami vospalitel'nogo protsessa mochevykh i polovykh organov éksperimental'nykh zhivotnykh.

Dependence of clinicomorphological changes in urinary and sexual organs of rats on biological variants of U.urealyticum (biovar Parvo or T960) used in experimental modelling of ureaplasmic infection by two variants: a) introduction in the sterile conditions of culture U.urealyticum (10(4)-10(6) U/ml) directly into the bladder by catheterisation b) infection of female anogenital region with culture U.urealyticum (10(6) U/ml) for 5 days and keeping healthy males and females together. Clinicomicrobiological and morphological evaluation of the urinary and sexual organs of the rats was made 3, 7, 14 and 30 days after the infection. Features of the inflammation were specified with reference to a certain biovar of U.urealyticum. Identity of U.urealyticun biovars used for infection and isolated from the urogenital organs of the test animals 14 and 30 days after the infection was confirmed microbiologically.

[A method of genotyping clinical isolates of Ureaplasma urealyticum biovar Parvo]. / Metod genotipirovaniia klinicheskikh izoliatov Ureaplasma urealyticum biovara Parvo.

A new method for typing clinical isolates of U. urealyticum (Parvo biovar) is based on SSCP analysis of amplicons of mba gene 5' region and upstream region. The mba gene is coding for MB gene of U. urealyticum. This method allows genotyping of U. urealyticum isolates using vaginal and cervical swabs without culturing. Sixty-two clinical specimens from patients with a history of chronic cystitis, chronic pyelonephritis, chronic salpingo-oophoritis, erosion of the cervix uteri, and spontaneous abortions were tested for U. urealyticum. The bacterium was detected in 64% (40 specimens), 83% (33) of which belonged to Parvo biovar. Parvo biovar isolates were analyzed and genotyped as follows: first genotype 52%, second genotype 33%, and third genotype 16%. Further sequencing of the first and second genotype amplicons showed that the first genotype belonged to serotype 3 and second genotype to serotype 6.

[The diagnostic and therapeutic characteristics of inflammatory urogenital diseases in women associated with Ureaplasma urealyticum]. / Osobennosti diagnostiki i terapii vospalitel'nykh urogenital'nykh zabolevanii u zhenshchin, assotsiirovannykh s Ureaplasma urealyticum.

Complex examination of 40 female in- and outpatients at the age 20 to 42 years with inflammatory urogenital diseases was performed. To verify the diagnosis, current clinical, microbiological, endoscopic and ultrasonic procedure were used. It was shown that the inflammatory processes in the urogenital tracts were mainly due to association of opportunistic and/or pathogenic organisms. Optimization of antibacterial therapy of urogenital infections was found possible with using homeopathic agents in the complex therapy. The significance of cooperation of the allied specialists in the choice of the examination and therapy policy for female patients with inflammatory urogenital diseases is indicated.

[Effectiveness of local application of cidipol in the treatment and prevention of infectious-inflammatory diseases of the urogenital organs in women]. / Effektivnost' mestnogo primeneniia tsidipola v lechenii i profilaktike infektsionno-vospalitel'nykh zabolevanii mochepolovykh organov u zhenshchin.

The efficacy of cidipol used locally in the treatment of infectious inflammatory diseases of the urogenital tracts and in the prophylaxis of urinary tract infection (UTI) in transurethral instrumental interventions (TII) was studied microbiologically and clinically in 42 females at the age of 18 to 51 years. In the treatment of 23 female patients the drug showed good clinical effects. The eradication of the primary pathogen was stated in 16 patients. When used prophylactically before TII in 19 patients no infectious inflammatory complications were observed in any of the females. The data are evident of the possible use of cidipol in the treatment (local application) of infectious inflammatory diseases of the urogenital tracts in females and in the prophylaxis of UTI in TII.

[The pathogenesis and prevention of urinary tract infection in women]. / Patogenez i profilaktika infektsii mochevogo trakta u zhenshchin.

Urinary tract infection (UTI) in females occurs significantly more frequently than in males because of specific anatomical and functional features of female urinary system, sequelae of pregnancy, delivery, gynecological diseases. Much controversy still exists as to pathogenesis of UTI and UTI-induced urinary inflammation. We have examined 233 females of different age with UTI and obtained evidence which shows participation of such factors as early and intensive sex, ignorance of sex hygiene, multiple pregnancies, deliveries, abortions, inflammatory gynecological diseases, anogenital infection in its pathogenesis. These factors were registered 2-4 times more frequently in UTI females than in controls without UTI. Bacteriological urinary and genital findings coincide in 80% of cases in terms of an infective agent. This suggests that it is essential to detect urogenital infection in girls and females as early as possible and to treat it adequately with antibacterial and other drugs. The leading role of an ascending urinogenic route in urinary tract infection from local sources in anogenital zone, sexual factor and the absence of relevant hygienic habits proved most contributing to UTI pathogenesis. This concept serves the basis for UTI prevention in females.

[The combined preparation ligentin in the treatment of inflammatory disease of the urogenital organs]. / Antimikrobnye peptidy i rezistentnost' zhivotnykh.

The actuality of the problem is conditioned by the persistence of residual inflammations in a significant number of the patients with urogenital infections after the completion of the etiotropic therapy. The main goal of the study was to develop a method for the treatment of post-gonorrheal and post-chlamydial colpitis, colpomycosis, endocervicitis and urethritis by local application of Ligenten, a gel containing gentamicin, ethonium and lidocaine (as an anesthetic). The trial included 28 females at the age of 20 to 58 years with residual inflammations in the urogenital organs after the completion of the antimicrobial therapy of the urogenital infections. The gel was applied locally as tamponade and/or irrigation of the urethra 1-2 times a day for 6 to 10 days. The results of the treatment showed that the residual inflammations were completely eliminated in 17 out of 26 patients, in 5 patients a significant improvement was stated and in 4 patients the treatment failed. The data indicated that Ligenten is useful in the complex treatment of urogenital infections as a local therapy of residual inflammations.

[The microbiocenosis of the intestinal mucosa during the treatment of infectious urogenital diseases with fluorinated quinolones]. / Mikrobiotsenoz slizistoi obolochki kishechnika pri lechenii infektsionnykh urogenital'nykh zabolevanii ftorirovannymi khinolonami.

Intestinal microecology was studied in 52 patients (47 females and 5 males aged 18-61) with urogenital infections. Group 1 consisted of 35 patients with new-onset urogenital infections, group 2 of 17 patients had long-term recurrent urogenital infection. All the patients exhibited abnormal intestinal mucosal flora manifest more definitely in group 2. The microfloral changes comprised reduced count of bifidal bacteria, E. Coli, lactobacteria, occurrence of atypical bacteria. Administration of fluorinated quinolones (abactal or maxaquine) affected aerobic intestinal microflora and insignificantly influenced anaerobic bacteria. It is thought valid to investigate intestinal flora in patients with urogenital infections for taking adequate corrective measures.

[Fluoroquinolones in the therapy of gonorrheal-chlamydial infection (a clinical and electron microscopic study)]. / Ftorkhinolony v terapii gonoreino-khlamidiinoi infektsii (kliniko-élektronnomikroskopicheskoe issledovanie).

Highly efficient methods for the treatment of gonorrheal and gonorrheal-chlamydial infections with fluorquinolones were developed and introduced into medical practice. The methods are pathogenetically substantiated. The etiological recovery in the patients treated with tarivid, quintorom and abaktal amounted to 97.8, 96 and 95.6 per cent respectively. The subcellular examinations of ultrathin sections of the pathological material from the patients with gonorrheal-chlamydial infection showed that the association of gonococcus and Chlamydia resulted in hyperproduction of drop-like formations that had a toxic action on leukocytes in the infection foci.

[Ofloxacin and ciprofloxacin in the treatment of sexually-transmitted diseases]. / Ofloksatsin i tsiprofloksatsin v terapii infektsii, peredavaemykh polovym putem.

A complex clinico-laboratory++ examination and treatment were made of 76 women with inflammatory processes in the urogenital tract. Gonorrhea, trichomoniasis, chlamydiosis and Ureaplasma infection were detected in 60, 31.4, 41 and 14 per cent of the cases, respectively. There were affections of the rectum by gonococci, chlamydia, ureaplasmas and Trichomonas in 55, 32, 10.6 and 6.6 per cent of the cases, respectively. The frequency of chlamydia in the oropharynx amounted to 30 per cent whereas gonococci and ureaplasma were less frequent i.e. 9 and 1.2 per cent, respectively. The combination of the above pathogens in the rectum were the following: gonococci and chlamydia (15 per cent of the cases), gonococci, chlamydia and Trichomonas (7.3 per cent), gonococci and ureaplasma (7.3 per cent), ureaplasma and chlamydia (7.8 per cent). In the throat the association of gonococci and chlamydia was detected in 3.7 per cent of the cases. It should be indicated that the signs of sex-transmitted diseases were few, which required careful clinico-laboratory examination of the extragenital foci in the patients with inflammatory urogenital diseases. Ofloxacin showed a high efficacy in the treatment of patients with gonorrhea and ureaplasmosis. Its use in treatment of chlamydiosis proved inexpedient while ciprofloxacin was effective in the treatment of the infection.

[Physicochemical and biological properties of an allergen from Trichomonas vaginalis]. / Fiziko-khimicheskie i biologicheskie svoistva allergena iz Trichomonas vaginalis.

The chemical and biological characterization of the preparation, found to be strictly specific, is presented. The allergen is nontoxic and has sensitizing properties. The active principle of the preparation is protein.