[Antibiotic Resistance of MRSA in the Russian Federation].

The results of the multicentre trial on estimation of MRSA antibiotic susceptibility to 17 antibiotics are presented. 474 nonrepeting isolates of MRSA (mecA+), collected in 2011-2014 in 10 cities of the Russian Federation were used in the trial. The antibiotic susceptibility was determined by the method of serial microdilutions in broth with estimation of the MICs in accordance with the international standards CLSI 2014 and EUCAST 2014. The highest levels of the MRSA resistance were stated against ciprofloxacin--92%(MIC50 32 mcg/ml), gentamicin--85% (MIC50 128 mcg/ml), erythromycin--54% (MIC50 32-mcg/ml) and clindainycin - 45% (MIC50 0.03 mcg/ml), as well as against rifampicin--38% (MIC50 0.06 mcg/ml). The frequency of MRSA isolated at the vancomycin dose of 2 mcg/ml equaled 26%. No correlation of the decrease in susceptibility to vancomycin and rifampicin was observed. In 5% of MRSA isolated from infected surgical wounds in patients with bone infection or sepsis, there was observed a decrease in the susceptibility to ceftarolin (MIC 2-4 mcg/ml). Co-trimoxasole, fusidic acid (MIC50 0.06 mcg/ml) and mupirocin (MIC50 0.5 mcg/ml) showed high antibacterial activity, 93-98% of the isolates being susceptible to the drugs. No resistance to linezolid and tigecycline was detected. By the associate resistance spectrum, most of the MRSA isolates were characterized by resistance to drugs of 3-7 groups (56%). The phenotypes with simultaneous resistance to drugs of 8-10 groups amounted to 6%. As a whole, 70 variants of associate resistance combinations were detected.

[The dynamics of changes in lysozyme activity and content of lactoferrin content of patients with chronic osteomyelitis].

The article demonstrates that the examination of patients with chronic osteomyelitis treated using the transosseous osteosynthesis technique established the ambiguous character of changes in concentration of lactoferrin and lysozyme in blood serum as compared with pre-surgery values. It is demonstrated that closer to the end of 2-3 months after surgery the normalization of analyzed indicators occurs. The complex detection of lactoferrin, lysozyme applied additionally to basal examination of cell immunity can be used to monitor the chronic osteomyelitis. This approach can play a significant diagnostic and prognostic role in evaluation of severity on infection process.

[Estimation of MRSA susceptibility to oxacillin, cefoxitine, vancomycin and daptomycin].

Prevalence and therapy of infections due to MRSA remain one of the most serious problems in the world. Therefore, correct laboratory identification of the MRSA phenotype based on the use of the marker antibiotic cefoxitine, as a more susceptibile one vs. oxacillin, is of great importance. There is lately being observed a tendency towards emergence of strains with lower susceptibility to the last reserve drugs protecting from MRSA, i. e. vancomycin and daptomycin. Susceptibility of MSRA to these drugs was not investigated in Russia and there are no data on the prevalence of the VISA and hVISA phenotypes. The results of our study on estimation of susceptibility of 316 MRSA isolates from several regions of Russia to oxacillin, cefoxitine, vancomycin and daptomycin are presented herein. It was shown that the ranges of the oxacillin MIC were extremely wide, i. e. 0.5 to 512 mcg/ml, while 2.2 +/- 1% of the isolates was susceptible by the phenotype to oxacillin, in spite of the mecA gene presence. As for cefoxitine, the MRSA isolates were rather resistant to it at the MIC > 16 mcg/ml. The tests with serial microdilutions revealed that 30.7 +/- 7% of the isolates had a critical level of susceptibility to vancomycin at the MIC 2 mcg/ml. The E-tests revealed 1.3 +/- 1% of the isolates which were susceptible at the MIC 2-4 mcg/ml. The MRSA isolates were highly susceptible to daptomycin, while high levels of the MIC (2 mcg/ml) were characteristic of 2.8 +/- 1% of the isolates. Cross reduction of the susceptibility to vancomycin and daptomycin was observed.

[Involvement of non-clostridial anaerobic microorganisms in pathogenesis of chronic osteomyelitis].

The microbic pattern of osteomyelitic foci were analyzed in patients with chronic osteomyelitis on the AB Expression Analyzer by the 'BioMerieux" anaerobic cultivation and identification system (France). The osteomyelitis-focus microcenosis was shown to be of the mixed anaerobic-aerobic nature. Anaerobic microorganisms were isolated in 65.4% of examined patients and made 34% of the isolated bacterial cultures, which is indicative of an important role of anaerobes in the development and persistence of the purulent-inflammatory process in chronic osteomyelitis. Thus, it is feasible to prescribe the antibacterial drugs, which are active in respect to both aerobic and anaerobic bacteria.

[Dynamics of antibiotic resistance of Staphylococcus aureus isolated from chronic osteomyelitis patients]. / Dinamika ustroichivosti k lekarstvennym preparatam Staphylococcus aureus, vydelennykh ot bol'nykh khronicheskim osteomielitom.

The level of antibiotic resistance of 365 S.aureus strains, isolated from chronic osteomyelitis patients in 1990 and 2000, was determined. As revealed in this study, over 10 years the isolation rate of strains adapted to the antimicrobial action of all tested preparations increased in some degree. The increase of the resistance level to aminoglycosides was most significant. The proportion of polyresistant strains was 9.1% in 1990 and 30.5% in 2000. The isolation rate of methicillin-resistant S. aureus (MRSA) did not increase during these 10 years, but the range of preparations suitable for the treatment of MRSA-infected patients was shown to become essentially narrower. These data confirm the view on the possibility of further decrease in the effectiveness of the conservative treatment of chronic osteomyelitis due to the rapid growth of the antibiotic resistance of S. aureus.

[Criteria of primary screening of attenuated strains for live vaccine against Influenza A]. / Kriterii pervichnogo skrininga attenuirovannykh shtammov dlia zhivo'i vaktsiny protiv grippa tipa A.

Reassortant strains for live influenza vaccine (LIV) were selected using two additional markers: intensity of cytopathic effect (CPE) at 40 degrees C in MDCK cells and toxicity for mice (induction of acute hemorrhagic pulmonary edema after intranasal challenge with undiluted virus). All wild-type viruses induced a high CPE in MDCK cells, while the reassortants differed by this sign. Only vaccine strains and attenuation donors were characterized by a low CPE. Modern epidemic viruses are highly toxic for mice, causing the death of 60-100% animals from hemorrhagic pulmonary edema on days 3-4 after intranasal infection. Attenuation donors and vaccine strains were not toxic for mice, the level of toxic effect correlating with CPE in MDCK culture. Evaluation of CPE in MDCK culture and toxicity for mice can be used for primary screening of candidates for LIV.