RESUMO
AIM: To substantiate the possibility to use the biological characteristics of microorganism, in particular, factors of its persistence, for assessment of severity of trophic ulcers of lower extremities. MATERIALS AND METHODS: Clinical examinations and bacteriological tests of 48 patients aged from 37 to 80 years with trophic ulcer of lower limbs were performed. Antilysozyme, anticomplement, anticarnosine as well as hemolytic activity of isolated microorganisms were assessed. RESULTS: It was established that microflora of trophic ulcers of lower limbs are diverse and microorganisms were isolated both in monoculture and in associations, with maximal significance of Staphylococcus aureus. Analysis of biological properties of microflora isolated in patients with various courses of trophic ulcers of lower limbs allowed to determine roles of antilysozyme, anticomplement, anticarnosine and hemolytic activities in severity of the illness. CONCLUSION: Performed studies allowed to develop diagnostic models for prediction of severity course of trophic ulcers of lower limbs.
Assuntos
Úlcera da Perna/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/patogenicidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas de Bactérias/metabolismo , Carnosina/antagonistas & inibidores , Carnosina/metabolismo , Proteínas Inativadoras do Complemento/metabolismo , Progressão da Doença , Hemolíticos/metabolismo , Humanos , Úlcera da Perna/etiologia , Úlcera da Perna/patologia , Extremidade Inferior/irrigação sanguínea , Pessoa de Meia-Idade , Muramidase/antagonistas & inibidores , Muramidase/metabolismo , Infecções Estafilocócicas/patologia , Staphylococcus aureus/isolamento & purificação , Varizes , Insuficiência Venosa/complicações , CicatrizaçãoRESUMO
The paper presents the data of examination of 62 patients with acute purulent diseases of the lung and pleura (abscess, empyema, pyopneumothorax). The persistent and virulent characteristics of causative agents isolated just from a suppuration focus during its puncture are described. There was an association of the high level of antilysozyme, anticomplementary, and hemolytic activities of bacterial pathogens with the severe course of a disease. On this basis, a mathematical model that can predict the course of acute purulent diseases of the lung and pleura with an accuracy of as high as 95% has been constructed.
Assuntos
Infecções Bacterianas/microbiologia , Pneumopatias/microbiologia , Pneumopatias/fisiopatologia , Pleurisia/microbiologia , Pleurisia/fisiopatologia , Doença Aguda , Adulto , Idoso , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
In the study of 65 microbial cultures isolated from the purulent foci in acute pulmonary abscess and acute pyothorax of 48 patients, a wide spectrum of microflora was detected. Staphylococci and Pseudomonas prevailed among aerobes, bacteroids and peptostreptococci--among anaerobes. In cases of the prolonged course of the pathological process, as compared with the common one, microorganisms exhibited hemolytic activity and high antilysozyme and anticomplementary levels. These findings served as the basis for working out a mathematical model for the prognosis of the disease course with 95% probability.
Assuntos
Fenômenos Fisiológicos Bacterianos , Empiema Pleural/microbiologia , Abscesso Pulmonar/microbiologia , Doença Aguda , Bactérias/isolamento & purificação , Bactérias/patogenicidade , Bacteroides/isolamento & purificação , Bacteroides/fisiologia , Proteínas do Sistema Complemento/metabolismo , Empiema Pleural/diagnóstico , Hemólise , Humanos , Abscesso Pulmonar/diagnóstico , Matemática , Muramidase/antagonistas & inibidores , Muramidase/metabolismo , Peptostreptococcus/isolamento & purificação , Peptostreptococcus/fisiologia , Prognóstico , Pseudomonas/isolamento & purificação , Pseudomonas/fisiologia , Staphylococcus/isolamento & purificação , Staphylococcus/fisiologiaRESUMO
Results of treatment of patients with acute pulmonary abscess, acute empyema of the pleura and pyopneumothorax were analyzed. The local treatment of the main group of patients consisting of 50 persons included oxitocin in combination with antiseptics and antibiotics which facilitated maximal reduction of the persistent potential of the pathogenic agent, its rapid elimination from the purulent focus and allowed to get better results using conservative therapy. The obtained clinical effect confirmed the experimental data on pronounced inhibition of persistent properties of the bacterial pathogens with the complexes "antibiotic-oxitocin".
Assuntos
Empiema Pleural/tratamento farmacológico , Empiema Pleural/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Pneumotórax/tratamento farmacológico , Pneumotórax/microbiologia , Doença Aguda , Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Cefazolina/uso terapêutico , Terapia Combinada , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Nitrofurazona/uso terapêutico , Peptostreptococcus/isolamento & purificaçãoRESUMO
The species composition and biological properties of microflora isolated from 42 patients with acute inflammatory pulmonary and pleural diseases were studied. A wide spectrum of aerobic and anaerobic microorganisms was detected. Infective agents causing severe course of the infectious process were found to have a high level of persistence properties.
Assuntos
Bactérias Aeróbias/isolamento & purificação , Bactérias Anaeróbias/isolamento & purificação , Empiema Pleural/microbiologia , Abscesso Pulmonar/microbiologia , Doença Aguda , Adulto , Idoso , Bactérias Aeróbias/metabolismo , Bactérias Anaeróbias/metabolismo , Proteínas Inativadoras do Complemento/análise , Proteínas Inativadoras do Complemento/metabolismo , Inibidores Enzimáticos/análise , Inibidores Enzimáticos/metabolismo , Humanos , Pessoa de Meia-Idade , Muramidase/antagonistas & inibidores , Muramidase/metabolismo , Especificidade da EspécieRESUMO
In a number of in vitro experiments the effect of oxytocin on the antilysozyme and anticomplemental activity of Propiobacterium propionicum, Bacteroides fragilis, Prevotella melaninogenica and Peptostreprtococcus anaerobius, isolated from patients with acute pyoinflammatory pleuropulmonary diseases, was studied. Antibiotic resistance dynamics of the infective agents under study to lincomycin, clindamycin, thienam, vancomycin was also detected. The inhibiting activity of oxytocin on the persistence properties of B. fragilis, P. melanogenica and P. anaerobius was noted. Under the influence of the preparations used changes in the sensitivity of the strains to a number of antibiotics of the lincosamide, carbapenem and glycopeptide groups were found to occur. The data thus obtained were indicative of the possible mechanisms of action of oxytocin in the treatment of acute pyoinflammatory pleuropulmonary diseases of anaerobic nonclostridial etiology.