[Identification of Corynebacterium diphtheria biovar belfanti among circulating C. diphtheriae strains in Ukraine]. / Obnaruzhenie Corynbacterium diphtheriae biovara belfanti sredi tsirkuliruiushchikh shtammov vozbuditelia difterii na Ukraine.

The biochemical test of the reduction of nitrates to nitrites made it possible to identify 5.2% of strains belonging to biovar belfanti among 135 C. diphtheriae strains, initially classified within biovar mitis. Out of 7 identified C. diphtheriae belfanti strains, 2 toxigenic strains were isolated from multiple foci diphtheria. According to the results of the polymerase chain reaction, 1 out of 5 non-toxigenic strains had tox gene. All C. diphtheriae belfanti strains were found to have pronounced capacity for adhesion to sheep and human red blood cells. At the stage of the extinction of diphtheria epidemic the practical identification of C. diphtheriae belfanti strains is necessary, as increased adhesion in combination with toxigenic properties may probably promote for bacteria of this biovar to take the leading role at the period of sporadic morbidity.

[Microbiological monitoring of the microbic strain stability to antibacterial preparations in surgical in-patient clinics]. / Mikrobiologicheskii monitoring ustoichivosti k antibakterial'nym preparatam mikroorganizmov v khirurgicheskikh statsionarakh.

While performing of microbiological monitoring, conducted in surgical stationaries of Dnepropetrovsk, of 775 cultures, isolated during one year from patients and outer space, the S. aureus cultures were revealed, resistant to methicillin were 23.6%, to gentamycin 12.3% culture of all Gram-negative bacteria. Most effective preparation, which is recommended for the empirical antibacterial therapy conduction, is meronem, to whom the sensitivity of 87.5% for Gram-positive and 92.1% for Gram-negative cultures of conventionally pathogenic microorganism were established.

[Diphtheroids and nontoxigenic Corynebacterium diphtheriae in the etiology of diphtheria]. / Difteroidy i netoksigennye Corynebacterium diphtheriae v étiologii difterii.

The review raises a problem of cooperation between a laboratory and clinics for diphtheria diagnosis. According to scientific literature nontoxigenic diphtheroids cause different nosocomial infections of immunocompromised patients. Nontoxigenic Corynebacterium diphtheriae may cause such systemic infections as septic arthritis and endocarditis in people belonging to unsecured strata of the society. A toxin which can be produced not only by C. diphtheriae but also by diphtheroids is the sole reason of diphtheric inflammation. The role of the C. diphtheriae nontoxigenic strains should be elucidated by the improving of standard methods and introduction of the methods of molecular biology for the toxigenicity assay of diphtheria strains (e.g. polymerase chain reaction). But a complexity of gene expression and difficulties in distinguishing between the infection and the microorganism colonization of a vaccinated person reserve the last word in the diagnosis of diphtheria for a clinical physician.

[Diagnostic problems in diphtheria infection]. / Problemy diagnostiki difteriinoi infektsii.

The problem of diagnosis of diphtherial infection has come to acquire especially significance at the present stage because here in Ukraine we have no legitimate standard procedure for identification of a case of diphtheria and because interpretation of results of bacteriological and serological studies in patients who might have diphtheria is often faulty. The diagnosis of atypical cases of mild localized diphtheria in the vaccinated subjects relies on the presence of chronic ENT-affections and a history of predisposition to sore throat. It is necessary that parallel culturing be done of smears obtained from the nasopharynx for diphtheria and pathogen microflora in order that no possibility of angina of other microbe etiology might be entertained. Isolation of nontoxicogenic strains C diphtheria in the absence of clinical signs of diphtheria should not prompt us to diagnose a patients as having this problem. Serologic investigation of the patients serum in the passive hemagglutination test for the presence of antitoxic antibodies can be recommended for use to verify the vaccination history in those having been taken ill rather than to aid in the differential diagnosis of diphtheria and bacteria-carrier states. Results of bacteriological and serological investigations do not give much ground for rejection or confirmation of the diagnosis made.

[Variants in the immune response to revaccination with diphtheria anatoxin in adults]. / Varianty immunnogo otveta na revaktsinatsiiu difteriinym anatoksinom u vzroslykh.

The immunological effectiveness of the revaccination (made in two injections) of 488 adults aged 18-67 years with diphtheria-tetanus toxoid is discussed; the parallel study of the results of this revaccination was carried out in the diphtheria toxin neutralization test on Vero cells and in the passive hemagglutination (PHA) test. The specific features of the dynamics of the increase of diphtheria antitoxic antibodies, depending on the initial immunity level, the age and the sex of revaccinated persons, were determined. Among persons with the low level of circulating antibodies before revaccination four variants of immune response to the injection of diphtheria toxoid were registered: variant 1--rapid reaction like in secondary immune response (53.6%); variant 2--delayed but effective reaction like in primary immune response (27.3%); variant 3--slow weak response (6.5%); and variant 4--the absence of effective immune response to immunization made in 2-3 injections (12.6%). The immunological and neutralizing properties of diphtheria antitoxic antibodies in the process of immunization made in 2 injections were evaluated. Persons with abnormal immune response (variants 3 and 4) produced defective antibodies, displaying immunological activity in the PHA test, but in most cases unable to neutralize diphtheria toxin in vitro when tested on Vero cells.