[The microbiological aspects of infectious complications in the oncology clinic]. / Mikrobiologicheskie aspekty infektsionnykh oslozhnenii v onkologicheskoi klinike.

At present 10 to 30 per cent of the microbial strains from cancer patients are problem ones: oxacillin resistant strains of Staphylococcus aureus, coagulase negative strains of Staphylococcus spp., aminoglycoside resistant strains of Escherichia coli, 3rd generation cephalosporin resistant strains of Klebsiella spp. and fungi of Candida which requires development of more rational approaches to antibacterial chemotherapy and prophylaxis of infectious complications. The infectious processes in the cancer patients proved to be highly polyetiological. Therefore, the study is significant for epidemiologic and therapeutic measures. Such an analysis in oncological clinic should be regular.

[Infections of a fungal etiology in the cancer clinic]. / Infektsii gribkovoi etiologii v onkologicheskoi klinike.

Candida fungi, more than half of which are Candida albicans, are responsible for up to 28% of microflora contaminating the pathological material during infectious processes coursing in cancer patients. They may be isolated as a monoculture or in associations with bacteria, depending on the localization of the process. In both cases their pathogenetic significance is really great, which is confirmed by the efficacy of antimycotic therapy and prophylactic measures. The prevalence of fungal infections necessitates taxonomic identification of the isolated fungal cultures.

[Etiologic structure of infectious complications in the urogenital tract of oncologic patients]. / Etiologicheskaia struktura infektsionnykh oslozhnenii v urogenital'nom trakte onkologicheskikh bol'nykh.

The investigation of the microflora of infectious complications in the urogenital tract of oncological patients showed that in spite of the similarity of the microbiotypes, the microflora of the infectious complications in the patients had marked differences. The causative agents in urological patients were mainly monocultures (69.9 per cent), whereas in gynecological patients they were mainly associations (67.2 per cent), more frequently of 2 and sometimes of 3 and even 4 or 5 taxa. The taxonomic spectra of such pathogens were also different. In the urological patients a much broader spectrum of the bacterial species with the predominance of gram-negative rod-shaped bacteria was detected. In the gynecological patients the predominating taxa were Candida spp., Staphylococcus spp., Escherichia coli and S. faecalis. The other bacteria in total amounted to 13.9 per cent. In the urological patients the predominating taxa were Pseudomonas aeruginosa, E. coli, Candida spp. and S. faecalis. The frequency of Staphylococcus spp. and Candida spp. was twice as low as that in the gynecological patients. Therefore, the comparative investigation of the causative agents in the urinary tract and female genitalia of the oncological patients revealed significant differences which cast doubt on the validity of empirical antibacterial therapy according to the principle of "above and below the waist" practiced by many physicians in the treatment of infectious complications in somatic hospitals.

[Piperacillin in the treatment of suppurative inflammatory complications in cancer patients]. / Piperatsillin pri lechenii gnoino-vospalitel'nykh oslozhnenii u onkologicheskikh bol'nykh.

Piperacillin (Pipril, Lederle, USA) is semisynthetic penicillin highly active against aerobic and anaerobic organisms. Its high activity was demonstrated with respect to 289 strains of aerobes, 82.7 per cent of the Pseudomonas aeruginosa strains being susceptible to Pipril. Diverse purulent inflammatory complications were treated with Pipril in doses of 8 to 24 g a day in 27 patients with malignant tumors. The clinical effect in 84.6 per cent of the cases was recorded. Complete elimination of the pathogens was observed in 73.5 per cent of the patients. Therefore, Pipril should be considered as one of the most active antibiotics for the treatment of purulent inflammatory complications in oncological patients.

[Taxonomic spectrum of pathogens of mixed infections in oncology patients and principles of their antibacterial therapy]. / Taksonomicheskii spektr vozbuditelei smeshannykh infektsii v onkologicheskoi klinike i printsipy antibakterial'noi terapii.

Mixed infections were observed in oncological patients irrespective of the tumor or infectious process localization. 25-30 per cent of the pathological materials from such patients were contaminated with bacterial associations. The number of the associates ranged from 2 to 5 depending on the pathological material tested. Therapy of infectious complications due to pathogen associations should stem from analysis of many factors, i.e. properties of the isolated or likely pathogens, individual characteristics of the patients, compatibility of the drugs used and their pharmacokinetic features.