[The evaluation of effectiveness of application of automated system of polymerase chain reaction to detect meticillin-resistant and meticillin-sensitive Staphylococcus aureus in clinical material from trauma orthopedic patients].

The article considers the evaluation of effectiveness of application of automated polymerase chain reaction system GeneXpert DX ("Cepheid USA) as compared with bacteriologic method in detection of S. aureus (SA) and meticillin-resistant S. aureus (MRSA) under infection of skin and soft tissues in orthopedic patients. The results of analysis of material from patients got in 2009-2011 using analyzer Vitek-2 to identify microorganisms demonstrated that separation and identification of agent was successful in 70.04% of 2153 examined samples. The representatives of genus of Staphylococcus made up 56% of strains. The percentage of MSRA consisted 29.8% of SA isolates. In 2012, the GeneXpert DX system was used to analyze 50 samples of clinical material. The analysis established full matching of results of detection of SA/MRSA in case of using this method and bacteriological analysis to detect agent. The DNA of SA was detected in 61.5% of patients in whom the application of bacteriological method was unsuccessful in separation and identification of agent. In 25% of patients DNA of MRSA was detected. This occurrence made it possible to begin corresponding therapy and to get clinical effect. The diagnostic using GeneXpert DX system took less than 1.5 hours from moment of availability of sample in laboratory. The application of polymerase chain reaction system GeneXpert DX is an effective additional method to identify SA/MRSA which does not exclude application of bacteriological analysis.

[Dioxidin: antimicrobial activity and prospects of its clinical use at present].

In vitro activity of dioxidin against pathogens of nosocomial infections and its cytotoxicity were estimated. The study involved 300 isolates from patients with nosocomial infections. The MICs of dioxidin were determined with the method of serial dilutions in broth. The dioxidin cytotoxicity was investigated with the MTI assay to assign the cell culture viability. In concentrations of 2 to 1024 meg/mi dioxidin was active against 279/300 (93%) strains. The drug inhibited the growth of all the gramnegative isolates. The highest activitywas observed against Enterobacteriaceae vs. nonfermenting gramnegative bacteria: the median, minimum and maximum MICs of dioxidin were 12 (4-32) and 32 (16-64) mcg/ml respectively. The dioxidin activity against gramnegative bacteria and fungi was lower. The MIC of dioxidin for 7/70 (10%) staphylococcal isolates, 9/28 (32%) enterococcal isolates and all the Candida isolates was > 1024 mcg/ml. The IC50 of dioxidin was 2.4+/-0.3 mM (low cytotoxicity). The results showed that the use of dioxidin as an antimicrobial for local application was advisable in the treatment of gramnegative bacterial infections provided adequate tissue concentrations were attained.

[Current disinfecting and antiseptic agents in anesthesiology and resuscitation]. / Sovremennye dezinfitsiruiushchie i antisepticheskie sredstva v anesteziologii i reanimatologii.

Prevention of nosocomial infection includes, along with other factors, measures aimed at maintenance of aseptic and antiseptic conditions by means of modern effective antiseptics and disinfectants. Efficacy of skin antiseptics (plivasept tincture, plivasept blue, plivasept foamy), disinfectants for instruments, surfaces, equipment (plivasept with and without PAV, aldesol, isosan G) manufactured by Pliva (Croatia) is assessed at Surgical Center. All these agents are recommended for improving the epidemiological situation in intensive care departments.

[Aspects of solution of the postoperative infection problem in heart surgery]. / Nekotorye aspekty resheniia problemy posleoperatsionnoi infektsii v kardiokhirurgii.

The study of the incidence and etiological pattern of infectious complications included 376 patients operated for acquired valvular disease. 40,280 bacteriological tests of the materials from the patients obtained during the operations and during the postoperative period as well as 30,113 sanitary bacteriological tests of the specimens from the cardiological operation unit were conducted. The possible use of the results of bacteriological monitoring for prediction of septic complications and optimization of antibiotic prophylaxis and therapy as well as for development and operation of a system of sanitary and hygienic measures for infection prevention was shown and statistically confirmed.

[Enterotoxigenicity of gram-negative microorganisms isolated from the region of congenital cleft palate in children]. / Enterotoksigennost' gramotritsatel'nykh mikroorganizmov, vydelennykh iz oblasti vrozhdennykh rasshchelin neba u detei.

One hundred and ninety four stains of opportunistic gram negative bacteria were isolated from 106 children with congenital cleft palate. 83 of them (42.7 per cent) reduced enterotoxin. For comparison, microflora of the oral cavity in 32 healthy children was investigated and 40 strains of opportunistic gram negative organisms were isolated. Only 3 of them proved to be enterotoxigenic. Therefore, the frequency of the enterotoxigenic bacteria in the children with cleft palate was higher than that in the healthy children.

[Antibiotic sensitivity of hospital strains of Staphylococcus]. / Antibiotikochuvstvitel'nost' gospital'nykh shtammov stafilokokkov.

Seven hundred and six clinical strains of Staphylococcus spp. isolated in different cities of the former USSR in 1986-1992 were investigated. It was shown that the isolates had multiple drug resistance. The hospital strains of Staphylococcus aureus more frequently contained the plasmids with the molecular weight of 21.0 and 18.0 MD as well as the plasmids with the molecular weight of 1.4 MD determining erythromycin resistance. The plasmids with the molecular weight of 3.0 and 2.6 MD were detected which determined streptomycin and tetracycline resistance respectively. Lincomycin and carbenicillin resistance was determined by the chromosomal genes. The elimination studies demonstrated that gentamicin resistance could be determined by the extrachromosomal genes.

[Biological characteristics and antibiotic sensitivity of Acinetobacter strains]. / Biologicheskaia kharakteristika i antibiotikochuvstvitel'nost' shtammov Acinetobacter.

Fifty Acinetobacter strains were investigated. Their differentiation according to the species position showed that 30 strains belonged to A. calcoaceticus and 20 strains belonged to A. lwoffi. It was found that the Acinetobacter strains had multiple drug resistance. They showed 100 per cent resistance to ampicillin, carbenicillin, erythromycin, methicillin, oxacillin, tetracycline, oleandomycin, streptomycin, rondomycin and lincomycin. According to the results of the study the most efficient antibiotics were cefazolin, cefotaxime, ceftazidime and polymyxin. The Acinetobacter hospital strains contained conjugative plasmids of different incompatibility groups. 50 per cent of the Acinetobacter strains contained conjugative R plasmids determining the resistance to streptomycin, kanamycin and tetracycline and referring to the T, J, M and N incompatibility groups. Their molecular weights were 42.0, 35.0, 30.0 and 50.0 MD respectively.

[New antiseptics and disinfectants in surgery. I]. / Novye antiseptiki i dezinfektanty v khirurgii. (Soobshchenie I)

The efficacy of disinfectants and sterilizers made by Schulcke and Mayer (Germany), such as lysetol AF, gigasept FF, and TPH 5225 was studied in the laboratory and clinical settings. Their high activity was revealed when the agents were used in the clinical settings: lysetol for disinfection and presterilization cleansing of tools and medical equipment, gigasept FF for disinfection and sterilization of fine tools, endoscopic instruments in particular, TPH 5225 for disinfection of the surfaces of environmental objects under clinical conditions.

[Current approaches to the prevention of infectious complications in heart surgery]. / Sovremennye podkhody k profilaktike infektsionnykh oslozhnenii v kardiokhirurgii.

Due to changes of humoral immunity, patients with rheumatic heart disease present, even before the operation, a high-risk group with regard to the development of infectious complications. Contamination of intraoperative material was revealed in 61.7% of cases during the operation. Extracorporeal circulation increases the cefotaxime half-life period which is in direct proportional dependence of the period of time between the beginning of the administration of the agent and the beginning of extracorporeal circulation. Immunocorrection by means of myelopid in the early postoperative period accelerates restoration of cellular and humoral immunity, and reduces the frequency of pneumonia occurrence and suppuration of the postoperative wound. Therefore, the prevention of infectious complications after operations on an open heart should be complex and should include broad-spectrum antibiotics and immunocorrective therapy.

[The activity of antiseptics and disinfectants against different species of non-fermenting gram negative bacteria]. / Aktivnost' antiseptikov i dezinfektantov v otnoshenii otdel'nykh vidov nefermentiruiushchikh gramotritsatel'nykh bakterii.

The efficacies of 7 antiseptics and disinfectants, routinely used in clinical surgery, in respect of six nonfermenting gram-negative bacterial species were under study. The microorganism strains were isolated from various objects in a surgical hospital. The detected differences in the activities of the tested agents towards different microorganism species point to the necessity of a differentiated approach to the choice of antiseptics and disinfectants with due consideration for their effects on nonfermenting bacteria.

[Clinical significance of non-fermentative bacteria isolated from the environment of a surgical department]. / Klinicheskoe znachenie nefermentiruiushchikh bakterii, vydelennykh iz vneshnei sredy khirurgicheskogo statsionara.

The article deals with the frequency of isolation of non-fermentative gram-negative bacteria, potential causative agents of postoperative infection, from objects found in the environment of various departments of a surgical inpatient clinic. The species composition of the grown culture was determined. The relation of the isolation rate of certain species of nonfermentative bacteria to the object of the examination, the department of the clinic, and the disinfection method applied was revealed. The authors point out that it is necessary to undertake systematically the investigations to determine of the activity of antiseptics and disinfectants in relation to the microorganisms indicated in order to choose the effective methods for the prevention of postoperative infection induced by nonfermentative bacteria.

[Intraoperative bacteriological examination of patients operated on under extracorporeal circulation]. / Intraoperatsionnoe bakteriologicheskoe obsledovanie bo'lnykh, operirovannykh v usloviiakh iskusstvennogo krovoobrashcheniia.

Results of bacteriological examination of 41 patients during surgical operations on the heart under conditions of artificial blood circulation are presented. The frequency of contamination of intraoperative++ samples and species composition of the isolated microflora were analyzed. It was shown that representatives of nonfermenting gram-negative++ bacteria isolated during the operations and characterized by high antibiotic resistance could be the agents causing purulent septic complications in the patients during the postoperative period. It is concluded that intraoperative++ bacteriological examination of cardiosurgical patients with successive investigation of several samples from the pericardium before and after perfusion, as well as specimens of perfusion blood at various stages and resected heart valves is advisable.