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Biomedical subjects

L V Bol'shakov

Publications and source records attributed to L V Bol'shakov.

17 recordsLinked to original sources
PubMed2005

[Microbiological monitoring in prophylaxis and treatment of pyoinflammatory complications during early postoperative period in patients with cicatricial tracheostenosis].

The species composition and antibiotic susceptibility of microflora isolated from patients with cicatricial tracheostenosis (CTS) and infectious processes were investigated. Schemes for the treatment of CTS with an account of the pathogen species and multidrug resistant staphylococcal infection are described. Comparative efficacy of the combined schemes (antibiotic + bacteriophage) for the therapy of pyoinflammatory processes in the patients with CTS and the efficacy of the treatment of the patients with CTS according to the traditional antibacterial schemes were studied.

Adolescent↗
PubMed2003

[Cefepime treatment efficacy in surgical patients].

Clinical and bacteriologial efficacies of cefepime were studied in the treatment of 20 surgical patients. Intraoperative prophylaxis is with the use of cefepime alone and postoperative prophylaxis with the use of cefepime in combination with some other drugs were applied to 10 patients. No postoperative complications in the group of the 10 patients were stated. The other 10 patients were subjected to intraoperative and postoperative combined prophylaxis with some other antibiotics. In 6 patients of the latter group postoperative complications developed. Obvious clinical advantages of cefepime were demonstrated.

Antibiotic Prophylaxis↗
PubMed1999

[Prevention and treatment of postoperative pyoinflammatory complications and cefuroxime].

Antibacterial activity and efficacy of cefuroxime (ketocef, Pliva, Zagreb) in the treatment and prophylaxis of surgical infections in a general hospital and particularly in the unit of vessel and aorta surgery, the unit of lung surgery and the unit of microsurgery were estimated. The study included 57 patients (43 males and 14 females) at the age of 21 to 70 years. Cefuroxime was administered intravenously in a dose of 1.5 g followed by its intramuscular administration in a dose of 750 mg with an interval of 8 hours. The results showed that cefuroxime was effective in the treatment (80 per cent) and prophylaxis (93.6 per cent) of the pyo-inflammatory complications and was active against the majority of the surgical infection pathogens.

Adult↗
PubMed1999

[The results of a multicenter study of the comparative activity of cefepime and other antibiotics against the causative agents of severe hospital infections (the Micromax program)].

A multicentre trial was performed on the activity of cefepime in comparison with ceftazidime, ceftriaxone, piperacillin/tazobactam, imipenem and ciprofloxacin against severe hospital infection pathogens in intensive care units. The isolates of Escherichia coli and Proteus spp. from the majority of the centres were highly susceptible to the antibiotics (90 to 100 per cent of the isolates). In some centres up to 40 per cent of the isolates produced ESBL. The isolates of Klebsiella spp. were characterized by lower susceptibility, in some centres the frequency of the strains producing ESBL exceeded 90 per cent, by the MIC geometric mean cefepime was superior to the third generation cephalosporins, the frequency of resistance to ciprofloxacin ranged from 0 to 31 per cent, no resistance to imipenem was recorded. The frequency of resistance to the third generation cephalosporins and piperacillin/tazobactam in Enterobacter spp., Serratia spp., Citrobacter spp., Morganella spp., and Providencia spp. ranged from 10 to 52 per cent, the resistance to cefepime equaled 0-11 per cent, 0 to 17 per cent of the isolates were resistant to ciprofloxacin, some isolates were resistant to imipenem. As for the nonfermenting microorganisms their resistance to all the antibiotics tested was comparatively high and markedly differed in various centres. As a whole, 7 per cent of all the isolates of the nonfermenting organisms was resistant to cefepime, 10 per cent was resistant to imipenem, 17 per cent was resistant to ceftazidime, 21 per cent was resistant to piperacillin/tazobactam and 36 per cent was resistant to ciprofloxacin.

Acute Disease↗
PubMed1998

[Pyogenic infectious complications in recipients with allogenic kidneys: clinical and bacteriological aspects].

The bacteriological study of wound discharge indicated no changes in the structure of the microflora in the allogenic kidneys of recipients throughout the follow-up. Among microbes isolated there were prevalent gram-positive microbes whose proportion has slightly increased in the past year, with Staphylococcus, mainly epidermal Staphylococcus, which contributes to the etiology. At the same time, studies of wound discharge in the past years showed that the incidence of mixed infections had increased from 4.3 in 1989-1991 to 15.6% in 1994-1997. Bacteriological urinalysis found no great differences in the etiological structures of the microflora. Gram-negative microbes are prevalent in all patients in three periods of follow-up. Noteworthy, there was an increase in the amount of yeast fungi (from 5.7 to 21.1%). Urinalysis showed that the rates in the isolation of bacterial and bacterial and fungal associations were steady-state and higher in all patients (20, 4-23, 5%). Examining the etiological structure of the pathogens of sepsis ascertained that patients of the early observation were found to isolate gram-negative microorganisms more frequently, while those of other observation periods have gram-positive ones. The overall proportion of microbial and microbe-fungal associations was 10.3% in the past 9 years. Since the patient's body is occupied by other pathogens due to immunosuppression, sepsis or wound infection was accompanied by high bacteriuria, cytomegalovirus infection, pneumocystic pneumonia, fungal infection, etc. For this reason, the patients had actually much higher quantities of mixed infections in sepsis, wound infection, or urinary infection than those taken into account while studying the only type of an infectious complication. The above leads to the conclusion that the incidence of mixed infection of recipients of allogenic kidneys is rather high. This infection substantially makes the choice of drugs and therapy difficult, the course of a wound process aggravated. For successful control of mixed infections, it is necessary to introduce new drugs having a high activity against bacteria, fungi, viruses, and protozoa and to use the latest differentially diagnostic culture media, to make diagnosis and treatment of pyoseptic diseases better.

Adolescent↗
PubMed1997

[Aspects of solution of the postoperative infection problem in heart surgery].

The study of the incidence and etiological pattern of infectious complications included 376 patients operated for acquired valvular disease. 40,280 bacteriological tests of the materials from the patients obtained during the operations and during the postoperative period as well as 30,113 sanitary bacteriological tests of the specimens from the cardiological operation unit were conducted. The possible use of the results of bacteriological monitoring for prediction of septic complications and optimization of antibiotic prophylaxis and therapy as well as for development and operation of a system of sanitary and hygienic measures for infection prevention was shown and statistically confirmed.

Bacterial Infections↗
PubMed1996

[Anaerobic infection in abdominal surgery].

The etiological pattern of non-clostridial anaerobic infection, its natural history and drug therapy in patients with its various types were studied and analyzed at the Surgery Research Center, Russian Academy of Medical Sciences. Peritonitis and cholangitis were examined in detail. Multimodality treatment of patients with acute peritonitis caused by a combination of aerobic and anaerobic pathogens by using hyperbaric oxygenation and therapy with directly acting antibiotics was found to enhance its efficiency, decrease therapy duration, prevent inflammation progression, and reduce mortality rates from 25.64 to 8.8%. The application to the techniques of preliminary decompression and the developed regimens of antibacterial therapy and hyperbaric oxygenation in the multimodality treatment for suppurative cholangitis noticeably yielded better therapeutical results, reduced mortality rates from 5.7 to 0% and these patients' hospital stay.

Abdomen↗
PubMed1996

[Ten-year experience with the use of ofloxacin in reconstructive surgery].

The data on the use of ofloxacin in more than 300 surgical patients for the last 10 years were analyzed. The results showed that despite the wide clinical use of ofloxacin in the prophylaxis and treatment of postoperative complications the drug remained highly active against the predominating majority of microbes causing surgical infections. Therefore, the broad spectrum, high bactericidal activity and optimal pharmacokinetics with the high biovailability at the level of 95 to 100 per cent provided the use of ofloxacin as a highly efficient agent in the treatment of postoperative infectious complications in surgical inpatients.

Administration, Oral↗
PubMed1992

[Cefoperazone in a multi-profile surgical clinic].

The results of the clinical trials of cefoperazone (cefobid, Pfizer, USA), a 3rd generation cephalosporin, carried out at the Research Centre of Surgery are presented. The antibiotic was used to treat and prevent postoperative infections in 44 patients. Good and satisfactory results were observed in 43 out of the 44 patients (99.9 per cent). Antimicrobial activity of cefoperazone against 182 bacterial strains isolated from the patients was assayed and compared with that of other cephalosporins i.e. cefotaxime, ceftriaxone and ceftazidime. The cefoperazone pharmacokinetics was studied in the patients with normal renal functions after surgical operations on the organs of the chest and abdominal cavity. The antibiotic was shown useful in the monotherapy of mixed infections involving anaerobic pathogens.

Adolescent↗
PubMed1990

[Efficacy of a combination of dioxidine with beta-lactam antibiotics in the prevention and treatment of purulent-inflammatory complications].

Schemes for prevention and treatment of purulent inflammatory complications were developed on the basis of in vitro studies on antimicrobial activity of dioxidine and 7 beta-lactam antibiotics such as mezlocillin, carbenicillin, ampicillin, cefotaxime, cefoxitin, cefuroxime and cephalothin under conditions of aero- and anaerobiosis with an account of the isolated microflora, its sensitivity to antibacterial agents and conditions required for vital activity of obligate anaerobes in humans, i.e. decreased partial oxygen pressure, low oxidation-reduction potentials and high tissue concentrations of carbon dioxide. The use of dioxidine in combination with the antimicrobial drugs enabled one to decrease the number of cases with purulent inflammatory complications after large intestine esophagoplasty to 30.4 per cent against 67.5 per cent in the control group of the patients untreated preventively with the antibacterial drugs. The number of cases with similar complications after gastrectomy amounted to 16.1 per cent against 62 per cent in the control. The use of dioxidine+ in combination with ampicillin and cefotaxime in treatment of purulent necrotic affections of the foot in patients with diabetes mellitus enabled one to increase the number of satisfactory outcomes by 32 per cent, to decrease the number of high amputations by 21.9 per cent and to lower the number of deaths more than 2-fold as compared to the results in the control group of the patients subjected to chemotherapy based on sensitivity of the aerobic microflora alone.

Anti-Bacterial Agents↗
PubMed1990

[Changes in sensitivity of clinical strains of bacteria to dioxidine from 1984 to 1988].

Dioxidine sensitivity of 7291 strains of aerobic bacteria and 163 strains of anaerobic bacteria was assayed with the disk diffusion method. The sensitivity of the aerobes was studied in the time course from 1984 to 1988. It was shown that during the 5-year period, the sensitivity of gram-positive bacteria to dioxidine gradually decreased. At the same time no increase in resistance of gram-negative organisms to dioxidine was observed. A high dioxidine sensitivity of obligate anaerobes, i.e. Clostridium spp., Bacteroides spp., Fusobacterium spp., anaerobic cocci and others was demonstrated.

Anti-Bacterial Agents↗
PubMed1990

[Sensitivity of the main causative agents of gas gangrene to currently available antibacterial drugs].

Sensitivity of the main microbial species causing gas gangrene to 21 antibacterial drugs was studied. The pathogens included 28 strains of Clostridium perfringens, 21 strains of C. oedematiens, 31 strains of C. septicum and 19 strains of C. histolyticum. Antibiotics having a bactericidal effect on the Clostridia were determined. The findings of the study were indicative of a variety of the antibiotic sensitivity spectra of the Clostridium spp., which accentuated the importance of antibiotic sensitivity assay in every particular case of gas gangrene.

Anti-Bacterial Agents↗
PubMed1989

[Antimicrobial activity of new beta-lactams and aminoglycosides in vitro under conditions of anaerobiosis].

Sensitivity of 135 strains of aerobic, facultative anaerobic and anaerobic asporogenous bacteria was tested in vitro with respect to 7 beta-lactam antibiotics and 4 aminoglycosides. It was shown that anaerobiosis influenced the MICs of the drugs for the majority of the strains. Under such conditions sensitivity of the aerobic and facultative anaerobic organisms to the beta-lactams increased 2-8 times. On the contrary, the MICs of the aminoglycosides for 74.6-85.1 per cent of the strains increased 2-16 times. The asporogenous anaerobic bacteria of clinical origin were highly sensitive to the beta-lactam antibiotics such as cefoxitin, cefotaxime, mezlocillin and carbenicillin whose MICs did not exceed 16-31.2 micrograms/ml.

Aminoglycosides↗
PubMed1986

[Antibacterial activity of dioxidine under aero- and anaerobic conditions].

The activity of dioxidine under the conditions of aerobiosis was studied with respect to 23 bacterial species (443 strains). High activity of dioxidine against enterobacteria and its less pronounced activity against P. aeruginosa, Staphylococcus and Enterococcus were shown. It was found for the first time that dioxidine was active against H. alvei, M. lacunata, M. nonliquefaciens, A. anitratus, A. lwoffii and P. maltophilia. Comparative activity of dioxidine under the conditions of aerobiosis and anaerobiosis against 21 bacterial species (101 strains) was investigated. It was demonstrated that under the conditions of anaerobiosis the activity of dioxidine increased 4-128 times. The coefficient of the increase in the antimicrobial activity of dioxidine depended on the species and strain of the bacteria and mainly on the initial level of the drug sensitivity. Thus, with respect to the strains having the MIC of 125 to 1000 micrograms/ml or higher under the conditions of aerobiosis the antibacterial activity of dioxidine increased 16-128 times. However, with respect to the highly sensitive strains (MIC of dioxidine under the conditions of aerobiosis was equal to 4-8 mg/ml) the antimicrobial activity of the drug increased only insignificantly i.e. 4-8 times. The results of the study indicated that the use of dioxidine as a reserve drug in treating pyoinflammatory infections such as phlegmon, abscesses, etc., developing at lowered concentrations of oxygen in the tissues was promising.

Aerobiosis↗
PubMedDate not supplied

[Principles of prevention of pneumonia associated with the use of artificial ventilation of the lungs in resuscitation and intensive care units].

Pneumonia ranks among the most incident complications associated with forced ventilation of the lungs (FVL). Its incidence depends on FVL duration and according to published reports varies from 9 to 70%. Pneumonia deteriorates the prognosis and essentially increases the mortality in intensive care wards. Based on published reports and their own experience, the authors formulate the fundamentals of prevention of pneumonia in patients on FVL: use of intubation tubes with low-pressure cuffs; minimum duration or no procedures involving the intubation tube cuff blowing off; regular sanitization of the tracheobronchial tree and oropharynx; use of devices for removal of tracheobronchial secretion in the closed contour and of disposable catheters; inhalation of bronchomucolytics and antibiotics through a nebulizer; patient's position in bed with elevated head part; rigid approach to prescription of antacide drugs and H2-receptor blockers; decontamination and regulation of intestinal function; antibiotic therapy with consideration for the results of bacteriological studies; no or minimum exposure to procedures involving the respiratory contour seal opening; use of sterile gloves; use of disposable respiratory contours and hydrophobic bacterial filters instead of humidifiers.

Age Factors↗
PubMedDate not supplied

[Use of ofloxacin in the treatment of suppurative-inflammatory complications in surgery].

Analysis of ofloxacin use in clinical surgery over the latest decade showed that despite its wide clinical application for the prevention and therapy of postoperative complications, this drug remains highly active for the majority of micro-organisms. Hence, a wide spectrum, high bactericidal activity of the drug, optimal pharmacokinetics, and a high bio-availability (95-100%) still recommend ofloxacin, a highly effective agent for the treatment of infectious complications of surgery.

Acinetobacter↗