[MICROBIOLOGICAL ASPECTS OF INFECTIOUS BALANOPOSTHITIS].

Treatment and prevention of diseases of the male reproductive organs largely influence male population fertility and the health of the future generations. This review summarizes current views on the problem of infectious balanoposthitis and presents generalized information on its pathogens. Refined classification and diagnostic workup are provided. The important role of pathogenic microflora in the formation of the glans penis and foreskin inflammation is shown. Importance of Enterococcus spp. in the etiology of balanoposthitis is demonstrated. The modern treatment regimens and prevention of balanoposthitis are described.

[Genetic identification as method of detection of pathogenic and symbiotic strains of enterococci].

Comparative study of 97 cultures of enterococci, including reference highly virulent strain Enterococcus faecalis ATCC 259212, 35 clinical isolates of E. faecium, 58 isolates of E. faecalis, and 3 probiotic strains of E. faecium: Linex (Lek company, Slovenia), SF68 (Bifiform, Denmark), and L3 (Avena, Russia). Thirteen of 93 cultures were isolated from patients treated with probiotic Linex, containing E. faecium (Linex) bacterium. Comparative analysis of cultures on the presence of 8 genes determining virulence (esp, asa1, efaA, cylA, cylM, gelE, sprE, and fsrB) was performed using polymerase chain reaction and testing with antibiotics. It was established that in some cases clinical cultures of enterococci used for analysis carried genes of pathogenicity and were not related to E. faecium (Linex) strain included in composition of the probiotic drug.

[Identification of potential causative infectious agents of chronic prostatitis].

Analysis of the data on etiology and pathogenesis of inflammatory processes in prostate including acute and chronic prostatitis as well as chronic pelvic pain syndrome is presented. It has been noted that about 50% of men of fertile age had clinical signs of chronic prostatitis at least once in life and that more than 60% of admissions to urologists in outpatient practices are related with clinical signs of chronic prostatitis. An appreciable decrease in quality of life similar to that due to myocardial infarction or Crohn's disease is observed in patients with chronic prostatitis. Prostatitis often has a chronic cyclic course with exacerbation and remission phases. Not rarely the disease has primary chronic course--without an apparent beginning as acute prostatitis. This leads to late diagnostics and difficulties with identification of etiologic factor, which commonly is a conditionally pathogenic microorganisms and mixed infections. Such difficulties can be a reason for inadequate treatment and complications of chronic prostatitis such as abscess, paraprostatitis, impotence, and infertility.

[Significance of detection of genomic markers of pathogenicity islands in Escherichia coli in urological practice].

Examinations of 86 (100%) patients aged 16 to 68 years who had urinary tract infection could isolate 67 Escherichia coli cultures, 32 of them in acute pyelonephritis with marked destructive changes, 24 during an exacerbation of chronic cystitis, 11 in asymptomatic bacteriuria. Twenty E. coli strains isolated from feces of apparently healthy individuals were used as a control. The genetic determinants associated with nucleotide sequences of pathogenicity islands (PI) known for enterobacteria: hlyA, hlyB, cnf-1, papC, fimA, and irp-2 were determined in bacteria, by using polymerase chain reaction. There was an association of the frequency of PI determinants in E. coli with the severity of the clinical course of urinary tract infection. The high frequency of 2 PI determinants or more was ascertained in highly pathogenic E. coli strains as compared with the cultures isolated from apparently healthy individuals.

[Clinical implications of E. coli pathogenic factors in patients with urinary infection].

The authors show perspectives of using primers detecting nucleotide gene sequences in isolated E. coli strains; pathogenic factors of E. coli, fimbrial adhesive (type I and type P); alpha-hemolysin (hly); cytotoxic necrotising factor I (cnf-1); iron-regulated proteins for predicting the course of the inflammatory process in urological patients with bacterial infection.

[Use of therapeutic polycomponent vaccine "Immunovac VP-4" for the treatment of chronic bacterial prostatitis]. / Primenenie terapevticheskoi polikomponentnoi vaktsiny "Immunovak-VP-4" pri lechenii khronicheskikh bakterial'nykh prostatitov.

A complex of clinical and laboratory examinations of patients with bacterial chronic prostatitis was carried out. The patients were divided into two groups: 55 patients treated by the method of immunotherapy and 20 patients (controls) undergoing basic therapy. Immunotherapy was carried out with the use of polycomponent vaccine VP-4 containing Staphylococcus aureus, Klebsiella pneumoniae, Proteus vulgaris and Escherichia coli antigens. Vaccinal therapy was indicated in cases with infection focus associated with opportunistic bacteria, a prolonged torpid course of prostatitis and when different schemes of etiotropic therapy proved to be ineffective. The vaccine was introduced in 4 or 5 subcutaneous injections at an interval of 5-7 days. The study revealed that in cases of chronic prostatitis accompanied by microecological and immune disturbances the use of complex therapy allowed to achieve good clinical and laboratory results in 91% of the patients. In the patients undergoing immunotherapy the elimination of opportunistic bacteria from the urogenital tract and the restoration of affected microflora occurred.