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L K Katosova

Publications and source records attributed to L K Katosova.

At least 19 recordsLinked to original sources

[Etiology and rational therapy of severe otitis media purulenta acuta in children].

Etiology and antibiotic susceptibility of the pathogens of otitis media purulenta acuta in children was studied within 2000-2005. A total of 161 children at the age of 1 to 14 years were examined. The middle ear discharge collected during paracentosis (79.5%) or spontaneous perforation of the tympanic membrane (20.5%) was used in the bacteriological tests. The microflora growth in the culture was detected in 80% of the cases. The leading pathogen was Streptococcus pyogenes (47.5%), the part of Streptococcus pneumoniae amounted to 36.6% of all the etiologically significant microflora, the part of Staphylococcus aureus amounted to 6.9% and that of Haemophilus influenzae amounted to 4.0%. The part of the associations of 2 microorganisms equaled 5.0%. The species composion of the pathogens differed from that described in the literature. The isolates of S. pneumoniae and S. pyogenes were characterized by low resistance to macrolides (4.0-6.3%). As for the S. pneumoniae isolates, 97.3% of them was susceptible to penicillin. The results of the etiology study and the pathogen antibiotic susceptibility showed that the drugs of choice for the empirical antibacterial therapy of otitis media purulenta acuta in children should be amoxicillin and 1st generation cepholosporins. When the antibacterial therapy within the first 3 days fails, it is advisable to use protected aminopenicillins or 2nd generation cephalosporins. In case of the drug intolerance, macrolide antibiotics should be used.

Adolescent↗

[Dynamics of Streptococcos pneumoniae antibiotic resistance extension in Moscow in 1998-2003].

During the 6-year observation period from 1998 to 2003 in Moscow there was recorded in 2000-2001 a decrease in the emergence of Streptococcos pneumoniae resistance to many antibacterials, while during the following years the respective index increased. The above dynamics in the resistance emergence was likely due to a decrease in the use of antibiotics in 1998-1999. In 2003 the rate of resistance to penicillin was 18.6%, 0.4 and 2.1% of the isolates were resistant to amoxicillin and cefotaxime respectively, the rate of resistance to erythromycin reached 19%, 65.4% of the resistant strains showed M phenotype. High rates of resistance were as well observed with respect to tetracycline (40.1%), co-trimoxazole (29.1%) and chloramphenicol (18.6%). Resistance to levofloxacin and moxifloxacin was detected only in rare strains.

Amoxicillin↗

[Efficacy of levofloxacin (Tavanic) in the treatment of children with chronic pulmonary diseases].

The efficacy of the fluoroquinolone levofloxacin in the treatment of 35 children with bronchopulmonary disease exacerbation was practically the same as that of amoxycillin/clavulanate, cefotaxime or ceftriaxone. The clinical and bacteriological results were favourable. The eradication of the pathogens responsible for the bronchopulmonary inflammations in 86% of the patients was stated. There is no doubt that fluoroquinolones should not be widely used in pediatrics. They should be considered as reserve drugs for the treatment of severe cases when the routine agents fail. Their use is justified when the situation is risky and the data on the pathogen susceptibility to the drugs are available. Still, levofloxacin is the most safe fluoroquinolone with low hepatotoxicity and lower effect on the central nervous system. The episodes of its negative cardiovascular action are less frequent. Moreover, the most frequent side effects of fluoroquinolones such as nausea, diarrhea or vomiting are less frequent with the use of levofloxacin. No signs of arthropathy in the patients treated with levofloxacin were observed in our trial.

Administration, Oral↗

[Moraxella catarrhalis in chronic and relapsing respiratory tract infections in children].

Examination of 700 children with chronic and relapsing respiratory tract infections showed that during the period from 1996 to 2003 Moraxella catarrhalis strains were isolated from the sputum of 5.5-9.7% of the patients. The frequency of the emergence was the third after Haemophilus influenzae and Streptococcus pneumoniae. In healthy children M. catarrhalis was isolated in 2.7% of the cases. The most frequent detection of M. catarrhalis was stated in children under 1 year (4.5%). The antibiotic susceptibility tests revealed that the majority of the M. catarrhalis isolates had beta-lactamase activity, were resistant to benzylpenicillin, ampicillin and lincomycin and highly susceptible to amoxycillin/clavulanate, macrolides, certain cephalosporins and levofloxacin. The isolates were most frequent in the patients of the rather severe contingent (congenital lung disease, alveolitis, chronic pneumonia, bronchial asthma). In such patients the bronchoobstructive syndrome was more frequent (46.6%). High frequency of the affection of the upper respiratory tracts in the examined children was stated (62.1%).

Adolescent↗

[Resistance of urinary tract infection pathogens and choice of antibacterial therapy in pediatric urologic practice].

The data on antibiotic resistance of the main uropathogens isolated from patients with urinary tract infection in an urologic department (319 isolates) and outpatient and diagnostic units (360 isolates) are presented. It was shown that by the antibiotic resistance the Escherichia coli isolates from the urologic department patients and outpatients did not practically differ: 44.1 and 47.8% of the isolates were resistant to ampicillin, 26.7 and 23.4% were resistant to amoxycillin/clavulanate, 28.9 and 24.9% were resistant to co-trimoxazole and 26.5% was resistance to cefuroxime (outpatients). The basic differences referred to Pseudomonas aeruginosa: resistance to ceftazidime in 38.5% of the isolates and resistance to gentamicin in 36.2% of the isolates. The activity against P. aeruginosa could be arranged as follows in the decreasing order: amikacin = meropenem > imipenem > cefepime = cefoperazone/sulbactam > gentamicin = ceftazidime. Resistance of P. aeruginosa to fluoroquinolones (ciprofloxacin and levofloxacin) remained low (7.4 and 8.0% respectively). No ampicillin resistance was revealed in the isolates of Enterococcus faecalis.

Anti-Bacterial Agents↗

[Haemophilus influenzae antibiotic resistant strains isolated in Moscow in 2002-2004].

The results of 3-year observation on emergence of H. influenzae antibiotic resistant strains in Moscow are summarized. The study included 566 strains isolated from patients in 2002-2004. The susceptibility was determined by the 2-fold microdilution method on the Haemophilus test medium. The percentage of the resistant strains isolated in 2002, 2003 and 2004 was the following: ampicillin --4.9, 3.2 and 3.6%, tetracycline--3.3, 3.2 and 1.8% and co-trimoxazole--10.9, 20.9 and 20% respectively. The strains isolated in 2003 and 2004 were resistant to azithromycin in 0.6 and 1.8% of the isolates and to clarithromycin in 1.3 and 3.2% of the isolates respectively. Five isolates differed by the minimum resistance to ampicillin whereas producing no beta-lactamase (BLNAR strains). The drugs of choice for the treatment of respiratory tract infections mainly due to H. influenzae, i.e. acute otitis and sinusitis, chronic bronchitis exacerbation and sometimes pneumonia remain betalactam antibiotics. From the microbiological viewpoint the inhibitor-protected aminopenicillins, cefuroxime and cefotaxime have no significant advantages vs. amoxycillin. The use of cotrimoxazole and chloramphenicol should be considered inexpedient.

Adolescent↗

[Etiology and treatment of pneumonia in children].

The most widespread pathogens of pneumonia in children i.e. Streptococcus pneumoniae and Haemophilus influenzae and their antibiotic susceptibility are described. The ways of selecting starting antibacterial drugs for the treatment of community-acquired and hospital pneumonia are recommended proceeding from the original findings and some literature data. Oral drugs for the treatment of uncomplicated pneumonia are shown to be preferential. In the treatment of nosocomial or hospital pneumonia the starting regimen should allow for the previous antibacterial therapy.

Administration, Oral↗

[Antibiotics in bacterial acute respiratory tract infection in children].

The data on changes in the susceptibility of the most frequent respiratory tract pathogens i.e. Pneumococcus spp. and Haemophilus influenzae within the last 15 years and Streptococcus spp., Staphylococcus spp. and Moraxella spp. at the present time as well as recommendations based on the original and some literature data on the choice of the antibacterial drugs for the initial treatment of bacterial complications of acute respiratory tract viral infections such as otitis, sinusitis and pharyngitis are presented. The necessity of decreasing the unjustified use of antibiotics in cases of uncomplicated acute respiratory tract viral infections is indicated.

Acute Disease↗

[Clinical significance of fungal and microbial associations and antibacterial therapy for treatment of chronic inflammatory respiratory tract diseases in children].

Microbiological examination applied to 270 children with chronic inflammatory and relapsing respiratory tract diseases revealed that by the frequency of the etiologically significant organisms the main pathogens isolated from the bronchial secretion belonged to Haemophilus influenzae, then followed Streptococcus pneumoniae and the less frequent isolates belonged to Branhamella catarrhalis characterized by high susceptibility to the 2nd and 3rd generation cephalosporins, erythromycin and azithromycin. Mycological investigation of the oral mucus and sputum from the patients revealed high frequency of Candida, mainly C.albicans. The fungi were most frequent and abundant in the children with chronic pulmonary diseases and congenital immune deficiency and in the children with bronchial asthma and asthmatic bronchitis, as well as in the children with exacerbation of the chronic disease, especially with bronchial obstruction. The antibacterial therapy with semisynthetic penicillins, cephalosporins and macrolides led to an increase in the number of the Candida carriers and in the biological material contamination level. The fungal contamination of the host was mainly observed after the use of the penicillins and cephalosporins. Chronic Candida carriers were detected among the patients with chronic inflammatory diseases of the lungs. The diseases in such patients were particularly severe. There were also detected children with colonization resistance to Candida. In the latter cases the chronic process was more favourable. The data made it possible to recommend a more differential use of the antibacterial and antimycotic drugs in the treatment of children with chronic inflammatory diseases of the bronchopulmonary system.

Adolescent↗

[Antibioticograms of microorganisms isolated from foci of local infections in infants].

Microbiological tests were performed in regard to 474 newborns within 1985-1995. It was shown that gram-positive microflora (Staphylococcus epidermidis and Staphylococcus aureus) predominated in the etiological structure of omphalitis and conjunctivitis. Among gram-negative isolates in the cases with omphalitis there predominated Klebsiella pneumonia. The antibioticograms were of great practical value for the adequate therapy.

Conjunctivitis↗

[Use of oral macrolide and azalide antibiotics in children with bronchopulmonary diseases].

The therapeutic efficacy of oral macrolides (erythromycin base and midekamycin, macropen) and azalides (azithromycin, sumamed) in the treatment of children with acute and chronic (during the aggravation) bronchopulmonary diseases was studied. The main etiological factors of acute and chronic pneumonia were Streptococcus pneumoniae and Haemophilus influenzae. The proportion of Staphylococcus aureus was high in infants with acute pleuropulmonary inflammations. The susceptibility of the isolates to the antibiotics was found to be high. The results of the trials showed that erythromycin, macropen and azithromycin were efficient in the treatment of acute and chronic pneumonia. The foci of acute pneumonia dissolved after oral administration of the drugs within the same periods as after the use of other parenteral antibiotics. The comparative estimation of the drug efficacy revealed that azithromycin was more active. The ease of the azithromycin administration (in the form of a suspension) in infants and children once a day for a shorter treatment course up to 5 days, high efficacy and no adverse reactions permitted to consider the antibiotic as the most promising antibacterial agent for the treatment of respiratory infections in children in hospitals and outpatient departments.

Administration, Oral↗

[The role of Pneumococcus in the development of acute bronchitis in young children].

To study the etiological role of Streptococcus pneumoniae in bronchial inflammation, 49 children with acute bronchitis and 21 children with acute nasopharyngitis were examined. The given patients' groups manifested no significant differences in the microflora of the upper respiratory tract, serotype landscape of pneumococcus, the level and dynamics of the immunologic characteristics. The growth of the titer of pneumococcal antibodies in the saliva in the early times of the disease as well as the lack of its changes in blood serum suggest that interaction of pneumococcus with the host is restricted in the given case by the bronchial lumen.

Acute Disease↗

[The coadaptation of the lymphocyte and neutrophil enzyme systems in intact mice and against a background of infectious exposures].

In experiments on mice the authors studied the correlation of the levels of the activity of a number of enzymes (dehydrogenase and acid phosphatase) of lymphocytes and neutrophils at three levels of organization: subcellular--inside the lymphocytes and neutrophils; intercellular--coordination of the enzymatic activity of two types of blood cells; temporary--inter-conjunction of the levels of metabolism in the blood cells prior to and in dynamics after infection. R. P. Nartsissov's cytochemical method with the use of n-nitrotetrazolium was employed. Introduction of systemic conceptions into the cytochemical analysis of neutrophils and lymphocytes made it possible to reveal a peculiarity of the metabolic status of the blood cells involved into the inflammatory process and also to determine coadaptation elements of the two types of leukocytes.

Adaptation, Physiological↗

[The indices of antipneumococcal immunity in children with chronic pneumonia].

In 76 children with chronic pneumonia the levels of serum antibodies to pneumococcal capsular polysaccharide antigens (serotypes 1, 3, 6B, 8, 9N, 15F, 23F), O-polysaccharide and pneumococcal protein somatic antigens were determined by ELISA techniques. The study showed that in sick children the content of antipneumococcal antibodies in the blood increased with age. No correlation between the content of total immunoglobulins and that of antipneumococcal antibodies in the blood of the patients was established, but a sharp decrease in the concentration of antibodies was registered in a child with hypoglobulinemia. No increase in the level of antibodies to pneumococcal antigens was observed in cases of the exacerbation of Pneumococcus-induced inflammatory process in the lungs.

Adolescent↗

[Streptococcus pneumoniae serotypes in children with chronic inflammatory diseases of the respiratory organs].

During the 7-year period of observation (1982-1988) the serotypes of 276 pneumococcal strains isolated from children with chronic bronchopulmonary diseases were studied. Among the serotypes of pneumococci under study, serotypes 6, 19 and 15 held the leading place and included a half of all typed pneumococci. Dynamic observation on the serotype composition of pneumococci revealed periodic fluctuations in the occurrence of some types/groups. The regional analysis of different serotypes of pneumococci showed the common occurrence of serogroups 6 and 19, as well as some regional features in the circulation of serotypes 6, 10, 3 and rarely occurring serotypes. The study revealed that any new exacerbation of the chronic bronchopulmonary process is caused by pneumococci of some other serotype. Pneumococcal strains, resistant (3.4%) and sensitive (1.8%) to penicillin, were detected; most of them belonged to serogroup 19.

Adolescent↗

[Streptococcus pneumoniae serotypes in children with acute pneumonia and pleurisy].

The study of pneumococci of different serotypes, isolated from patients with acute pneumonia and pleuritis and from healthy children was carried out. Among the pneumococcal serotypes causing pneumonia and pleuritis in children serotypes 1, 6, 19, 14 and 3 were most widely spread and constituted 62.3% of all isolated pneumococci. In young children cases of acute pneumonia and pleuritis were more often induced by serotypes 6 and 14 and in older children, by serotypes 1 and 3. In patients with uncomplicated pneumonia and pleuritis differences in the detected serotypes of pneumococci were observed, and the disease course differed in severity. Serotypes 14, 3 and 3 induced destructive processes in the lungs more often than other serotypes. Monitoring of the sensitivity of pneumococci to antibiotics showed that most of the strains retained high sensitivity to penicillin and ampicillin. In most cases the detected resistant pneumococcal strains belonged to serogroup 19.

Acute Disease↗