[Use of imipenem in the treatment of patients with surgical infection]. / Primenenie imipenem dlia lecheniia bol'nykh s khirurgicheskoi infektsiei.

The efficacy of thienam, a product of Merck, Sharp and Dohme (USA) composed of imipenem and cylastatin was studied in the treatment of 52 patients with surgical infection. In 48 and 4 patients the drug was used therapeutically and prophylactically respectively. When the drug was used therapeutically the recovery and improvement were observed in 41 out of 44 patients (93.2 per cent), 4 patients being excluded from the treatment group because of adverse reactions such as hyperthermia and skin eruption. When the drug was used prophylactically the recovery and improvement were stated in all the 4 patients. The pathogens were eradicated in the wound in 40 patients (91 per cent). 114 clinical isolates were tested and the imipenem resistance was detected only in 6.5 per cent of the Staphylococcus aureus strains, in 20 per cent of the Pseudomonas aeruginosa strains and in 50 per cent of the P. mirabilis and P. vulgaris strains. All the isolates of Escherichia coli, Enterobacter, Acinetobacter and Citrobacter were susceptible or moderately susceptible to imipenem.

[The use of the carbon dioxide laser in acute surgical infection of the soft tissues]. / Ispol'zovanie uglekislotnogo lazera pri ostroi khirurgicheskoi infektsii miagkikh tkanei.

Clinico-laboratory studies were conducted in 46 patients with wound infection for the treatment of which carbon-dioxide laser was used, and in 78 patients who were operated on with a metal scalpel (control). It is shown that "excision" and "evaporation" of tissues took 15-45 minutes. Repeated interventions were performed in 15% of cases due to bleeding from vessels measuring 1.0-1.5 mm in diameter. After surgical debridement with a scalpel the number of microbes reduced from 10(7)-10(9) to 10(3)-10(4) per g. After exposure to the laser beam this value was 10(1) but on day 3-4 it was 10(5)-10(6). The extent of the zone of coagulation necrosis in the zone exposed to the laser beams measured up to 500 microns, and began diminishing only on day 7-9 of postoperation. Suppuration of the wounds in 56% of patients of the main group treated by operation was in conformity with the results of bacteriological and morphological studies. In the control group this index was 15.4%. It is concluded that the use of carbon-dioxide laser as a "light scalpel" with subsequent primary closure of the wound is inexpedient. Its use in preparing a wound for closure with secondary sutures has no advantages over radical surgical debridement.

[Effect of a controlled abacterial environment on the Pseudomonas aeruginosa infection of suppurative wounds]. / Vliianie uprialiaemoi abakterial'noi sredy na sinegnoinuiu infektsiiu gnoinykh ran.

The present work deals with the data on the isolation rate of P. aeruginosa from suppurative wounds of different origin during their treatment by the commonly used methods under dressings and by the open method under the conditions of controlled germ-free environment. The results of the immunotyping of P. aeruginosa strains isolated from patients treated by different methods are presented. The dynamics of changes in the isolation rate of P. aeruginosa at different periods of treatment, both by the open method and with the use of dressings, is shown. Among P. aeruginosa strains isolated from suppurative wounds, those belonging to immunotypes 6, 7 and 2, as well as nontyping strains, occurred most frequently. Treatment in the controlled germ-free environment permits the protection of the wound surface from hospital infection. During treatment with the use of dressings the cases of hospital infection were revealed (31.3%). Such infection occurred, as a rule, at a later period of treatment.

[Immunotyping of freshly isolated strains of Pseudomonas aeruginosa]. / Immunotipirovanie svezhevydelennykh shtammov Pseudomonas aeruginosa.

During 1972-1982 the bacteriological study of 1391 patients with thermal burns was carried out. As the result of clinico-bacteriological studies, the occurrence of P. aeruginosa was found to increase from 39.3% to 70.5% during this period. The immunotyping of P. aeruginosa cultures isolated in 3 burn-treatment centers showed that strains belonging to immunotypes 2, 3, 7 and 3/7 were most frequently isolated from burn wounds. These strains were found to be the cause of hospital infections in burn-treatment hospitals. In connection with the data thus obtained immunological preparations intended for the prophylaxis and treatment of P. aeruginosa infection should include P. aeruginosa strains, immunotypes 2, 3, 7 and 3/7.

[Selective media for isolating Pseudomonas aeruginosa]. / Selektivnye sredy dlia vydeleniia Pseudomonas aeruginosa.

The comparative study of 4 selective media (medium containing N-cetylpyridinium chloride, acetamide agar, cetrimide agar, medium containing irgasane) showed that their use permitted one to enhance the isolation of P. aeruginosa, especially pigment-free forms, from pathological material and to reduce the time of their isolation by 24-48 hours. Of all the media subjected to testing medium containing N-cetylpyridinium chloride and acetamide medium proved to have the highest selectivity.