[Microflora metabolites of different habitats in bronchopulmonary diseases].

PURPOSE: To investigate the content and profile of metabolites of bronchopulmonary and intestinal microflora, especially such as short chain fatty acids (SCFA) in various biological substrates in patients with lung malignant tumors on the background of COPD. Estimate their diagnostic and tactical implication. MATERIALS AND METHODS: The study involved 98 patients with diseases of the bronchopulmonary system. According to the basic nosology patients were divided into two main groups: COPD (38 patients), and lung cancer in combination with COPD (hereinafter LC) (60 patients). The diagnosis was verified by modern methods of examination. Group of norm included 30 healthy individuals. Groups matched by gender and age. The microbiological examination of sputum and feces was conducted in the studied groups of patients. SCFA in sputum and feces of patients with COPD and LC were identified by GLC method. In healthy individuals the SCFA investigation was performed in bronchial washings, obtained during bronchoscopy in 20 people, the SCFA investigation in feces was performed in 30 people. RESULTS: Study of the content and profile of short-chain fatty acids (SCFA) in patients with COPD and lung cancer (LC) in various biosubstrates indicate on the obvious changes in microbiocenosis ofbioptate (bronchopulmonary and intes- tinal), characterized by the dominance of residual and facultative anaerobic microorganisms in the spectrum. Except that more pronounced changes are ascertained at LC. Also, changes of the SCFA parameters in the sputum may indicate on the alterations in the metabolism of epithelial cells of the lower respiratory tract (LRT). Unidirectional change the SCFA in sputum and feces can indicate on either translocation of microflora in the LRT out of the intestine, and on the possible systemic changes in themetabolism of epithelial tissue in the oncological process. The identification of SCFA by GLC method in various biological substrates can be used in examination of patients with lung cancer for diagnostic purposes (for objectification of microecological violations), as well as to evaluate the prognosis of the disease and its complications.

[The comparative characteristic of immune status of males with bacterial inflammatory urogenital pathology of different etiology in the city of Orenburg].

The article discusses presence of typical characteristics of parameters of system immunity under gonococcal and nonspecific uretroprostatitis and diagnostic value of these indicators. The reliable differences of immunologic indicators in patients with gonorrhea are established as compared to patients with nonspecific bacterial uretroprostatitis. The study established in peripheral blood the reliable decrease of level of leukocytes, relative amount of monocytes, phagocyte index, functional reserve of leukocytes at the expense of spontaneous and stimulated NBT test, IgA, sIgA. On the contrary, the study detected increasing of level of IgM and lactoferrin in patients with gonorrhea as compared to corresponding indicators in patients nonspecific infections. Under gonorrhea, the largest deviation of indicators from standard values was established for lactoferrin. The detected differences of immunologic parameters can be used as differentiating markers of nonspecific and gonococcal uretroprostatitis and criteria of effectiveness of immune correction.

[The Bayesian framework of detection of cariesgenic Streptoccocus in dental plaque in children with distal occlusion under orthodontic treatment].

The application of Bayes theorem in medical diagnostic includes such important step as derivation for every symptom and diagnosis data values of finite or a posteriori probability of presence of germ, for instance S. sanguis, in patients receiving orthodontic treatment. This value expresses importance of the given symptoms for detection of germ presence. In the implemented studies the Bayes theorem was applied to evaluate probability of presence of particular germ in particular concentration (degree of semination, CO) under concrete symptom group. The rates were used to calculate probability of presence of cariesgenic streptococcus S. mutans and S. sanguis in prospect patient. The rates were calculated for the group with fixed orthodontic apparatuses. The high degree of risk of development of caries in children under orthodontic treatment is conditioned by a whole complex of existing unfavorable factors present in oral cavity. Hence, a powerful negative potential to develop expressed cariesgenic situation in oral cavity is present. The analysis of medical data of patients with distal occlusion was applied using Bayes theorem from the point of view their diagnostic value. The study established 36 symptoms, factors, risk factors and background diseases common in case of distal occlusion in children. The probability to detect the mentioned characteristics and likelihood ratio under different degree of concentration of cariesgenic Streptococcus mutans and Streptococcus sanguis in dental plaque of children was considered. The establishment of character of likelihood ratio for different qualitative content of streptococcus in case of isolation from biotope of dental plaque permitted to determine the informative characteristics. The Bayesian model can be applied in clinics as a computer program to process incoming information about patients with distal occlusion under active orthodontic treatment. The developed diagnostic algorithm in a fast and simple mode of clinical detection of caries and determination of concentration of cariesgenic Streptococcus.

[The formation and spread of MRSA strains in patients with pyoinflammatory diseases].

The article considers the results of study of formation and spread of MRSA in patients with suppurative focuses of stafillococus ethiology after application of antibacterial therapy. The antibacterial therapy applied to these patients used one of the following pharmaceuticals--cefazolin, lincomycin, gentamicin, oxampicin, ciprofloxacin, ofloxacin. All the strains of S. aureus ssp. aureus isolated from patients were tested on MRSA. Their phagovars were detected using international kit of phages for grouping of S. aureus ssp. aureus. The comparison of data received after analysis of resistance to oxacillin of strains and their phages isolated at the onset of disease and after applied treatment was carried out. The study established that against the background of applied antibacterial therapy in 10.7% of patients, MRSA formed and in 15.4% of patients, the change of initial strains of S. aureus ssp. aureus by MRSA strains of other phages groups was established. The presented results testified the need of obligatory testing of strains isolated from patients with staphylococcus infection on antibiotics resistance. The application of antibacterial therapy and its correction taking in account the laboratory data on antibiotics resistance and strict following the sanitary hygienic standards.

[The microbiocenosis of intestine and immune status of children of primary school age].

The article deals with the study of species and quantitative structure of microbiocenosis of intestine and characteristics of immune status in children aged 8-10 years. In children with chronic tonsillitis pharyngitis and bronchitis and with diseases of gastro-intestinal tract (biliary dysfunction, chronic gastroduodenitis and gastritis) the microbe imbalance of various degree of manifestation was established which was prevailing in cases of children with pathology of gastrointestinal tract. The increase of quantity of opportunistic microflora induces the production of both immunoglobulins and cytotoxic lymphocytes and cells-natural killers.

[The ability of diphtheria causative agent to form biofilm].

The article deals with results of studying diphtheria causative agent capacities to form biofilm as one of mechanisms of persistence in human organism. The study object was strain of C.diphtheriae gravis tox+ obtained from nasopharynx of patient aged 19 in municipal hospital No 1 of town of Gukovo of Rostov oblast in 2011. The patient had diagnosis of "diphtheria of nasopharynx, typical filmy, localized, mild severity, even course". The control was implemented using the museum strain C.diphtheriae gravis tox+ No 665 from the L.A. Tarasevitch state research institute of standardization and biologic preparations control. It is established that diphtheria causative agent as an ability to form biofilm. The intensity of process of formation of exopolysaccharide is higher on glass that on plastic surfaces. The differences in degree of intensity of formation of biofilm are revealed between the strain circulation in population and museum strains C.diphtheriae gravis tox+. The vital capacity of biofilm forming microorganisms is related with adaptation possibilities of strains.

[The disbiotic changes of intestines microflora in healthy people].

The article presents the results of study of species and quantitative composition of intestinal flora in volunteer students aged 18-21 years. The disbiotic abnormality of different degrees was diagnosed in 75% of students. The associations of microorganisms, in case of normobiosis and disbacteriosis degree I included predominantly representatives of normoflora, in case of disbiotic abnormality II and III degrees included both representatives of normoflora and opportunistic pathogenic microorganisms.

[The antibiotics sensitivity of strains of Corinebacterium non diphtheriae circulating in Rostov-on-Don and Rostov oblast].

The article deals with the results of study of sensitivity of strains of Corinebacterium non diphtheriae circulating in Rostov-on-Don and Rostov oblast to antibacterial preparations. The strains of Corinebacterium non diphtheriae isolated from urogenital tract (C. xerosis, C. pseudotuberculosis. C. amycolatum, C. striatum) are analyzed. The sample of 41 strains of C. non diphtheriae was used to detect the sensitivity to 9 antibacterial preparations. The technique of serial dilutions in liquid growth medium was applied. The range of variations (minimal suppressive concentration) of preparations as related to C. non diphtheriae made up 0.003-20.0 mkg/ ml. The results demonstrated that C. non diphtheriae are: highly sensitive to gentamycin, vancomycin and cefotaxime: sensitive to rifampicinum; and resistant to lincomicyn. In all analyzed strains of Corinebacterium non diphtheriae the greatest indicators of minimal suppressive concentration are detected in lincomicyn and at that the maximal indicator was for C. striatum and consisted 11.52 +/- 2.26 mkg/ml.

[The architectonics of microbe ecology in the purulent surgery department of municipal clinical hospital].

S. aureus, S. pyogenes, P. aerugenosa, E. coli, P mirabilis, A. baumannii, S. epidermidis, K. pneumoniae, E. faecalis, E. cloacae are the priority pathogens of various forms of pyoinflammatory diseases. They form the architectonics of microbe ecology of the purulent surgery department of multi-type hospital of regional level with S.aureus subsp.aureus playing dominating role. In case of unchanged specter of priority pathogens of pyoinflammatory and pyoseptic diseases the number of gram-positive coccuses decreases at the expense of decrease of number of streptococcuses and staphylococcuses. At the same time, the number of enterobacteria and gram-negative non-fermentative bacteria increases. The resistance ofgram-positive coccuses increases regarding erythromycin, clyndamicin and cyprofloxacin. The resistance of gram-negative bacilli increases regarding ciprofloxacin, cephalosporins of III-IV generations, amikacin. The resistance is the highest among clinical isolates MRSA, K. pneumoniae, A. baumannii. The vancomycin is active regarding all gram-positive pathogens. The carbapenems are active regarding all enterobacteriae. The carbapenems, cefoperazone/tazobactam, cefepime are most active regarding non-fermentative glucose oxidizing bacteria. The netimicin is active regarding A.baumannii. The polymyxine is active regarding P. aerugenosa. The circulation of S. aureus hospital strain of particular genotype is established confirming the propagation of epidemic S. aureus strains in Moscow multi-type medical institutions. The strains are genetically affined to epidemic strains in European and other countries according the international data base (http://SpaServer.ridom.de). The genetic typing of S. aureus ssp. aureus out-hospital hemocultures detected their considerable genetic variety. The epidemic relationship between isolates from different patients is not established. The algorithms of rationale antibacterial chemotherapy of pyoinflammatory and pyoseptic diseases are developed to be implemented in the purulent surgery department of municipal clinical hospital of Moscow.

[The molecular mechanisms of resistance to B-lactams of pathogens of hospital-acquired infections].

The data of local microbiologic monitoring was used to study the profiles and mechanisms of resistance to beta-lactams antibiotics of gram-negative isolates of bacteria, pathogens of hospital-acquired infections in hospital reanimation and surgical departments. The study included 210 clinical isolates of pathogens of hospital-acquired infections: Pseudomonas aeruginosa--86 (40.9%), Acinetobacter baumannii--45 (21.4%), Klebsiella pneumoniae--52 (24.8%), Escherichia coli-23 (11.0%), Enterobacter spp.--4 (1.9%). The profiles of resistance to antibiotics were analyzed using the technique of serial micro-dilutions. The detection of the most common and clinically significant gens of beta-lactamases of gram-negative bacteria was implemented using the PCR technique and sequence analysis. The most activity was detected among carbapenems and cephaperazone/sulbactam. The local characteristics of prevalence of gens coding beta-lactamases (TEM, SHV, CTX) in K. pneumoniae and E. coli were established The study detected 11 isolates of P aeruginosa resistant to carbapenems and having genetic determinants of VIM-group and coding metal-beta-lactamases. The discussed data permits to assess the indicators of resistance to beta-lactams antibiotics and basic mechanisms of resistance of causative agents of hospital-acquired infections. The studies of this kind are unique for every type of hospital-acquired infection. The results can be used in the development of the concept of etiotropic and empiric therapy.

[The actual approaches to laboratory diagnostics of anaerobic non-clostridial infection (a lecture)].

The actual approaches to laboratory diagnostics of anaerobic non-clostridial infection using gas chromatography and mass spectrometry are described. The data concerning anaerobes' indication in analyt is presented. The focus is made on molecular markers, chemotaxonomy and classitic mechanisms of interaction between germ and organism on molecular level. The express determination of anaerobes' sensitivity to chemotherapeutical preparations is discussed.

[Genetic identification and study of the ability of lactobacilli isolated from the oral cavity of healthy individuals to form biofilms].

The highly antagonistic lactobacillus strains isolated from the oral cavity of human individuals were genetically passported as L. fermentum 39, L. rhamnosus 50, and L. rhamnosus 24, by applying the RAPD-PCR technique with two types of primers (M13, MSP). These lactobacillus strains showed high degrees of autoaggregation, surface hydrophobicity, coaggregation, and adhesion. These characteristics determine the obvious capacity of lactobacilli to form biofilms, which may be used to design new probiotic agents.

[Genetic identification of antagonistically active lactobacillus strains isolated from the oral cavity of healthy individuals].

Examination of dental deposits from 45 healthy individuals detected 3 lactobacillus strains showing a high antagonism toward test cultures. The api 50 CH "bio Merieux" test systems were employed to identify strains as Lactobacillus fermentum 39, Lactobacillus rhamnosus 24 and Lactobacillus paracasei 50. The results of analyzing the sequences of the 16S rRNA genes of the test strains confirmed this identification, except for the latter strain. The taxonomic status of the third strain L. rhamnosus 50 was determined by the bioinformative analysis of the nucleotide sequence of the 16S rRNA genes.

[Gramnegative opportunistic microflora as etiological factor of secondary infection in patients with pulmonary tuberculosis].

The results of the laboratory diagnoses of respiratory tract secondary infections in patients with pulmonary tuberculosis within a period of 12 months in a tuberculosis clinic were generalized. The species composition of the causative agents of lower respiratory tract secondary infection and the frequency of their detection in various clinical speciments (sputum, bronchial washings) were determined. The data on resistance of the opportunistic gramnegative bacilli (enterobacteria, pseudomonads, Acinetobacter spp.) isolated from the patients with pulmonary tuberculosis to various groups of antibacterials are presented.

[Evaluation of diagnostic criteria of syphilitic infection by means of gas chromatography and mass-spectrometry]. / Otsenka diagnosticheskikh kriteriev sifiliticheskoi infektsii metodami gazovoi khromatografii i mass-spektrometrii.

In order to estimate possibility of chromatographic criteria application in diagnostics of syphilitic infection, the authors researched in three directions: evaluation of dysmetabolism of carbohydrate, lipid and amino acid components in patients' serum; search of signal compounds that serve as microbe "cooperative sensitivity" activators (lactones, quinolones, furan boron ethers) with evaluation of the risk of luetic infection generalization; indication of organ lesion markers (the brain, liver, bone structures). The factor analysis performed by the researchers allowed to determine priorities of clinical, laboratory and chromatographic data according to their value. The diagnostic value of various diagnostic chromatographic criteria was estimated as follows: the diagnostic sensitivity was 79.6% to 97.2%, the diagnostic specificity was 50.0% to 92.7%, the positive diagnostic predictability was 61.8% to 94.7% and the negative diagnostic predictability was 60.9% to 95.1%.

[Rational antimicrobial pharmacotherapy of secondary infections in patients with pulmonary tuberculosis].

The results of 3-year (2002-2004) local microbiological monitoring of secondary infections due to opportunistic microflora that complicated the treatment of the main disease in patients of a regional (Moscow) tuberculosis hospital are presented. The monitoring revealed the leading microorganisms, the etiological agents of the secondary lower respiratory tract infection in the patients with pulmonary tuberculosis. The level of their resistance to the up-to-date antimicrobials was determined. Recommendations for optimization of antibacterial therapy of patients with pulmonary tuberculosis complicated by secondary lower respiratory tract infection due to opportunistic microorganisms were developed and validated.

[Monitoring of etiological agents of acute enteric infections in the Moscow region]. / Monitoring vozbuditelei ostrykh kishechnykh infektsii v regione Moskovskoi oblasti.

The fecal microflora of patients with acute enteric infections (AEI) has been examined on the territory of the Moscow region. The pathogens of high, moderate and low priority levels have been detected. As revealed in this study, shigellae, salmonellae, enteropathogenic and enteroinvasive Escherichia are the etiological agents of bacterial diarrheas on the territory of the Moscow region. The dynamics of the etiological agents of AEI in the region has been established.

[Opportunistic microorganisms in purulent inflammatory otolaryngologic diseases and meningitis]. / Uslovno patogennye mikroorganizmy pri gnoino-vospalitel'nykh zabolevaniiakh lor-organov i meningitakh.

The contamination of clinical specimens material, obtained from patients with otolaryngology inflammatory processes and purulent meningitides in the Moscow region, has been studied. Etiologically significant causative agents dominating in different purulent inflammatory diseases have been established. As revealed in this study, in the Moscow region the leading causative agents of purulent inflammatory otolaryngology deseases and meningitides are coagulase-negative ataphylococci, Escherichia coli, meningococci, pyogenic streptococci and fungi of the genus Candida.

[Microflora in ENT and CNS diseases in patients living in the Moscow region]. / Mikroflora pri zabolevaniiakh Lor-organov i nervnoi sistemy u bol'nykh regiona Moskovskoi oblasti.

Patients with ENT and CNS inflammation living in the Moscow Region have been examined for pathogenic contamination of relevant clinical samples. The microflora changes were followed up, pathogenic agents of high and moderate priority were identified. It is shown that for Moscow Region, ENT and CNS purulent inflammation is associated primarily with coagulase-negative staphylococci, E. coli, meningococci, S. viridans and yeast fungi.