COMPREHENSIVE BACTERIOLOGICAL STUDY OF THE VAGINAL DISCHARGE DURING BACTERIAL VAGINOSIS.

Along with sexually transmitted infections opportunistic pathogens and normal microbiota are becoming increasingly clinically important. Opportunistic pathogens can lead to purulent-inflammatory process of the genitals The aim of the current work was to detect qualitative and quantitative composition of vagina contents in non-specific bacterial vaginosis. Vaginal microbiota of 298 women aged from 16 to 64 years old was analyzed. Examination was provided by polymerase chain reaction. In normocenosis with domination of enterobacteria the prevalence index of conditionally-pathogenic microflora wasn't more than 3 lg GE/sample. With absence of mycoplasmas the quantity of conditionally-pathogenic microorganisms wasn't more than 104,5. At same time in patients with dysbiosis of I and II levels index of conditionally-pathogenic microflora was from 3 to 1 and less than 1 lg GE/sample accordingly; there was diagnosed a significant decrease of the total bacterial mass. Simultaneously, decreasing of Lactobacillus quantity (more expressed in dysbiosis-II) meanwhile appearance of mycoplasmas and utmost constant quantity of Candida was revealed. A comprehensive determination of a wide range of opportunistic pathogens on the background of normal flora in the vaginal discharge of women of different ages had been studied.

[Young and old animals use different strategies for forming an immune response to infectious agents (Pseudomonas aeruginosa и Escherichia coli).]

Features of the immune response to injection of suspension of bacteria (Pseudomonas aeruginosa and Escherichia coli) in young (3 months) and old (20 months) Wistar rats at 3, 5 and 7 days after infection were investigated. The dynamics of the content of circulating immune complexes (CEC), complement C3 fragments, and the activity of oxygen-dependent and oxygen-independent phagocytosis were determined. It was shown that infection was accompanied by a multiple increase in the content of circulating immune complexes in young and, especially, in old animals. It remained at a high level from the 3d to the 7th day of the development of pathology in young animals, while they content decreased to 7 days in old animals. On the background of the development of the infectious process, the content of complement C3 fragments decreased in young animals, and it increased in old animals, in the case of infection with P. aeruginosa and E. coli. The activity of oxygen-dependent and oxygen-independent phagocytosis decreased in different ways in young and old animals on the background of infections, i.e. the ratio of the forms of phagocytosis in old and young animals was different. Old animals were not inferior to the young in terms of the ability of the immune system to respond to the presence of an infectious agent. So they used a different strategy for forming the immune response.

[Species-specific detection of Proteus vulgaris and Proteus mirabilis by the polymerase chain reaction].

Sets of primers for the species-specific detection of P. mirabilis and P. vulgaris by the polymerase chain reaction (PCR) were developed. As targets for these primers beta-lactamase and 16S rRNA gene fragments were chosen on the basis of the multiple leveling of the sequences of the DNA of all known P. mirabilis and P. vulgaris isolates. For differential detection oligonucleotides were selected in such a way that primers, specific for P. vulgaris, contained the non-paired nucleotide for P. mirabilis isolate at the 3'-end, and all other nucleotides were complementary to the beta-lactamase gene fragment. Primers, specific for gene 16S rRNA of P. mirabilis, contained the non-paired nucleotide for P. vulgaris isolates at the 3'-end. Standard PCR was carried out for 6 P. mirabilis and P. vulgaris strains. The use of PCR species-specific primers to P. vulgaris DNA made it possible to amplify the DNA fragment of the expected length only for P. vulgaris isolates, while the result of PCR for P. mirabilis was negative. PCR with primers specific to P. mirabilis permitted the detection of amplicon sized 101 nucleotides pairs only for P. mirabilis strains. These primers were optimized so as to use them in the specific differentiation of closely related P. mirabilis and P. vulgaris species by multiplex PCR. Genus-specific primers permitted the detection of bacterial gyrB gene of the genus Proteus were developed also.

[An experimental validation of the use of levomycetin preparations for the treatment of burns infected with Pseudomonas aeruginosa]. / Eksperimental'noe obosnovanie primeneniia preparatov s levomitsetinom dlia lecheniia ozhogov, infitsirovannykh Pseudomonas aeruginosa.

Application of 1% of chloramphenicol (gel and cream) for local treatment of Pseudomonas aeruginosa burn infection has been studied in experiment. In vivo, both medical forms show pronounced therapeutic effect, they promote elimination of P. aeruginosa from wounds and decrease inflammation. In noninfected thermal trauma in laboratory animals application of gel and cream of chloramphenicol reduces transition from the phase of inflammation to the phase of reparation by 3-8 days and prevents infection of the burn wound by conditionally pathogenic microflora.

[The protective properties of the lysosomal form of Pseudomonas aeruginosa anatoxin in a test of its active protection of experimental animals]. / Izuchenie protektivnykh svoistv liposomal'noi formy anatoksina Pseudomonas aeruginosa v teste aktivnoi zashchity éksperimental'nykh zhivotnykh.

The protective activity of the liposomal form of P. aeruginosa toxoid and intact phosphatidylethanolamine liposomes has been evaluated in mice with experimental P. aeruginosa infection. It has been revealed that the liposomal form of P. aeruginosa toxoid, introduced in a single injection, ensures the formation of more intense and prolonged immunity in comparison with that induced by the toxoid adsorbed on aluminum hydroxide. This investigation has revealed that intact phosphatidylethanolamine liposomes also possess protective properties, protecting 10-36.7% of the animals from infection with P. aeruginosa toxigenic strain.

[Antibiotic sensitivity of the main opportunistic pathogenic aerobic bacteria]. / Chuvstvitel'nost' k antibiotikam osnovnykh uslovno-patogennykh aérofilov.

Antibiotic sensitivity of 1421 strains of Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa and Klebsiella spp. was studied. Gentamicin, levomycetin (chloramphenicol) and ristomycin proved to be the antibiotics of choice in treatment of purulent inflammatory diseases caused by S. epidermidis and S. aureus. For antibiotic therapy of infections caused by gram-negative organisms gentamicin and polymixin might be recommended.

[Immunogenic properties of the liposomal form of Pseudomonas aeruginosa anatoxin]. / Immunogennye svoistva liposomal'noi formy anatoksina sinegnoinoi palochki.

Studies of immunogenic properties of P. aeruginosa anatoxin incorporated into liposomes of varying lipid compositions have shown that single immunization of mice with the anatoxin included into phosphatidyl ethanolamine and lecithin cholesterol liposomes induces a 6-8-fold higher antitoxin antibodies production than immunization with unadsorbed or adsorbed on aluminum hydroxide P. aeruginosa toxoid. The maximal production of antibodies against exotoxin A of P. aeruginosa is observed already on the 14th day. The adjuvant properties of lecithin-cholesterol liposomes were revealed only in the primary immune response, while phosphatidyl ethanolamine-containing liposomes exhibited the capacity for enhancing both the primary and the secondary immune responses. The use of liposomal P. aeruginosa anatoxin made of lipids varying in composition and charge is a promising trend of research aimed at designing new highly effective immunization preparations for P. aeruginosa infection prevention.

[Effectiveness of tobramycin and immunologic preparations in experimental Pseudomonas infection]. / Effektivnost' tobramitsina i immunopreparatov pri eksperimental'noi sinegnoinoi infektsii.

Certain indices of immunity were studied in mice with burn sepsis due to P. aeruginosa during their treatment with tobramycin (Tb) alone or in combination with immunological drugs. The most significant stimulation of the phagocytic function of peritoneal macrophages was observed when Tb was used in combination with polyvalent corpuscular vaccine of P. aeruginosa. When Tb was used alone or in combination with hyperimmune plasma of P. aeruginosa there was observed close correlation between the phagocytic index and the levels of cyclic adenosine-3',5'-monophosphate in them. Therapy of P. aeruginosa infection with the antibiotic and immunological drugs resulted in much higher levels of agglutinine antibodies in blood serum of the mice than the therapy with Tb alone.

[The etiology of suppurative-inflammatory diseases caused by opportunistic microorganisms at the noninfectious disease clinic]. / Etiologiia gnoino-vospalitel'nykh zabolevanii, vyzvannykh uslovno-patogennymi mikroorganizmami v neinfektsionnoi klinike.

5,853 strains of opportunistic microorganisms have been isolated from hospitalized patients at a polyclinic. The following microorganisms have been found to cause purulent inflammatory diseases most frequently: Escherichia coli (21.6%), Staphylococcus epidermidis (15.93%), Staphylococcus aureus (14.54%), microorganisms of the genus Klebsiella (11.86%), Pseudomonas aeruginosa (7.91%) and microorganisms of the genus Proteus (7.5%). In cases of mixed infections Gram-negative bacteria prevail. The analysis of microbial species contained in the pathological excreta of patients in different departments has shown the prevalence of staphylococci in general surgery patients, E. coli in peritonitis and gynecological diseases, P. aeruginosa in patients with burns, Klebsiella, Proteus, E. coli, P. aeruginosa in patients with multiple traumatic lesions.

[Treatment of an infection due to the intraperitoneal inoculation of mice with Pseudomonas aeruginosa with tobramycin and hyperimmune Pseudomonas aeruginosa plasma used per se and in combination]. / Lechenie infektsii, obuslovlennoi vnutribriushinnym zarazheniem myshei Pseudomonas aeruginosa, tobramitsinom i giperimmunnoi sinegnoinoi plazmoi, primenennykh per se i v sochetanii.

Schemes for treating infections caused by intraperitoneal administration of P. aeruginosa to mice were tested. The animals were treated with tobramycin and hyperimmune pyocyanic plasma (HPP) used per se or in combination. In a dose of 5 mg/kg body weight tobramycin protected 72.9 per cent of the animals from death. HPP with a titer of the antipyocyanic antibodies of 1:320-1:160 had a stable 100 per cent protective effect on the infected animals. However, no complete elimination of P. aeruginosa from the host was observed. The combined use of tobramycin and HPP LD50 protected 97.23 per cent of the mice from lethal infection, the drugs being titrated for their separate use. The combined administration of tobramycin and HPP in treatment of mice with acute infection due to P. aeruginosa was more efficient than their use alone.

[Dynamics of the contamination of mice during the treatment of burn sepsis due to Pseudomonas aeruginosa using tobramycin alone or combined with active and passive immunization]. / Dinamika obsemenennosti myshei pri lechenii ozhogovogo sepsisa, obuslovlennogo Pseudomonas aeruginosa, tol'ko tobramitsinom ili v sochetanii s aktivnoi i passivnoi immunizatsiei.

An experimental study was made with a view to finding out the possible bacteriological advantages of the combined use of tobramycin (Tb) and P. aeruginosa corpuscular polyvalent vaccine (PaCPV) or P. aeruginosa hyperimmune plasma (PaHIP) in burn sepsis caused by P. aeruginosa. The use of the median therapeutic dose of Tb (2.5 mg/kg body weight per day), alone or in combination with immunopreparations, ensured the survival rate of the animals equal to 100%. The contamination of the body with P. aeruginosa after treatment with Tb and PaHIP or PaCPV was lower than after the administration of Tb alone, this phenomenon becoming manifest starting from day 5 of observation in the first case and from day 10 in the second case. The combined use of Tb and immunopreparations (PaCPV or PaHIP) in acute P. aeruginosa infection proved to be more effective than treatment with Tb alone.

[Experimental basis for the combined use of tobramycin and immune preparations for treating acute Pseudomonas aeruginosa infections]. / Eksperimental'noe obosnovanie kombinirovannogo primeneniia tobramitsina i immunopreparatov dlia lecheniia ostroi sinegnoinoi infektsii.

The possibility of using tobramycin (Tb) in combination with P. aeruginosa polyvalent corpuscular vaccine (PaPCV) or pyocyanosis hyperimmune plasma (PHP) for the treatment of P. aeruginosa sepsis was experimentally studied. The combined use of Tb and PHP, administered in amounts corresponding to ED50 of each preparation used separately, ensured the survival of 90% of the infected mice, and the injected of PaPCV with ED50 of the antibiotic ensured the survival of 73% of the experimental animals. The combined use of Tb and the two immuno-preparations (PaPCV and PHP) for the treatment of P. aeruginosa infection proved to be more effective than their separate administrations.