Comparative Assessment of Cytokine Pattern in Early and Late Onset of Neonatal Sepsis.

Neonatal sepsis is a significant health issue associated with high mortality. Immune responses associated with neonatal sepsis, such as proinflammatory cytokine production, are believed to play a central role in the pathogenesis of this disease. In the present study, serum levels of the proinflammatory cytokines TNF-α, IL1-ß, and IL-6 and the anti-inflammatory cytokines IL-4 and IL-10 were evaluated for 25 subjects with neonatal sepsis. We observed that subjects with late onset of sepsis (LOS), as well as those with early onset of sepsis (EOS), had a substantial increase in serum TNF-α. In contrast to EOS, subjects with LOS demonstrated a significant increase in serum levels IL-6 and IL-10. Additionally, we observed a significant difference in cytokine profiles between acute and postacute cases of neonatal sepsis. For instance, the level of proinflammatory cytokines, such as TNF-α and IL-6, was elevated in the acute phase, whereas the production of anti-inflammatory cytokines, such as IL-10, became substantially upregulated during the postacute phase. Additionally, no correlation was observed between cytokine levels and CRP levels or lymphocyte counts. Thus, in contrast to CRP levels and lymphocyte counts, examination of the cytokine profile can provide valuable information when determining the most effective therapy for treating neonatal sepsis. This information may be useful to physicians when determining if anti-inflammatory or immune stimulatory therapy is warranted.

[Species composition and antibiotic resistance of lactobacillus in infants].

AIM: To study species composition and antibiotic resistance of indigenous bacteria from Lactobacillus genus in infants. MATERIALS AND METHODS: Twenty-six strains of lactobacilli isolated from feces of infants living in Kazan. Species membership of lactobacilli was determined using PCR with primers for identification of 7 species of lactobacilli: L. acidophilus, L. plantarum, L. rhamnosus, L. delbrueckii, L. casei, L. paracasei, and L. zeae. Susceptibility to antibiotics was determined by indicator paper discs method. RESULTS. In breastfed infants L. fermentum and L. rhamnosus dominated, whereas in artificially fed infants colonization with L. casei and L. paracasei was characteristic. L.acidophilus, L. plantarum, and L. zeae were not detected in infants. In 6 cases isolates could be identified only to genus characteristic. Lactobacilli were polyresistant and had from 8 to 15 markers of resistance. All strains were resistant to ciprofloxacin, co-trimoxazole, ceftriaxone, nitroxoline, metronidazole, furazolidone, and 95% of strains were resistant to vancomycin. In 60-70% of cases lactobacilli were susceptible to penicillin, linezolid, erythromycin and lyncomycin. CONCLUSION: Regional features of species composition and antibiotic resistance of lactobacilli in infants depending on type of feeding were revealed.

[Influence of maternal microflora on the composition of infants' intestinal microcenosis during breastfeeding].

Composition of intestinal microflora in 38 breastfed infants and their mothers was studied. Microflora of mothers' breast milk was studied also. In all 38 (100%) infants as well as 29 (76.3%) mothers abnormalities in normal intestinal microflora composition were detected. In 50% of cases milk of breastfeeding mothers was contaminated with bacteria without clinical symptoms of infection. Staphylococcus epidermidis predominated between bacteria. In 31.6% of pairs "mother-infant" identical bacterial species were detected in breastmilk and infant's intestine with detection rate highest for S. aureus. It was concluded that improvement of bacteriological examination and preventive measures for breastfeeding mothers and their children is necessary.

[Genetic determinants of Escherichia coli pathogenicity isolated from urine and feces of children with different clinical variants of urinary system infection]. / Geneticheskie determinanty patogennosti Escherichia coli, izolirovannykh iz mochi i fekalii detei s razlichnymi klinicheskimi variantami infektsii mochevoi sistemy.

In the process of examination of 156 children of different age groups 176 E. coli cultures were isolated; of these, 98 cultures were isolated from acute cystitis and pyelonephritis patients, 28--from urine in cases of aysmptomatic bacteriuria, 30--from feces in cases of asymtomatc bacteriuria and intestinal dysbacteriosis, while 20 cultures--from feces of healthy children. In these bacteria the presence of genes associated with pathogenicity islets (PI) hlyA, hlyB, cnf-1, papC, sfaG and gene irp-2 (iron-regulated protein) was established with PCR. The detection rate of PI determinants in uropathogenic E. coli (UPEC) was shown to depend on the variants of the clinical manifestation of urinary tract infection. The total detection rate of PI gene fragments in UPEC cultures of different origin was indicative of their definitely less frequent occurrence in asymptomatic bacteriuria, observed simultaneously with intestinal dysbacteriosis, in comparison with acute urological infection. Practically the same detection rate of PI determinants in E. coli, isolated in asymptomatic bacteriuria in children, reflected high probability of genetic exchange in the above-mentioned fragments and made it possible to presume the existence of DNA sites, characteristic mainly of pathogenic clones. The established heterogeneity of the detection rate of PI determinants in E. coli clinical isolates requires further study.

[Clinical and diagnostic importance of the evaluation of the Ig proteases activity in children with intestinal dysbacteriosis]. / Kliniko-diagnosticheskoe znachenie otsenki aktivnosti Ig-proteaz u detei s disbakteriozom kishechnika.

The specific activity of serine, metal dependent and thiolic Ig proteases in the coprofiltrates of children with manifestations of intestinal dysbacteriosis was determined by the enzyme immunoassay. 56 children with pronounced symptoms of intestinal disorders (37 children aged up to 1 year and 19 children over 1 year) were examined. A group of 25 clinically healthy children was used as control. Simultaneously with protease activity of coprofiltrates, there was detected the level of Ig-degrading activity of the opportunistic bacteria islolates of different taxonomic groups from feces of children with dysbacteriosis of different severity (as determined by the classical bacteriological method). The evaluation of the Ig-proteolytic activity of fecal supernatants, associated with the presence of serine, metal-dependent and thiolic proteases in the intestine, as well as detection of such proteases in microbial isolates, seems to be highly important for the diagnosis of intestinal disorders in children and is recommended for screening of intestinal dysbacteriosis.

[Characteristics of antitoxic and antibacterial immune response in nontoxic forms of oropharyngeal diphtheria]. / Pokazateli antitoksicheskogo i antibakterial'nogo immunnogo otveta pri netoksicheskikh formakh difterii rotoglotki.

The enzyme immunoassay system (EIA) for differentiation of antibodies in therapeutic heterogeneous antitoxic serum and antibodies to Corynebacterium diphtheriae toxigenic strains in patients and carriers was developed. The use of EIA permitted the dynamic evaluation of the characteristics of humoral antitoxic and antibacterial immune response in 50 patients with the localized and disseminated forms of stomatopharyngeal diphtheria and 14 "healthy" carriers of toxigenic C. diphtheriae. As revealed in this study, the symptoms of the disease in patients with disseminated forms of stomatopharyngeal diphtheria developed in the presence of statistically significant low quantitative values of antitoxic and antibacterial antibodies to C. diphtheriae antigens. In the group of patients with the localized forms of the disease the initially low level of antitoxic antibodies was detected with the concentration of antibacterial antibodies remaining unchanged. During the period of convalescence the levels of antitoxic antibodies in both groups reached those of healthy persons. In case of localized forms of the disease the level of antibacterial antibodies decreased as compared with healthy persons, starting from the second week of the disease. The period of convalescence in the disseminated forms was characterized by the low concentration of antibacterial antibodies. Carrier state was formed in the presence of high levels of antitoxic antibodies and significantly low levels of antibacterial ones.

[Drug resistance of Staphylococcus aureus strains, isolated from children with intestinal dysbacteriosis]. / Lekarstvennaia ustochivost' shtammov Staphylococcus aureus, vydelennykh u dete s disbakteriozom kishechnika.

The level of antibiotic-sensitivity of 73 S. aureus strains isolated from children with dysbacteriosis of the large intestine in an outpatient clinic was determined. The isolation rate of polyresistant strains was 44%. Methicillin-resistant S. aureus (MRSA) were isolated from 25 children (34.2%). 60% of MRSA strains could not be typed with the international set of phages. Among the strains capable of being lyzed by the phages the representatives of phage groups 3 and 4 prevailed. All MRSA strains were sensitive to vancomycin, 84-88% of the strains were sensitive to chloroamphenicol, rifampicin, spiramycin and neomycin, 80% of the strains were sensitive to fusidin and phosphomycin. The level of sensitivity of methicillin-sensitive S. aureus strains (MSSA) to different groups of antistaphylococcal antibiotics was higher. 36-64% of MRSA strains and 21-27% of MSSA strains were resistant to the action of curative bacteriophages. The suppression of obligate microflora was the risk factor in the development of staphylococcal infection of the gastrointestinal tract in children.

[Plasma fibronectin in complicated forms of respiratory viral infections in young children]. / Plazmennyi fibronektin pri oslozhnennykh formakh respiratornykh virusnykh infektsii u detei rannego vozrasta.

As many as 89 infants with acute respiratory viral infections (ARVI) were examined to establish a decrease of the levels of immunochemical and bioactive fibronectin, seen during the marked clinical manifestations of the disease. Changes in the level of fibronectin in the course of ARVI are reversible in nature, being related to the intensity of the general toxic manifestations. Measurements of bioactive fibronectin are most informative for assessing the degree of intoxication. Profound and long-term reduction of the level of bioactive fibronectin may be seen in grave focal confluent and polysegmental pneumonia.

[The effect of triiodothyronine and catecholamines on the stability of trace effects of cold adaptation in rats]. / Vliianie triiodtironina i katekholaminov na stoikost' sledovykh éffektov kholodovoi adaptatsii u krys.

The role of three-iodine-thyronine, noradrenaline (NA), adrenaline (A), reserpine and propranolol in extinguishing of trace-effects of the long-term cold adaptation was studied in rats. A possibility to control the process of the temperature disadaptation through administration of different hormonal drugs, was shown. Three-iodine-thyronine and NA proved to be the most effective in this respect. Weakening of sympathetic-adrenal effects by means of combined reserpine and propranolol during the disadaptation accelerated the process of extinguishing of practically all the trace-effects of the long-term cold adaptation.