[The development and testing of reagents kit for detection and qualitative evaluation of DNA of methicillin sensitive and methicillin resistant Staphylococcus aureus and also methicillin resistant coagulase negative Staphylococcus spp. applying technique of polymerase chain reaction in "real time" mode].

The reagents kit is developed to identify and quantitatively detect DNA of methicillin sensitive and methicillin resistant Staphylococcus aureus, methicillin resistant coagulase negative Staphylococcus spp. in biological material using technique of polymerase chain reaction with hybridizational fluorescent detection and having higher analytical and diagnostic characteristics. The application of the given reagents kit makes it possible to optimize the epidemiologic monitoring of propagation of methicillin resistant strains of Staphylococcus spp. Significantly decreasing duration and laboriousness of study.

[Problems of prevalance and resistance of nosocomial Klebsiella pneumonia in hospitals of Russia].

Prevalence of Klebsiella pneumoniae among gramnegative pathogens of nosocomial infections in intensive care units of 33 hospitals of 22 towns in Russia was investigated. Antibiotic susceptibility and extended-spectrum beta-lactamase production were tested in 420 nosocomial K. pneumoniae isolates. Carbapenems (imipenem, meropenem and ertapenem) showed the highest activity. Extended-spectrum beta-lactamase production based on the phenotyping methods was revealed in 342 (81.4%) isolates. The maximum activity against the K. pneumoniae isolates producing extended-spectrum beta-lactamase was observed in imipenem and meropenem (no unsusceptible strains were isolated). 3.2% of the isolates was not susceptible to ertapenem. Differences in the activity of cefoperazone/sulbactam, amikacin, ciprofloxacin and levofloxacin against the extended-spectrum beta-lactamase producing isolates in various hospitals were recorded.

[Risk factors of pseudomonas infection in hemoblastosis patients]. / Faktory riska psevdomonadnoi infektsii u patsientov s gemoblastozami.

A total of 67 patients with diseases of the blood system and infectious complications, admitted to the Hematological Department of the Novosibirsk Regional Clinical Hospital, were examined. For this study only patients with etiologically established diagnosis were taken. The study revealed that Pseudomonas sp., whose strains were susceptible to Ceftazidime in 100% of cases and resistant to Cefepime and Imipenem in 15-17% of cases, was the etiological agent of 13.6% of all cases of infectious complications in hemoblastosis patients. Infectious lesions of pulmonary parenchyma, the presence of chronic diseases of the respiratory tract in the medical history, neutropenia, artificial ventilation of the lungs were found to be adverse prognostic factors with respect to a high risk of Pseudomonas infection in such patients. Therapy with glucocorticosteroids and cytostatics, preceding antibacterial prophylaxis were not linked with the isolation of Pseudomonas from the patients exhibiting the same levels of lethality and severity of infectious complications.

[Isolation rate of gram negative microflora and its sensitivity to antibiotics in hemoblastosis patients]. / Chastota vydeleniia i antibiotikochuvsvitel'nost' gramotritsatel'noi mikroflory u patsientov s gemoblastozami.

A total of 67 patients with blood system diseases and infectious complications were examined. During the period of the examination 139 microorganisms were isolated. Of these gram negative microorganisms constituted 51%, gram positive microorganisms--34.8% and fungal flora--14.2%. Most frequently the following gram negative microorganisms were isolated from the patients: Pseudomonas sp. (including P. aeruginosa), Klebsiella pneumoniae, Escherichia coli, Haemophilus influenzae. All isolated microorganisms retained sensitivity to imipenem, with the exception of individual strains of Pseudomonas sp.; the latter exhibited sensitivity to amicacin and ceftazidim. Cefotaxime was active with respect to 75% of K. pneumoniae strains and all E. coli strains, ciprofloxacin was active with respect to 43% of E. coli strains, 80% of K. pneumoniae strains and 83.4% of Pseudomonas sp. strains, cefepim was active with respect to 85.7% of Pseudomonas sp. strains and all E. coli strains, ceftazidim was active with respect to all Pseudomonas sp. and E. coli strains. 75% of K. pneumoniae strains, 77.8% of Pseudomonas sp. strains and 86% of E. coli strains retained sensitivity to amicacin. 25% of K. pneumoniae strains required testing for ESBL production.

[Resistance of ambulatory urinary infection pathogens according to the data of multicenter microbiological studies UTIAP-I and UTIAP-II]. / Rezistentnost' vozbuditelei ambulatornykh infektsii mochevyvodiashchikh putei po dannym mnogotsentrovykh mikrobiologicheskikh issledovanii UTIAP-I i UTIAP-II.

AIM: To study causative agents and sensitivity of E-coli strains isolated from adult outpatients with uncomplicated urinary infection (UI) in different regions of Russia. MATERIAL AND METHODS: A multicenter prospective epidemiological study included adult patients with uncomplicated infections of the upper or lower urinary tracts. MPK of antibiotics was established by dilution in agar according to NCCLS recommendations, 2000-2002. RESULTS: Among UI causative agents, E. coli was most frequent (85.9%). K. Pneumoniae, Proteus spp., Staphylococcus spp., P. Aeruginosa, Enterococcus spp. occurred much less frequently (6, 1.8, 1.6, 1.2, and 1.0%, respectively). E. Coli UI was highly resistant to ampicilline (37.1%), cotrimoxasol (21%), maximal resistance being in St-Petersburg (51.9 and 31.5%, respectively). Such oral antibiotics as norfloxacin and ciprofloxacin, cefuroxim, amoxicillin/clavulanat, nitrofurantoin were maximally active against E. Coli (4.3, 2.4, 2.6 and 1.2%, respectively). CONCLUSION: High resistance of E. coli, which is the chief causative agent of uncomplicated UI, to ampicillin, cotrimoxasol was detected. Fluoroquinolones, amoxicillin/clavulanat, nitrofurantoin, cefuroxim have high microbiological activity. On the basis of the pharmacokinetic, safety and other evidence it is concluded that drugs of choice for therapy of uncomplicated UI in Russia are oral fluoroquinolones.

[Microbiologic characteristics of wound infectious process in use of ion-exchange sorbents]. / Mikrobiologicheskaia kharakteristika ranevogo infektsionnogo protsessa pri ispol'zovanii ionoobmennykh sorbentov.

In Wistar rats with modified Danilina's method a purulent wound was simulated. The animals were divided into 5 groups of treatment. In the study groups applications on the wound of ion-exchange sorbents of natural origin (ceolyt including its modification with 1% silver, multicomponent ointment with bentonit, poviargol, propolis and metronidazol) were used. In the control groups gauze bandages and polyethylenoxyde were applied. When modified ceolyt and the ointment were used, earlier reduction of general contamination lower to critical level was seen. Ceolyt modified with silver demonstrated higher antimicrobic effect on gramnegative microflora compared with ointment composition. Ceolyt and its silvered modification were studied in vitro. Zones of growth absence were detected in places of application of silvered ceolyt that testifies to antimicrobic activity of silvered composition.

[Antibacterial drug resistance of gram-negative agents causing urinary infections in female outpatients in Russia: results of multicenter study]. / Rezistentnost' gramotritsatel'nykh vozbuditelei infektsii mochevyvodiashchikh putei k antibakterial'nym preparatam u ambulatornykh patsientok v Rossii. Rezul'taty mnogotsentrovogo issledovaniia.

AIM: To investigate the spectrum of gram-negative agents causing acute and recurrent cystitis in outpatients and sensitivity of uropathogenic E. coli to antibacterial drugs; to compare drug resistance of uropathogenic E. coli isolated in Russia and other countries. MATERIAL AND METHODS: The spectrum of gram-negative bacteria was identified in 299 cases of acute and recurrent cystitis in Moscow, Smolensk and Novosibirsk. 271 E. coli uropathogenic strains were examined according to CA-SFM and NCCLS criteria for sensitivity to ampicilline, gentamycin, trimetoprim, co-trimoxasol, nitrofurantoine, nalidixic acid, pipemidine acid, norfloxacine, ciprofloxacine, nitroxoline. RESULTS: E. coli, K. pneumoniae, K. oxytoca, P. mirabilis, P. vulgaris caused acute and recurrent cystitis in 90.6, 6.4, 1, 1.7, 0.3% of the examinees, respectively. For Moscow relative agents were: E. coli (80.8%), K. pneumoniae (13.1%), K. oxytoca (2.3%), P. mirabilis (3.1%), P. vulgaris (0.7%). In Smolensk E. coli, K. pneumoniae, P. mirabilis were isolated in 96.3, 2.5 and 1.2%, respectively. E. coli occurred in 100% of Novosibirsk cases. Mean Russian values of the resistance to ampicilline, gentamycin, trimetoprim, co-trimoxasol, nitrofurantoin, nalidixic acid, pipemidine acid, norfloxacine, ciprofloxacine, nitroxoline were the following: 33.3, 5.9, 20.3, 18.4, 2.9, 5.5, 4.4, 2.6, 2.6 and 94.1%, respectively. Resistance to 2 and more drugs was registered in 18.4% of E. coli strains. CONCLUSION: Cystitis in women was in most cases caused by E. coli. The highest resistance among uropathogenic strains E. coli was observed to nitroxoline, ampicilline, trimetoprim and co-trimoxasole; maximal antibacterial activity against uropathogenic E. coli was shown by fluoroquinolones (norfloxacin and ciprofloxacin).

[Structure of mental diseases of the 2d half of life according to the results of an epidemiologic study]. / Struktura psikhicheskikh zabolevanii vtoroi poloviny zhizni po dannym épidemiologicheskogo issledovaniia.

An investigation of all patients (with the exception of alcoholics) residing in a city district and registered at a psychoneurological dispensary revealed that after 40 years the disease began in almost one-fourth of the cases (24.7%). In the majority of cases (56%) these were diseases characteristic of the second half of life: vascular pathology (45.3%), involutional psychoses (6.6%), presenile dementia (2.2%) and senile dementia (1.9%). Other findings included schizophrenia in 24.3%, manic-depressive psychoses in 2.7%, psychogenias in 7.6%, consequences of head trauma in 2.2% and other exogenias in 3.7%. The clinical and social parameters of the prognosis in mental diseases first expressed after 40 years of age were on the whole lower but they reflected the modern tendency to attenuation of pathological manifestations: by the time of examination the status of 48% of patients was characterized by intermission or syndromes of a nonpsychotic level.

[Conditions for the transition of premorbid states into borderline forms of pathology]. / Ob usloviiakh perekhoda sostoianii predbolezni v pogranichnye formy patologii.

Conditions for the transformation of some premorbid states into borderline forms of pathology in the menopausal and pubertal periods are analyzed. It has been established that factors of higher risk of the transformation of a menopausal preneurosis-like condition into a neurosis-like one in women with a history of complete or partial castration are as follows: older (over 45 years) age by the time of surgical intervention, complete castration, a combination of the previous operation and attendant additional hazards (psychogenias and somatogenias) as well as the occurrence of the menopause before the operation. In the pubertal period behavioural deviations and neuropsychic disturbances usually reach a degree of obvious pathology (psychopathies, psychogenias) in cases where a long-standing psychotraumatic situation is combined with unfavourable biological factors such as minimum brain deficit, severe and prolonged debilitating somatic disease, a shain of infections, and pathological heredity.