[The incidence and antibiotic resistance of common nosocomial uropathogens in the urine of urological patients in the Ivanovo region].

AIM: To clarify the etiology of nosocomial UTIs occurring in the urology departments and the outpatient clinic of the Ivanovo Regional Clinical Hospital (IvRCH), to develop recommendations on the empirical use of antibiotic therapy. MATERIALS AND METHODS: Bacterial composition of urine in urological patients was monitored from 1999 to 2015. The sensitivity of the pathogens to the main antibacterial agents was determined using the Kirby-Bauer disk diffusion susceptibility test. RESULTS: The study determined the frequency of detecting pathogens associated with urinary tract infections in adults and children, established the association between the spectrum of pathogens and patient age and determined the most effective antibacterial drugs in patients with nosocomial UTI in the Ivanovo region. High resistance levels of E. coli strains were detected against fluoroquinolones, nalidixic acid, and nitrofurans; they were three times higher than that against cephalosporins. CONCLUSION: The findings show the need to reduce the empirical use of fluoroquinolones, nalidixic acid, and nitrofurans and completely exclude the use of ampicillin in patients with nosocomial UTI in the Ivanovo region. To reduce the occurrence of nosocomial infections, patients discharged from the hospital should be administered empirical therapy with third-generation cephalosporins.

[EXPERIENCE WITH E. COLI LYOPHILIZED BACTERIAL LYSATE OM-89 (URO-VAKSOM®) IN MEN WITH ASYMPTOMATIC BACTERIOSPERMIA].

Chronic prostatitis is a significant problem of modern urology because it is the most common urological disease among the male population. We consider a 3 month course of OM-89 (Uro-Vaksom®) the most rational treatment of asymptomatic bacteriospermia caused by not only E. coli, but also by coexisting bacteria. Administration of OM-89 (Uro-Vaksom®) for 3 months to patients with asymptomatic bacteriospermia resulted in greater E. coli eradication in 98% of men and no growth of microorganisms in the ejaculate in 66%. Compared to these results, after a 3-4 week course of fluoroquinolones, E. coli occurred in significant titer in 15.2%, in non-significant--in 5.7% and the absence of microbial growth was noted only in 19% of cases. The course of OM-89 (Uro- Vaksom®), compared with fluoroquinolones, resulted in significantly increased sperm concentration and occurrence of greater number of spontaneous pregnancies. Rate of THB (Take Home Baby) for OM-89 (Uro-Vaksom®) group was 21%, for fluoroquinolones treatment group--7%.

[Experience in the treatment of autoimmune male infertility in patients with category 4 chronic prostatitis].

Administration of longidaza at a dose of 3000 IU intramuscularly twice a week after 1 month of treatment leads to the statistically significant reduction of antisperm antibodies (ASAB) at the surface of sperm cells to 23% (7-48%) for MARIgG and to 14.5% (3-34%) for MARIgA. Maximum reduction of ASAB, however, was observed after third month of treatment, mean MARIgG was 2% (1-26,5%) and MARIgA - 1% (0-11.5%). ASAB level has not reduced less than 50% only in one patient (1.67%). At follow-up three months after the cancellation of Longidaza, only 17 (28.33%) men showed an increase of ASAB IgG and (or) IgA more than 50%. Inthe study group, during the observation, spontaneous pregnancy occurred in 6 (10%) pairs, and IVF was successfully performed in 3 (5%) pairs. Thus, we consider it necessary to appoint Longidaza in patients with category 4 chronic prostatitis and elevated levels of antisperm antibodies on sperm cells, who preparing for assisted reproductive technologies, or preparing for natural pregnancy, as a high-effective pathogenetical agent for the treatment of autoimmune infertility.

[Some features of recovery of upper urinary tract urodynamics after surgical treatment of vesicoureteral dysplasia in children]. / Nekotorye zakonomernosti vosstanovleniia urodinamiki verkhnikh mochevykh putei posle operativnogo lecheniia displazii puzyrno-mochetochnikovogo segmenta u detei.

Urodynamics of the upper urinary tract (UUT) was examined in 327 children aged 1.5 months to 15 years with congenital vesicoureteral reflux (VUR) dysplasia treated surgically. 230 patients were followed up for 1 to 20 years. Staging of chronic disorders of UUT urodynamics is thought to be the key criterion of objective assessment of VUR effective surgical treatment. The better long-term treatment outcomes are the earlier the disease was diagnosed and corrected. Early defects of urodynamics in the absence of marked dilatation of the ureter are better corrected by Lich-Gregoir operation which is physiological, low traumatic, technically available and most effective (97% of favourable long-term outcomes). Ureterocystoneostomy by Politano-Leadbetter (in modification of the authors) is indicated in urodynamic disorders stage III and marked ureteral dilatation as providing improvement of urodynamics or stabilization in 93.7% patients.

[Modified technique of ureterocystoneostomy]. / Modifitsirovannyi sposob ureterotsistoneostomii.

The authors describe a technique of ureterocystoneostomy based on the principle suggested by Politano-Leadbetter but using an original set of instruments approved by the patent committee. The technique was applied in the treatment of 12 children aged 11 months to 5 years. The operation was highly effective: it became easier to perform in reduced duration and traumatism.