[Microbiota of lower urine tract and genital organs of healthy men and in infertility].

AIM: Study microflora of urine, ejaculate, urethra scrape in normal state and infertility. MATERIALS AND METHODS: 2 groups of men were examined: I (28)--control, conditionally healthy men (20 - 25 years of age), II (26)--infertile patients (25 - 35 years of age). Middle portion of morning urine, ejaculate, urethra scrape were studied in group I, in II--ejaculate. Bacteriologic study of urine and ejaculate was carried out in an extended kit of nutrient media (HiMedia) for facultative- anaerobic (FAB) and non-clostridia anaerobic bacteria (NAB). Urethra scrape and ejaculate were studied by PCR in group I. RESULTS: In urethra scrape and ejaculate a wide spectrum of FAB and NAB was detected in group I. Corynebacterium spp. and coagulase-negative staphylococci (67.9% each) were the dominant cluster of FAB. Eubacterium spp.--in NAB. Bacteriologic study of ejaculate corresponded in PCR with similar results of dominating bacteria. Among FAB the same clusters dominated during bacteriologic study of ejaculate from group II patients, among NAB--Propionibacterium spp., Peptococcus spp. and Peptostreptococcus spp. Quantitative characteristics of ejaculate of group I and II differed insignificantly. CONCLUSION: The frequency of detection of certain genera of FAB and NAB was significantly higher in patients with infertility than in conditionally healthy men, however quantitative parameters of the isolated microorganisms practically did not differ between groups.

[Unsterile urine in health human--new paradigm in medicine].

The 3-fold urine culture evaluation in healthy women (24) and men (28) was performed. In 100% of cases, various types of multicomponent aerobic-anaerobic microorganism associations were found. Dominant clusters in the urine of women incleded coagulase-negative staphylococci, Corynebacterium sp., Lactobacillus sp., Peptococcus sp., Propionibacterium sp., in men--coagulase negative staphylococci, Corynebacterium sp., Eubacterium sp. For aerobic microorganisms, level of bacteriuria in both groups was 10(2) CFU/ml, for most anaerobes--≥10(3) CFU/ml. Spectrum of microorganisms isolated from the urine was quite wide and variable. In women, number of assiociates in urine ranged from 3 to 10, in men--from 6 to 9, as well as individually--in each subject, the original range of microorganisms was not repeated in any other case.

[The microbial spectrum of urine and bladder bioptic samples in women with chronic recurrent cystitis].

The evaluation of urine and bladder bioptic samples (bacteriological examination and polymerase chain reaction) of 28 women with chronic cystitis was performed. In 85.7% of cases, mixed infections with predominance of nonclostridial anaerobes in the urine was detected. Herpes simplex virus type 1 was detected in 7.1% of cases. In the same manner as in urine, predominance of nonclostridial anaerobes in bladder bioptic samples (85.7%) was observed. Identical bacteria in urine and bladder bioptic samples were revealed in 64.3% of patients. Herpes viruses and papillomaviruses were frequently registered (p < 0.05) in the bioptic samples.

[Formation of digestive tract microflora of neonates in dynamics].

AIM: Comparative study of the microbiota of neonates in relation to vaginal and intestinal microflora state of conditionally healthy primipara pregnant women. MATERIALS AND METHODS: Bacteriological study of vaginal and intestinal microflora of 24 conditionally healthy primipara pregnant women at week 32 and 38 of pregnancy as well as bacteriological study of meconium and feces at day 5 of their neonates was performed. RESULTS: Despite detection of lactobacilli by delivery in all the pregnant women their quantity was significantly lower than normal. In colon microflora dysbiotic changes corresponding to grade 1 (46.7%) and 2 (53.3%) dysbacteriosis were detected. In 60.0% of cases of conditionally healthy neonates various microorganism species were isolated from meconium. At day 5 in feces of neonates at natural feeding lactobacilli (85.8%), bifidobacteria and escherichia (71.4% each), enterococci (100%) were detected. CONCLUSION: The course of dysbiotic changes in vagina and intestines of conditionally healthy pregnant women had subclinical level. Detection of microorganisms in meconium in conditionally healthy neonates could be explained by translocation mechanism.

[Non-clostridial anaerobic bacteria can cause acute pyelonephritis (an experimental trial)].

Acute obstructive pyelonephritis (PN) caused by Peptococcus niger (Pn), E. coli and mixed infection (Pn + E. coli) was modeled in rabbits. Morphologic examination showed that in animals with peptococcal infection renal lesions were identical to those in escherichial PN. Hemorrhagic infarctions and vasculitis develop in animals with mixed infection. These morphological findings were confirmed bacteriologically. The experimental trial confirms the role of Pn in development of acute obstructive PN in animals.

[Revealing the genetic determinants of Pks-pathogenicity island in clinical strains of enterobacteria].

AIM: Detection by PCR the frequency of clbB, clbN, clbA H clbQ genes of Pks-pathogenicity island in clinical strains ofenterobacteria. MATERIALS AND METHODS: 112 strains various genera and species of enterobacteria, including 16 museum and 96 clinical are investigated. Isolated strains represents Escherichia species (n = 68), Klebsiella (n = 16), Enterobacter (n = 9), Serratia (n = 7) and others minor species of Enterobacteriaceae family (n = 12). Fifty nine strains isolated from urine of urinary tract infection, 26 isolates from intestines of patients with dysbiosis and 11--from children with complications after a liver transplantation. A total bacterial isolates were screened by multiplex PCRforthe presence ofclbB, clbN, clbA and clbQ genes. RESULTS: Among 41 uropathogenic E.coli it is revealed 15 (36,6%) Pks-positive strains carring all of clbB, clbN, clbA ? clbQ genes, that composed 27,1% from total number of the enterobacteria, isolates from urine. Among 44 clinical isolates of various species of enterobacteria only one Pks-positive strain K. pneumoniae was revealed. Strains enterobacteria, isolated at pyoinflammatory complications after liver transplantation (n = 11) and isolates from intestinal tract in dysbiosis (n = 26), were Pks-negative. CONCLUSION: The clbB, clbN, clbA ? clbQ genes of the Pks-island which have been detected in 36,6 % E. coli urological strains are markers of pathogenicity of clinical isolates of extraintestinal origin and advisable of their detection by PCR.

[Bacterial mixed infection in women with chronic recurrent cystitis].

AIM: To study microbial repertoire of urine in healthy women and patients with chronic recurrent cystitis (CRC) including facultative anaerobic (FA) and non-clostridial anaerobic (NCA) bacteria. MATERIALS AND METHODS. Triple bacteriological study of urine was performed in three groups of women: group I--22 healthy virgin women aged 18- 25 years, group II--24 women aged 18 - 25 years with regular sexual contacts, group III--72 women aged 20 - 60 years with CRC, before antibacterial therapy. Bacteriological method was used to study qualitative and quantitative composition of urine microflora. RESULTS: In all subjects from groups I and II aerobic-anaerobic associations with predomination of coagulase-negative staphylococci (CNS), corynebacteria, peptococci, and peptostreptococci were isolated from urine. Quantity of isolated NCA bacteria was significantly higher than that of FA. In etiologic structure of CRC, NCA bacteria, enterobacteria, and CNS predominated. Spectrum of NCA bacteria isolated from patients with CRC was wider and level of bacteriuria--higher (p < 0.05) compared to groups I and II. Bacteria were identified in aerobic-anaerobic associations. In 85.7% of cases following NCA were identified in biopsy samples: Propionibacterium sp. (41.8%), Peptococcus sp. (35.7%), Eubacterium sp. (28.6%), Peptostreptococcus sp. (14.3%), and Bacteroides sp. (14.3%). Aerobic-anaerobic associations were observed in 7.1% of samples. CONCLUSION: Urine of healthy women is not sterile. Aerobic-anaerobic mixed infections were detected in patients with CRC that should take into account during diagnostics and treatment of this disease.

[Etiological structure and antibiotic sensitivity of uropathogens in chronic recurrent infection of the lower urinary tract].

While acute infections of the lower urinary tract (UT) have been studied in detail and antibiotic therapy of such infections is well known, etiology and choice of antibacterial treatment in recurrent chronic UT infection are not so clear. In our trial we aimed at elucidation of etiological structure of chronic cystitis recurrences by means of microbiological investigation of urine samples from 72 women on extended spectrum of nutrient media. In all the cases urine was infected with both aerobic and non-clostridial anaerobic bacteria. We determined prevalent pathogens and their antibiotic sensitivity and compared them with standard pathogens and their sensitivity in acute lower UT infection. We came to the conclusion that it is necessary to develop new recommendations on antibiotic treatment of recurrent chronic cystitis in women.

[Microbial biocenoss in chronic purulent otitis media].

The objective of the present work was to study microflora in the middle ear of 100 patients aged from 30 to 70 years presenting with chronic purulent otitis media (CPOM) by microbiological and genetic (PCR) methods. An important role of persistence factors, pathogenicity, and microbial antibiotic resistance in the development of CPOM was demonstrated. The frequency of occurrence of herpes and papilloma viruses was estimated. The most common form of the mixed infection was two-component virobacterial associations (46.2%). Three-component associations of viruses with bacteria (Chlamydiae or Mycoplasmas) formed less frequently (34.6%). In 19.2% of the cases, yeast-like fungi of the genus Candida were identified in these associations.

[Microbial associations defecting in children with chronic pyelonephritis].

AIM: To study rate of detection of bacteria and viruses from different taxonomic groups and their associations in children with pyelonephritis. MATERIALS AND METHODS: Two hundred seventy-four patients aged 5-10 years divided on two groups were studied: 1st group--240 children with chronic secondary pyelonephritis, 2nd group--children with nephrectomy due to terminal stage of renal obstructive process. Qualitative and quantitative composition of bacterial flora in urine and renal biopsy samples was studied by bacteriological methods as well as presence of viruses (HSVI, HSVII, CMV, EBV, HPV) by means of PCR. RESULTS: In group 1, 72.2% of children had bacterial mixed infection with associations of coagulase-negative staphylococci, Escherichia, peptococci, and Mycoplasma. Herpesviruses and human papillomaviruses were detected in 50.0% of cases. In group 2, bacterial flora was isolated from preoperative urine in diagnostically-significant titer in 91.2% of cases, whereas in urine obtained from the same patients during operation the microorganisms were detected in 38.2% of cases with predominance of Mycoplasma and Ureaplasma. Bacteriological tests of renal biopsy samples yielded bacteria in 29.5% of cases. Studied viruses were detected in preoperative and intraoperative urine as well as in renal biopsy samples in 52.9%, 44.1%, and 58.8% of cases, respectively. In 32.4% of patients viruses were detected in biopsy samples but not in intraoperative renal pelvis' urine. There was no difference in HPV and CMV detection rate in the nephrectomy group. CONCLUSION: Bacterial-viral mixed infection is encountered in children with obstructive pyelonephritis and this should be taken into account during diagnostics and treatment of this condition.