[Daptomycin in the treatment of infectious endocarditis].

Overcoming polyresistance of pathogens of infectious endocarditis (IE) is only possible through the use of new antibiotics, such as daptomycin, that was successfully used in 4 patients. The clinical features of endocarditis caused by Enterococcus faecalis resistant to penicillin, gentamicin, and streptomycin are described. Cases of IE with negative blood cultures and a failure of previous antibacterial therapy are considered. The literature data on the use of daptomycin in IE caused by oxacillin-resistant S. aureus are presented along with the information on valve prosthetics, peculiarities of IE in pregnant women and patients on hemodialysis.

[Clinical laboratory diagnosis of trichomoniasis in patients with internal diseases].

Urogenital trichomoniasis is an infectious inflammatory disease of the urogenital system caused by protozoan Trichomonas vaginalis and characterized by rapid dissemination and development of complications. Because laboratory diagnosis by microscopic methods encounters difficulty, we undertook detection of T. vaginalis by microscopic study of native and stained (methylene blue, acridine orange, Gram, Romanovsky-Giemsa) uretheral scrapings. 69 patients having no clinical signs of the disease were examined after sexual contacts with women suffering infection of the urogenital tract. Staining with acridine orange and by Romanovsky-Giemsa method proved the most informative methods for diagnosis of torpid trichomoniasis (85.5 and 75.4% respectively). The study of native samples is of little informative value (5.8%). The data obtained were used to develop an algorithm of microscopic investigation for the examination of patients with urogenital acute, subacute or chronic trichomoniasis and carriers of T. vaginalis.

[Isolation rate of enterotoxigenic staphylococci in patients with sepsis, pneumonia and burns].

The occurrence of Staphylococcus aureus strains producing enterotoxins of types SEA and SEB, which isolated from patients of different profile and caused the infectious process accompanied by pronounced intoxication without vomiting and enteric disturbances, was determined by means of the indirect hemagglutination test. The collection included 28 strains isolated in sepsis, 38 strains isolated in pneumonia, 57 strains isolated from patients with burns and 23, from the hands and nasopharynx of the medical staff. Among the staphylococcal strains isolated in sepsis, 75.6% synthesized SEA and 5.4%, SEB. The occurrence of SEA- and SEB-positive strains isolated in pneumonia was, respectively, 42.1% and 2.6%. From patients with burns SEA-positive staphylococci were mainly isolated (92.9%). Only 3% of the cultures isolated in wound infections produced SEA. From the medical staff, 13.4% of SEA-positive strains and 17.3% of SEB-positive strains were isolated. The data obtained from this study indicate the expediency of the determination of the enterotoxigenic properties of S. aureus clinical isolates in medical institutions for prophylactic measures with a view to the prevention of the spread of pathogenic clones.

[Bacteriological monitoring of infective agents of purulent septic diseases in an emergency hospital]. / Monitoring vozbuditelei gnoino-septicheskikh zabolevanii v statsionare skoroi meditsinskoi pomoshchi.

During the period of 1995-2001 bacteriological examination of 13,842 patients with purulent septic diseases (PSD) was carried out. The statistical processing of data revealed that equalization of the dynamic rows of intensive and extensive values characterizing the number of patients with PSD caused by etiologically important infective agents made it possible to evaluate the reliability of information. A trend to increased etiological importance of the genera Pseudomonas, Escherichia and Klebsiella was established. The number of diseases caused by Staphylococcus, Streptococcus, Enterococcus and Proteus decreased.

[Antibiotic susceptibility of the bacterial strains isolated at the emergency hospital]. / Lekarstvennaia chuvstvitel'nost' vozbuditelei gnoino-septicheskikh protsesov v statsionare skoroi pomoshchi.

Comparative evaluation of the incidence of the drug resistant pathogens at the patients with sepsis was performed. High ratio of the resistnt strain was shown and the most potent drugs were estimated. The investigation results demonstrates the necessity to improve diagnostic quality control. The data on drug susceptibility of the pathogens may be used for their taxonomic clarification.

[The use of data on the composition and drug resistance of the causative agents of suppuration in a retrospective analysis of the epidemiological situation in a hospital]. / Ispol'zovanie dannykh o sostave i lekarstvennoi ustoichivosti vozbuditelei nagnoenii pri retrospektivnom analize épidemiologicheskoi situatsii v statsionare.

The analysis of bacterial 16,530 strains, dynamically isolated from 6,157 patients with purulent septic processes (PSP) in surgical, traumatological, burn, toxicological and resuscitation departments, was made. The computer processing of data on the spread of the causative agents of PSP, depending on their taxonomic classification and drug resistance spectra, was carried out, which made in possible to obtain information on the outbreaks of hospital infections. Correlation of the number of PSP cases and the spread of hospital resistovars was analyzed. The data on the composition and drug resistance of pyogenic microorganisms could be used in the retrospective analysis of the epidemiological situation in a hospital. 3-year observations revealed the tendency to a decrease in the spread of the hospital variants of the causative agents of PSP, multiresistant to antibacterial preparations, which was indicative of the effectiveness of the antiepidemic measures carried out during this period.

[Diagnosis of chlamydia and gardnerella infection in patients with acute gynecological diseases]. / Diagnostika khlamidiinoi i gardnerelleznoi infektsii u bol'nykh s ostrymi ginekologicheskimi zabolevaniiami.

Chlamydial infection was diagnosed by indirect immunofluorescence in 26.3% and Gardnerella infection in 28.7% of patients with acute gynecological diseases. The degree of vaginal contamination in patients with chlamydiasis was virtually the same as in all other examinees, whereas in patients with gardnerellosis the third and fourth degrees of purity predominated. Hence, assessment of the vaginal contamination (purity) is an additional criterion for screening for gardnerellosis but providing no clinically significant information for the detection of chlamydiasis.

[The wound microflora of patients with gunshot injuries to the extremities during a mass hospitalization]. / Mikroflora ran bol'nykh v usloviiakh ikh massovogo postupleniia v statsionar s ognestrel'nymi povrezhdeniiami konechnostei.

The dynamic study of the microflora of bullet wounds in 32 patients was carried out. In cases of mass hospitalization coccal microflora (staphylococci and streptococci) was mainly isolated from wounds, at the period of treatment hospital infections with enterobacteria, Pseudomonas and Enterococcus occurred. Before cleaning the wound a decrease in the contamination rate for all microbial species was observed. As the disease progressed an increase in the amount of antibiotic-resistant bacterial strains was registered. The results of sanitary microbiological investigations made in the wards where the wounded patients were treated correspond to the structure of the causative agents of purulent processes in patients.