[Z.V.Ermol'eva: cholera control and prevention--her life commitment].
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Biomedical subjects
Publications and source records attributed to E A Ved'mina.
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One thousand and four hundred strains of V. cholerae 01 isolated in 1994 in the Ukraine were studied with respect to their antibiotic susceptibility and resistance. The study showed that it was possible not only to estimate the present tendencies in and the regularities of the change in their character but also to presuppose the probable circulation and incidence of the microbe based on the differences in the susceptibility, frequency and resistance pattern of the strains of V. cholerae 01 isolated from the environment and humans before and during the cholera outbreak. Unlike the strains of V. cholerae 01 isolated from the environment before the outbreak, the strains isolated during the outbreak from the environment and humans were characterized by resistance to levomycetin (chloramphenicol) and streptomycin. The results suggested that the cholera outbreak in 1994 was incidental. The data are useful for cholera epidemic surveillance. However, the final conclusion is possible after investigation of the gene type pattern in the circulating V. cholerae strains.
The analysis of the dynamics of the antibiotic susceptibility of 442 strains of V. cholerae 01 isolated within 1986-1994 from the environment showed that the susceptibility level was different. Strains of V. cholerae 01 with high susceptibility to tetracyclines, erythromycin, gentamicin, rifampicin and cefazolin and with moderate susceptibility to monomycin, kanamycin, ampicillin, carbenicillin and levomycetin (chloramphenicol) were detected as well as the strains resistant to streptomycin and polymyxin B. The susceptibility of the V. cholerae 01 strains to certain antibiotics (tetracyclines, levomycetin, streptomycin) changed in regard to the isolation time and object and its geographical location. In 1991-1994 a tendency was observed towards an increase in the number of the strains resistant to the drugs. The resistance of the isolates from the objects connected with the vital activity of humans (sewage, washings from the cholera foci, fish from polluted water reservoirs) was higher than that of the isolates from open water reservoirs. There were definite difficulties in the detection of the cultures with antibiotic susceptibility characteristic of various regions because of their different origin. The results of the study were indicative of a necessity of monitoring of the biological properties of V. cholerae 01 isolates from the environment important for cholera control.
The concentrations of gentamicin and cefotaxime (claforan) in the humor of the anterior chamber and vitreous body of the eye were estimated in the study on the pharmacokinetics of the antibiotics in rabbits. The antibiotics were administered intravitreally in single doses. It was shown that the residence time of the antibiotics in the therapeutic concentrations in the eye cavity was 48 hours. Cefotaxime proved to be the most efficient agent in the prevention and treatment of postoperative endophthalmitis.
The sensitivity of 252 Vibrio cholerae-O1 strains isolated from environmental objects to antibiotics of various groups was assayed by the method of serial dilutions on solid media. The biological characteristics of the isolates are presented. The Vibrio cholerae isolates with serological variation were the most frequent (36.6 per cent), so are the cultures detected by their sensitivity to the specific phages (87.5 per cent). It was found that changes in some biological properties of the strains did not coincide with the changes in the antibiotic sensitivity. The isolates were highly sensitive to tetracycline, chloramphenicol, gentamicin, erythromycin and rifampicin and less sensitive to novobiocin and the other aminoglycosides. The sensitivity to the beta-lactams was the lowest. The resistance determinants were detected in single strains (6.3 per cent), the kanamycin and novobiocin resistance determinants being detected in 15 out of the 16 strains tested. The study showed that the cultures of Vibrio cholerae-O1 isolated from the environmental objects generally preserved their sensitivity to the diverse group antibiotics.
The antibiotic sensitivity of 696 cultures belonging to the family Vibrionaceae (V. cholerae O1, V. cholerae non-O1, V. albensis, V. parahaemolyticus, V. alginolyticus and Aeromonas spp.) was studied and general regularities of the antibiotic sensitivity were shown: a high sensitivity to broad-spectrum antibiotics (tetracycline and chloramphenicol) and a low sensitivity to ++beta lactams (carbenicillin and ampicillin). The comparative examinations revealed similarity in the antibioticograms of V. cholerae O1 (el Tor++), V. cholerae non-O1 and V. albensis, especially the latter two groups, as well as the tested halophilic Vibrio cultures by the range of the MICs, Mo, Me and the nature of the antibiotic resistance. Cultures of V. cholerae and luminescent Vibrio tended to preserve a high sensitivity. High resistance levels were noted in the halophilic Vibrio and Aeromonas cultures. No significant differences in the sensitivity of the strains of various origin (from man and environmental objects) were detected. However, several more resistant strains were isolated from the environmental objects.
The authors present the qualification requirements to laboratory physicians specialized in bacteriology. The knowledge and skills of a bacteriologist, necessary for his organizations, methodologic, prophylactic, and diagnostic activities, are listed.
The S. aureus 209P UF mutant dehydrogenase activity suppression method was used for detection of enterotoxin of Enterobacteriaceae opportunistic bacteria. Comparison of V. cholerae non 01, E coli and K. pneumonia toxigenic and nontoxigenic strains, neutralization test with antitoxic anticholera serum, comparative study of toxigenicities in paw edema test (according to Yu. P. Vartanyan) have shown that Escherichia and Klebsiella toxigenic strains can suppress S. aureus 209P UF mutant dehydrogenase activity, which fact permits the employment of this method for the detection of opportunistic bacteria enterotoxigenicity.
Sensitivity of 82 cultures of parahemolytic vibrios to 8 antibiotics was studied. It was shown that the majority of the strains were highly sensitive to levomycetin and gentamicin, sensitive to tetracycline, rifampicin, streptomycin, neomycin and kanamycin and resistant to ampicillin.
Sensitivity of Shigella spp. isolated in one of the hospitals of Nukus within 1987-1988 and earlier in 1977 and 1985 was studied. S. flexneri 1-5 remained the main causative agents of dysentery on the territory. However, beginning from 1987 there were registered cases of dysentery caused by S. dysenteriae 1. The isolates were most sensitive to cefotaxime, cephaloridine, polymyxin B and gentamicin. The majority of the isolates were resistant to tetracycline, levomycetin (chloramphenicol) and streptomycin. No significant changes in the sensitivity levels of the strains isolated in 1987-1988 as compared to those isolated in 1985 were observed.
Antibiotic sensitivities of 120 Ps. aeruginosa strains isolated from patients and environmental objects have been studied by microdilutions in modified Jorgensen's liquid synthetic nutrient medium. Use of "transitional" concentrations of antibiotics permits a simultaneous examination of the sensitivities of 7-8 Ps. aeruginosa cultures to 6-11 antibiotics. The simplicity, low price, low consumption of nutrient medium, sufficient accuracy and good reproducibility of the results recommend this method for laboratory practice.
The rapid method for measuring antibiotic concentrations in biologic substrates, developed by the authors, is based on the suppression of Staphylococcus aureus 209 P test culture dehydrogenase activity. Comparison of the rapid method and the routine agar diffusion test has shown a high correlation of the results, the correlation coefficient r being 0.84-0.93 and its probability 99.9%. The new technique permits getting an answer in 4 hours, is simple, and saves nutrient media.
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Subcultures with a number of signs characteristic of epidemically significant strains have been isolated from cholera vibrios, nonpathogenic and atypical in a number of properties, by a new in vitro method developed by the authors. This method makes it possible to increase the virulence of poorly agglutinating cultures of V. cholerae O1 and their agglutinability with cholera antisera.