[Pyogenic infectious complications in recipients with allogenic kidneys: clinical and bacteriological aspects]. / Infektsionno-gnoinye oslozhneniia u retsipientov allogennykh pochek (klinicheskie i bakteriologicheskie aspekty).

The bacteriological study of wound discharge indicated no changes in the structure of the microflora in the allogenic kidneys of recipients throughout the follow-up. Among microbes isolated there were prevalent gram-positive microbes whose proportion has slightly increased in the past year, with Staphylococcus, mainly epidermal Staphylococcus, which contributes to the etiology. At the same time, studies of wound discharge in the past years showed that the incidence of mixed infections had increased from 4.3 in 1989-1991 to 15.6% in 1994-1997. Bacteriological urinalysis found no great differences in the etiological structures of the microflora. Gram-negative microbes are prevalent in all patients in three periods of follow-up. Noteworthy, there was an increase in the amount of yeast fungi (from 5.7 to 21.1%). Urinalysis showed that the rates in the isolation of bacterial and bacterial and fungal associations were steady-state and higher in all patients (20, 4-23, 5%). Examining the etiological structure of the pathogens of sepsis ascertained that patients of the early observation were found to isolate gram-negative microorganisms more frequently, while those of other observation periods have gram-positive ones. The overall proportion of microbial and microbe-fungal associations was 10.3% in the past 9 years. Since the patient's body is occupied by other pathogens due to immunosuppression, sepsis or wound infection was accompanied by high bacteriuria, cytomegalovirus infection, pneumocystic pneumonia, fungal infection, etc. For this reason, the patients had actually much higher quantities of mixed infections in sepsis, wound infection, or urinary infection than those taken into account while studying the only type of an infectious complication. The above leads to the conclusion that the incidence of mixed infection of recipients of allogenic kidneys is rather high. This infection substantially makes the choice of drugs and therapy difficult, the course of a wound process aggravated. For successful control of mixed infections, it is necessary to introduce new drugs having a high activity against bacteria, fungi, viruses, and protozoa and to use the latest differentially diagnostic culture media, to make diagnosis and treatment of pyoseptic diseases better.

[Use of ofloxacin in the treatment of suppurative-inflammatory complications in surgery]. / Opyt primeneniia ofloksatsina v lechenii gnoino-vospalitel'nykh oslozhnenii v khirurgii.

Analysis of ofloxacin use in clinical surgery over the latest decade showed that despite its wide clinical application for the prevention and therapy of postoperative complications, this drug remains highly active for the majority of micro-organisms. Hence, a wide spectrum, high bactericidal activity of the drug, optimal pharmacokinetics, and a high bio-availability (95-100%) still recommend ofloxacin, a highly effective agent for the treatment of infectious complications of surgery.

[Ten-year experience with the use of ofloxacin in reconstructive surgery]. / Desiatiletnii opyt primeneniia ofloksatsina v rekonstruktivnoi khirurgii.

The data on the use of ofloxacin in more than 300 surgical patients for the last 10 years were analyzed. The results showed that despite the wide clinical use of ofloxacin in the prophylaxis and treatment of postoperative complications the drug remained highly active against the predominating majority of microbes causing surgical infections. Therefore, the broad spectrum, high bactericidal activity and optimal pharmacokinetics with the high biovailability at the level of 95 to 100 per cent provided the use of ofloxacin as a highly efficient agent in the treatment of postoperative infectious complications in surgical inpatients.

[Cefoperazone in a multi-profile surgical clinic]. / Tsefoperazone v mnogoprofil'noi khirurgicheskoi klinike.

The results of the clinical trials of cefoperazone (cefobid, Pfizer, USA), a 3rd generation cephalosporin, carried out at the Research Centre of Surgery are presented. The antibiotic was used to treat and prevent postoperative infections in 44 patients. Good and satisfactory results were observed in 43 out of the 44 patients (99.9 per cent). Antimicrobial activity of cefoperazone against 182 bacterial strains isolated from the patients was assayed and compared with that of other cephalosporins i.e. cefotaxime, ceftriaxone and ceftazidime. The cefoperazone pharmacokinetics was studied in the patients with normal renal functions after surgical operations on the organs of the chest and abdominal cavity. The antibiotic was shown useful in the monotherapy of mixed infections involving anaerobic pathogens.

[Various aspects of the status of humoral immunity in patients after surgical correction of rheumatic heart defects under artificial circulation]. / Nekotorye aspekty sostoianiia gumoral'nogo immuniteta u bol'nykh posle khirurgicheskoi korrektsii revmaticheskikh porokov serdtsa v usloviiakh iskusstvennogo krovoobrashcheniia.

The serum concentrations of immunoglobulins A, M, and G were studied in 70 patients with rheumatic heart diseases and in 72 patients with spontaneous and pokeweed mitogen-induced production of these immunoglobulins and mononuclear peripheral blood cells. The investigations were done before and 1-2 and 7-8 days after surgery. Some patients received myelopid in the early postoperative period in addition to the conventional methods of therapy. With high serum IgA, IgM, and IgG levels, reduced humoral immunity was noted. Within the first two days after the operation, the capability of cells to produce IgA and IgG in response to pokeweed mitogen stimulation was lost, the induced IgM production was reduced considerably, and the serum IgA and IgM levels fell significantly. Eight days after surgery, the immune response was partially recovered. Myelopid facilitates complete restoration of humoral immunity and reduces the incidence of postoperative pneumonia more than threefold.