[Antibacterial therapy of early bacterial inflammation of the upper respiratory tracts in patients treated in a critical care department].
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Biomedical subjects
Publications and source records attributed to V G Zhukhovitskiĭ.
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Vacuolizing toxin (VacA) Helicobacter pylori is an important factor of pathogenicity of Helicobacter pylori and a basic marker in the diagnosis of helicobacteriosis and related diseases. A coagulation-based diagnostic test-system was elaborated for the detection of VacA in clinical samples. A fragment of vacA was cloned, for the purpose, in Escherichia coli and expressed in preparative quantities; the coded protein was purified and used in raising the diagnostic serum. The thus designed coagulating test-system was successfully tested under the modeling conditions with clinical samples. Therefore, the designed express method can be used for the invasion-free determination of VacA in patients with gastric and duodenal pathologies.
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The problem of pyoinflammatory ENT and upper airway diseases is reviewed. Some new approaches are proposed.
The article presents current views on etiopathogenesis of the diseases associated with contamination with microorganisms; reviews inflammatory ENT diseases in terms of current literature on clinical microbiology of these diseases; characterizes microorganisms more or less specific for each relevant nosological entity; analyses basic groups of antibacterial drugs with formulation of bacteriologically grounded principles of initial antibacterial therapy of ENT inflammation.
Microbiological and chromato-mass-spectrometric examinations were made in 53 patients with chronic maxillary ethmoiditis and 52 patients with chronic tonsillitis. The microflora showed strong resistance to unprotected penicillines and cephalosporins, 100% sensitivity to amoxicilline clavulanate and mupirocine. The role of opportunistic microflora as pathogens of ENT inflammation is growing as well as the percentage of anaerobic microorganisms detected chromato-mass-spectrometrically in chronic inflammation. Administration of mupirocine on polyethylenglicol base early after operation in patients with chronic maxillary ethmoiditis accelerated recovery of the study group patients by 2-3 days vs control patients.
The efficacy of short-term treatment with azithromycin in 17 patients with acute doudenal ulcer associated with H. pylori was evaluated. Bioptats of the gastric mucosa taken at the beginning and after one month of treatment were investigated for H. pylori presence by histological, bacteriological methods, by urease test and by PCR. All the patients with positive H. pylori test were treated with Gastrozol (omeperazole, ICN Pharmaceutical) 40 mg per day for 1 week followed by 20 mg per day for 3 weeks, Sumamed (azithromycin, peira) 0.5 g once daily for 3 days and amoxycillin 0.5 mg four times a day for 10 days. Bioptats analysis before treatment revealed H. pylori in 100% for PCR methods, in 94.1% for urease test, in 88.2% for histological test. After the treatment H. pylori was revealed in 12.5% for urease and histological test, in 18.8% for bacteriological test and in 25% for PCR test. Thus the treatment efficacy was 75%. Side effects for short-term azithromycin therapy were shown in 5.9% cases.
The study assessed efficiency of local antibiotic therapy with mupirocin and amoxicillin/clavulanate in 28 patients radically operated on the maxillary sinus (MS). Early after the operation, MS tamponing with a latex tampon was made. The tampon was filled with mupirocin for patients of group 1. In patients of group 2 and controls the tampon was sterile but in group 2 after the tampon removal postoperative maxillary washing was made with amoxicillin/clavulanate solution. The results of the study demonstrated high efficiency of local administration of mupirocin and amoxicillin/clavulanate and validity of bacteriological examination in planning antibiotic therapy early after surgery.
There is the HP diagnostic methods review. The classification of main methods is presented. Diagnostic significance and defects of all these methods were demonstrated. There are own data of HP and its strains revealing in the patients with duodenal peptic ulcer.
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Seventeen duodenal ulcer patients were examined. H. pylori were detected in all the patients by histological and bacteriological methods. Changes in the enteric microflora, manifested by a decrease in the number of lacto- and bifidobacteria and by an increased level of opportunistic microflora, were established. Cimetidine treatment and the suppression of the acid-producing function of the stomach augmented enteric dysbacteriosis and H. pylori contamination of the gastric and duodenal mucosa.
The study of the influence of cyprofloxacin on the microflora of the gastrointestinal tract has been made under experimental and clinical conditions. As revealed in this study, cyprofloxacin produces a corrective effect on the intestinal microflora; the action of this preparation, in contrast to that of other antimicrobial preparations, is retained for a long time. In patients having duodenal ulcer with bacteriosis caused by Campylobacter pylori and with intestinal dysbacteriosis the combination of cyprofloxacin and cimetidine yields a higher therapeutic effect than the use of cimetidine alone.
The capacity of Campylobacter for mobile was studied on the cultures of 5 reference strains and 153 newly isolated strains of clinical origin, used as an experimental model. The study revealed that the capacity of Campylobacter for mobile growth was best manifested in cases of its cultivation in nutrient media based on tryptose agar with the density of 0.35% at 37 degrees C in the usual atmosphere: under these conditions the capacity for mobile growth was exhibited by 92.8% of all cultures of the strains under study. The description of the cultural properties of Campylobacter cultures exhibiting mobile growth demonstrated the difference between the phenomenon of mobile growth and the phenomenon of clustering. The possibility of using the capacity of Campylobacter for mobile growth for the rational diagnosis of Campylobacter infection was suggested.
The adhesive activity of C. jejuni isolated from feces of children with Campylobacter infection was studied with the use of a newly developed model. 47 clinical isolates were analyzed; of these, 91% were found to be enteroadhesive to a variable degree. As the result of in vitro studies, Campylobacter were found to have much greater tropism to colonic cells and epithelial cells of Peyer's patches in comparison with the epithelial cells of the small intestine. The correlation between the degree of adhesive activity and the severity of the course of Campylobacter infection in children.
Gastric biopsies from 90 children (from 5- to 15-year-old) with chronic gastroduodenitis were examined for Campylobacter pylori (CP) by bacteriological, histological (Giemsa stain, argentation by Warthin-Starry, acridine orange stain) and electron microscopical methods. CP is detected in 81.2% children. The degree of colonization was low or moderate. The increase of occurrence was noted with age and duration of disease. Persistence of CP went down with the increase of atrophic change in the gastric mucosa and duodenum, but there was no clear-cut correlation with the morphological variant of gastritis and the stage of disease. Colonization with CP is regarded as an important part in the pathogenesis of chronic gastroduodenitis in children.
The clinical course and epidemiological features of campylobacteriosis in Moscow and Moscow Province in 1986-1987 are described. The specific proportion of this infection in the structure of acute enteric infections is, on the average, 4.8%. The level of Campylobacter contamination of animals and birds and their role in the spread of campylobacteriosis have been established. The possible ways and factors of the transfer of this infection are discussed.