[Some current aspects of diagnosis of calculous pyelonephritis].

Immunomicrobiological examination was made of 656 urine and 71 blood samples from 71 patients with chronic pyelonephritis and coral nephrolithiasis. Bacteriuria in blood agar was quantified in colony-forming cells (CFC) in 1 ml of the urine. Identification of the bacterial strains was made by conventional methods. Blood samples were examined for phagocytic activity (PA) of neutrophils and phagocytic index (PI) in incomplete (30 min) and complete (2 hours) variants (S.aureus-209P), levels of IgA, IgM, IgG (in IU/ml), complement (CH50), T- and B-lymphocytes and 0-cells. Opportunistic bacteria (OB) in titer from Ig 2 to Ig 5 CFC/ml and more were identified in 428 (65.25%) samples. OB monocultures prevailed (48.6%). In exacerbation of the disease the majority of the examinees (73.0%) showed deficiency of both cellular and humoral components of antiinfection resistance system (AIRS). First-line defense against bacterial invasion was impaired as shown by incomplete neutrophil digestion in 62.0% of examinees. Among patients with humoral immunodeficiency, those with low IgM were the minority (45.0%). T-RFC and B-RFC deficiency (in 68.0 and 52.0%, respectively), low levels of IgG and IgA (66.0 and 73.0% cases, respectively) indicated deficiency of immunocompetent cells and their functional activity. The study of the AIRS established significance of its components for early and significant diagnosis of calculous pyelonephritis. Pyelonephritis in nephrolithiasis runs with deficiency of both cellular and humoral components of AIRS.

[The anti-infective resistance system in women with chronic urogenital inflammatory diseases of chlamydia ethiology].

A complex clinico-instrumental and immuno-microbiological examination of 433 reproductive age women was performed. The results show that a lingering and relapsing chlamydian infection in women with an exacerbation of a chronic inflammatory urogenital disease develops against the background of disturbances in the anti-infective resistance system (AIRS), and is characterized by combination of chlamydian infection with other sexually transmitted infections and the presence of dysbiosis. The immunological aspects of this process consist in almost a total absence of neutrophiles' ability to digest a bacterial antigen, and incompleteness of phagocytosis, in general. These changes may be connected with a low immunogenicity and intracellular parasitizing of chlamydiae, on the one hand, and with primary incompetence of the subjects' AIRS, on the other. From a microbiological point of view, this is manifested by complete combined urogenital and colon dysbiosis.

[Surgical treatment of chronic purulent diseases of extremities' bones and great joints].

Results of treatment of chronic purulent diseases of extremities' bones (n=414) and great joints (n=136) were analyzed. Combined treatment included surgical sanation of the inflammatory focus, autospongioplasty of residual cavities and defects after sequesterectomy (87 cases), extrafocal osteosynthesis, aspiration- flushing drainage. In 46 cases of severe suppuration in the zone of hip joint's endoprosthesis the resection arthroplasty was performed, in 43 cases of severe consequences of ankle-joint's fracture-dislocations -- compression talo-tibial and calcaneo-tibial arthrodesis. The follow-up was 15 years. Positive results were seen in 93.6% patients.

[Microbiocenosis of the mucous membranes of the upper respiratory tract and its correction with acipol in the treatment of patients with acute respiratory virus infections]. / Mikrobiotsenoz slizistykh obolochek verkhnikh dykhatel'nykh putei i ego korrektsiia pri ispol'zovanii atsipola v lechenii bol'nykh ORVI.

Clinical and laboratory evaluation of the preparation Acipol in 45 children greatly susceptible to acute respiratory virus infections (ARVI) was carried out. Simultaneously with the clinical analysis, the study of the microflora of the mucous membranes of the upper respiratory tracts and intestine, as well as the levels of secretory IgA in saliva and coprofiltrates before and after treatment, was made. The inclusion of Acipol into the therapy of ARVI patients facilitated their clinical convalescence, uncomplicated course of the disease, correction of disturbances in the biocenosis of the upper respiratory tracts and increased infectious resistance.

[Biliary microflora of patients with chronic pancreatitis]. / Mikroflora zhelchi bol'nykh khronicheskim pankreatitom.

Data on the contamination of bile specimens (1997 and 2001, 205 specimens, 137 cultures), examined in the Laboratory of Clinical Microbiology of the Vladimirsky Regional Research Clinical Institute, as well as data on the microflora composition in 40 specimens of bile, obtained from patients with clinically diagnosed chronic pancreatitis at the stage of exacerbation, are presented. Out of 40 specimens of bile 54 cultures of microorganisms were isolated; of these, 33.3% were bacteria of the genus Staphylococcus, Gram negative bacilli took the second place in occurrence (27.8%) and the third place belonged to bacteria of the genus Streptococcus (18.5%). The antibiotic sensitivity of the isolated microorganisms is characterized.

[Evaluation of microecology of colonic contents in patients with chronic pancreatitis]. / Otsenka mikroékologii soderzhimogo tolstoi kishki u bol'nykh khronicheskim pankreatitom.

The paper deals with microbiocenosis in the colonic content in 60 patients with chronic pancreatitis during its exacerbation. An analysis has indicated that in the colonic content there are the following microorganisms: Bifidobacterium sp., 10(8)-10(10) CFU/g; Lactobacillus sp., 10(1)-10(5) CFU/g; Escherichia coli, 10(8)-10(10) CFU/g; Enterococcus faecalis, 10(6)-10(10) CFU/g; Enterococcus faecium, 10(6)-10(10) CFU/g; the family Enterobacteriaceae (mainly Klebsiella-Enterobacter sp.), 10(1)-10(6) CFU/g; yeasty (including the Candida genus) and mold fungi, 10(1)-10(5)/g; Staphylococci, 10(1)-10(3) CFU/g. Comparing the findings with those of normal cenosis according to different authors' data suggests that there are no apparently impairments in the levels of some microoranisms, the representives of microbiocenosis in the colonic content in the examinees.

[Monitoring of etiological agents of acute enteric infections in the Moscow region]. / Monitoring vozbuditelei ostrykh kishechnykh infektsii v regione Moskovskoi oblasti.

The fecal microflora of patients with acute enteric infections (AEI) has been examined on the territory of the Moscow region. The pathogens of high, moderate and low priority levels have been detected. As revealed in this study, shigellae, salmonellae, enteropathogenic and enteroinvasive Escherichia are the etiological agents of bacterial diarrheas on the territory of the Moscow region. The dynamics of the etiological agents of AEI in the region has been established.

[Monitoring of uropathogens and their susceptibility to antibiotics]. / Monitoring uropatogenov i ikh chuvstvitel'nosti k antibiotikam.

Samples of urine collected from patients with complicated urology infection and hospitalized to the Moscow Region Research Clinical Institute in 1986, 1991, 1995 and 1999 were analysed. Of 11,444 samples examined, bacteriuria was estimated in 7143 samples. 9786 strains (29 genus) of bacteria were isolated--56.9 per cent as mono culture and 43.1 per cent as associations. Susceptibility to 21 antibiotic was determined by disk diffusion method for 1607 strains; beta-lactamase production was determined in 198 strains, MIC was determined for 41 antibiotics. Gram-negative rods relative amount among pathogens decreased substantially (84.7 per cent in 1986 against 61.6 per cent in 1999), particularly Enterobacteriaceae (74.7 per cent in 1986 against 41.4 per cent in 1999). Nonfermenting Gram-negative rods (NFGNR) relative amount increased (10.8 per cent against 19.2 per cent), along with Gram-positive cocci (19.8 per cent against 64.2 per cent), particularly coagulasenegative staphylococci (CNS) (10.8 per cent against 35.9 per cent) and enterococci (5 per cent against 16.5 per cent) and candida and fungi (0.5 per cent in 1986 against 15.9 per cent in 1999). At the period 1986-1999 the main pathogens in urology infection were E. coli, Enterobacter spp., NFGNR (including P. aeruginosa), Staphylococcus, CNS, Enterococcus spp. The problem pathogens for urological department were the following: E. coli, Klebsiella spp., Enterobacter spp., Proteus spp., NFGNR including P. aeruginosa, CNS, Enterococcus spp., candida and fungi. At the period 1991-1997 Gram-negative pathogens susceptibility to amikacin, ofloxacin, ciprofloxacin, imipenem, ceftazidime, cefotaxime was not changed in general, Gram-positive cocci (staphylococci and enterococci) retained the same susceptibility to vancomicin, cefamandol and amoxyclave. Staphylococci were also susceptible to amikacin, imipenem, rifampicin, oxacillin, ciprofloxacin, and ofloxacin. Production of beta-lactamase was registered for 38.7 per cent of CNS, 26.5 per cent of E. coli, 38.5 per cent of K. pneumoniae, 25 per cent of P. mirabilis and 55.6 per cent of P. aeruginosa strains.

[Opportunistic microorganisms in purulent inflammatory otolaryngologic diseases and meningitis]. / Uslovno patogennye mikroorganizmy pri gnoino-vospalitel'nykh zabolevaniiakh lor-organov i meningitakh.

The contamination of clinical specimens material, obtained from patients with otolaryngology inflammatory processes and purulent meningitides in the Moscow region, has been studied. Etiologically significant causative agents dominating in different purulent inflammatory diseases have been established. As revealed in this study, in the Moscow region the leading causative agents of purulent inflammatory otolaryngology deseases and meningitides are coagulase-negative ataphylococci, Escherichia coli, meningococci, pyogenic streptococci and fungi of the genus Candida.

[Microflora in ENT and CNS diseases in patients living in the Moscow region]. / Mikroflora pri zabolevaniiakh Lor-organov i nervnoi sistemy u bol'nykh regiona Moskovskoi oblasti.

Patients with ENT and CNS inflammation living in the Moscow Region have been examined for pathogenic contamination of relevant clinical samples. The microflora changes were followed up, pathogenic agents of high and moderate priority were identified. It is shown that for Moscow Region, ENT and CNS purulent inflammation is associated primarily with coagulase-negative staphylococci, E. coli, meningococci, S. viridans and yeast fungi.

[Opportunistic microorganisms in urinary tract diseases]. / Uslovno-patogennye mikroorganizmy pri zabolevaniiakh mochepolovykh putei.

The microflora of clinical material (urine, urethral discharge and smear, vaginal discharge and smear, feces in colonic dysbacteriosis) from patients with urinary tract infections (UTI) in the Moscow Region was studied. Escherichia coli and Staphylococcus epidermidis have been found to be the most common agents isolated from the urine of UTI patients. Pseudomonas aeruginosa and other staphylococcal species and enterococci account for a smaller proportion of infections. High- (E. coli and S. epidermidis) and moderate-priority pathogens are translocated into the urinary tract from the colonic biotope in dysbacteriosis. The causative agents of non-gonococcal urethritis are staphylococci (more commonly epidermal ones) in 50% of cases, those of pyelonephritis are staphylococci (predominantly E. coli) in more than 50% of cases. The etiological agents of female genital infections are staphylococci (mainly epidermal ones) in 40% of cases.

[Opportunistic microorganisms in respiratory tract diseases in patients of the Moscow Province region]. / Uslovno patogennye mikroorganizmy pri zabolevaniiakh dykhatel'nykh putei u bol'nykh regiona Moskovskoi oblasti.

The respiratory tract microflora in patients with inflammatory processes of the upper and lower respiratory tracts in the Moscow Province region has been studied. Changes in the microflora were found to occur in patients with pyoinflammatory diseases (PID) of the upper and lower respiratory tracts have been found to occur. Gram-positive cocci, mainly staphylococci and streptococci, were shown to play the leading etiological role in the development of PID. As revealed in this study, the microorganisms detected in the inflammations of the upper and lower respiratory tracts are coagulase-negative staphylococci, mainly S. epidermidis, as well as enterococci and streptococci belonging to the group viridans.

[Microflora of patients with purulent septic diseases in the Moscow region]. / Mikroflora gnoino-septicheskikh zabolevanii u bol'nykh v Moskovskoi oblasti.

The microflora of clinical material (blood, wound discharge, abdominal exudate, pleural exudate, milk in mastitis, as well as feces in dysbiosis of the large intestine), obtained from patients with purulent septic diseases in the Moscow region was studied. The study revealed the change of microflora from surface biotopes to closed cavities of the body. Gram-positive cocci, primarily coagulase-negative staphylococci, mainly epidermal, were shown to play the leading etiological role in the development of purulent septic diseases. The development of bacteriemia was found to be caused by the penetration of staphylococci from local pyoinflammatory foci (appearing in purulent mastitis, wounds, peritonitis, pleural empyema and pleuritis), as well as by the translocation of staphylococci and Escherichia coli from the large intestine in dysbiosis.

[Immuno-microbiological aspects of chronic bacterial prostatitis pathogenesis]. / Immunomikrobiologicheskie aspekty patogeneza khronicheskogo bakterial'nogo prostatita.

The paper deals with a role of the factors of the body's antiinfective resistance system in the pathogenesis of chronic bacterial prostatitis and with the identification of an etiological factor of the disease. Long-term studies have revealed that chronic bacterial prostatitis runs in the presence of impairments in the antiinfective resistance system, in failures of T lymphocytes, phagocytic activity, and opsonization in particular. Gram-positive cocci, predominantly Staphylococcus and Enterococcus alone or as part of 2-component associations have been found to be the leading agents in the etiology of chronic bacterial prostatitis.

[Use of piperacillin-tazobactam in abdominal surgery]. / Primenenie piperatsillin/tazobaktama v abdominal'noi khirurgii.

Piperacillin/tazobactam (P/T) was used in the monotherapy of 40 patients with various inflammatory diseases of the abdominal cavity organs. P/T was administered as dropwise intravenous infusions in a single dose of 4/0.5 g 3 times a day for 5 to 17 days. In 82.5 per cent of the patients with infection of the abdominal cavity: severe postoperative purulent wounds, peritonitis of various etiology (biliary, serous-fibrinous, hemorrhagic fibrinous), postnecrotic cyst of the pancrease, abscesses of the liver and subhepatic space P/T proved to be highly efficient. The P/T monotherapy resulted in practically complete eradication of anaerobic microbes, coagulase negative staphylococci, enterobacteria and nonfermenting bacteria except for Pseudomonas aeruginosa in the inflammation foci.

[Effect of piperacillin/tazobactam on the anti-infection resistance in patients with infections in the peritoneal cavity]. / Vliianie piperatsillin/tazobaktama na sistemu antiinfektsionnoi rezistentnosti bol'nykh s infektsiei v briushnoi polosti.

The effect of the monotherapy with piperacillin/tazobactam (P/T) or tazocin on microflora of the mucous membranes of the nose and pharynx of 33 patients and the contents of the large intestine of 21 patients as well as on the immunological aspects (cellular and humoral factors) of the antiinfectious resistance systems (AIRS) in patients with abdominal cavity infection (ACI) was studied. Before the treatment serious impairment of the AIRS in all the patients was observed. The P/T monotherapy in a daily dose of 12/1.5 g at the average for 10 days had no unfavourable effect on the indices characterizing the phagocytic function of the neutrophils in the incompleted and completed variants, on the immunocompetent cells, hemolytic complement and the levels of IgM, IgG and IgA. No significant effect of the treatment on the mucosal microflora on the whole was detected. However, Neisseria spp. and Corynebacterium pseudodiphtheriticum were eradicated in the pharynx while the number of the Klebsiella pneumoniae [symbol: see text] Escherichia coli isolates from the pharynx mucosa increased. The number of the bifidobacteria in the contents of the large intestine significantly lowered while the number of the hemolyzing forms of enterococci and stapylococci increased. The investigation of the AIRS immunological aspects in the patient groups of different total (clinicomorphological) efficacy showed that the neutrophil phagocytic function was the efficacy predictor and P/T in its turn had an immunomodulating effect on the neutrophil phagocytic activity in the patients with ACI.

[Use of microtest systems for identification of newly isolated clinical strains]. / Ispol'zovanie mikrotest-sistem dlia identifikatsii svezhevydelennykh klinicheskikh izoliatov.

Species appurtenance of 425 clinical strains isolated from various types of material from December 1993 to November 1994 was identified using Lachema (Czechia) Micro-la-test. There were 99 staphylococcal, 139 streptococcal, 119 enterobacterial cultures, and 68 nonfermenting gram-negative bacteria. The microorganisms were characterized completely according to their code in 67.7% cases (STAPHYtest), 54% (STREPTOtest), 25.2% (ENTEROtest), and 22.1% (NEFERMtest). False-positive reactions in the control were detected in 22.2% (STAPHYtest), 33.3% (STREPTOtest), 11.8% (ENTEROtest), and 41.7% (NEFERMtest) of the number of biochemical characteristics in a plaque. Unclear reactions (+/-) making identification difficult were observed in 100% cases for STAPHYtest, 83.3% for STREPTOtest, 91.7% for ENTEROtest-1, and 58.3% for NEFERMtest. Atypical reactions, not corresponding to the studied species, were observed in 62.5% cases with STAPHYtest, 41.7% with STREPTOtest, 66.7% with ENTEROtest-1, and 58.3% with NEFERMtest. Still, STREPTOtest with the probability of verifying 61.5 to 87.5% of the cultures may be used for identifying the species appurtenance of alpha-hemolytic streptococci.

[Indicators of resistance to infection in children with respiratory papillomatosis]. / Pokazateli antiinfektsionnoi rezistentnosti u detei, bol'nykh respiratornym papillomatozom.

The study was made of microbiological and immunological aspects of antiinfectious resistance (AIR) in children with respiratory papillomatosis (RP). At admission to hospital RP patients exhibited dysbacteriosis of the upper respiratory tract and colon. Immunological and microbiological response to the infection recurrences was adequate. Interrelated immunological and microbiological indices in RP objectively reflect the course of the pathological process and may be used in objective assessment of the disease and choice of its treatment.