Purulent-inflammatory Diseases Research Articles

Modern View on the Problems of the Diagnosis and Treatment of Purulent-inflammatory Diseases and Sepsis in Obstetrics and Gynecological Practice

Modern View on the Problems of the Diagnosis and Treatment of Purulent-inflammatory Diseases and Sepsis in Obstetrics and Gynecological Practice

FILM-FORMING PROPERTIES OF STREPTOCOCCUS SPP. IN THE PRESENCE OF ANTISEPTICS BASED ON CATIONIC SURFACE-ACTIVE COMPOUNDS

According to the American National Institutes of Health, about 80% of bacterial infections are film-associated that impedes their treatment and prevention. Scientists emphasize that the frequent chronicity of diseases associated with film-forming pathogens, and their significant resistance to antimicrobials today poses the major health problem worldwide. The aim of this study is to determine the film-forming properties of clinical isolates of Streptococcus spp. isolated from patients having odontogenic purulent-inflammatory diseases of the soft tissues of the maxillofacial area in the presence of antiseptics decasan and chlorhexidine. Materials and methods. The clinical isolates of S. warneri (n = 3), S. sanguinis (n = 4), S. sobrinus (n = 4), S. mitis (n = 4), S. salivarius (n = 5) were the objects of the study. To identify film-forming properties of the clinical isolates, a spectrophotometric method according to G.D. Christensen was applied. The antiseptics based on cationic surfactants as Decasan 0.2 (LLC "Yuri-Pharm", Kyiv, Ukraine) and chlorhexidine bigluconate 0.05 (Chlorhexidine-KR®, PJSC "Chimpharmzavod" Red Star ", Kharkiv, Ukraine) were used. Results and discussion. The study has shown that S. sorbinus and S. sanguinis have high film-forming properties; S. mitis and S. warneri demonstrate moderate film-forming properties. The antiseptic Decasan helped to reduce the film formation by all investigated isolates of Streptococcus spp. The effect of chlorhexidine on the ability of microbial isolates to produce biofilms was slightly lower compared to Decasan; moreover, in the case of S. mitis species, chlorhexidine even enhances film-forming properties. Conclusion. Streptococci of the viridans group, which are isolated from patients having odontogenic purulent-inflammatory diseases of the soft tissues of the maxillofacial area, have different film-forming properties. Decasan is more effective against the film formation by streptococci compared to Chlorhexidine.

Modern aspects of cesarean section

The increase in the frequency of cesarean section (CS) remains one of the actual problems of modern obstetrics and causes the concern to the world community. Today, it is believed that the abdominal delivery is a safer and more non-traumatic method of delivery for the benefit of the fetus than vaginal delivery. The relative number of cases of abdominal delivery, according to the WHO, should not exceed 10 % of the total number of births, which minimizes the occurrence of complications and prevents the development of bleeding and purulent-inflammatory diseases in the postpartum period. But the latest data demonstrate that this percentage is 18.6 % worldwide, that is one in five births ends in CS. The frequency of CS has been growing rapidly in recent years in most countries of the world, and in this context Ukraine is no exception (14.2 % in 2006, to 25.08 % in 2020). This increases the risk of maternal and perinatal morbidity and mortality. In the presented material for the distance learning about the operative delivery, doctors will find up-to-date information on indications, contraindications, methods of CS, as well as recommendations on counseling of pregnant women before surgery and preventive measures to minimize complications during obstetric surgery. According to the modern approach, the indications for the CS are divided into planned and urgent ones, which are clearly defined in this article. Considerable attention is paid to counseling of the patients before this operation and the obligatory acquaintance of the pregnant woman with the method of performing CS, anesthesia and potential perioperative complications and signing her the informed consent on the possible expansion of surgery. According to the standpoint of evidence-based medicine, the most optimal method of CS is presented, which significantly reduces the likelihood of hemorrhagic, purulent-inflammatory complications during surgery and in the postoperative period. The issues related to modern methods of anesthesia of CS with the use of multimodal analgesia, early mobilization of women in labor and prevention of thromboembolic complications, rehabilitation measures are also identified.

Possibilities of clinical application of nano-crystal hydroxyapatyte in treatment of purulent-inflammatory diseases

Objective. To investigate the impact of the sorbtion-aspiration drainage system on background of hydroxyapatite and zinc oxide on experimental peritonitis.
 Materials and methods. The experiment was performed on 55 white laboratory rat males, ageing 2 - 3 mo, with the body mass 225 - 250 g, which were kept in the typical vivarium conditions. Suspension of E. coli in physiological solution, 1.0 - 1.5 ml in concentration 1010 , was used for the peritoneum contamination. The suspension was introduced into abdominal cavity in the dose, dependent on the animal body mass, using the syringe for insulin injection. Peritonitis in the rats was developed in 48 h and characterized by intoxication, which exaggerated rapidly, as well as by intestinal motor disorders and pronounced microcirculatory disturbances. The experimental animals were distributed into 5 Groups. In patients of Group I the interventions were not performed (control); in laboratory animals of Group II peritonitis was not simulated, but the abdominal cavity was drained, using the sorption-aspiration drainage system; in laboratory animals of Group III peritonitis was simulated; in the Group IV of laboratory animals on background of peritonitis the abdominal cavity was drained, using the sorption-aspiration drainage system; in the Group V animals the abdominal cavity was drained by a standard silicon drain on background of peritonitis.
 Results. Reduction of abdominal contamination by 43.12% and of histological features were produced in abdominal organs under the influence of the composite system, witnessing its bactericidal and sorption-antiinflammatory action.
 Conclusion. Experimentally there was confirmed the possibility of application of sorption-aspiration drainage system on background of hydroxyapatite and zinc oxide in treatment of an acute peritonitis.

Comprehensive non-drug programs in the treatment of acute inflammatory diseases of the maxillofacial region

The article presents the results of treatment of patients with acute inflammatory diseases of the maxillofacial region using non-drug methods of treatment. Study material: 60 patients with acute purulent-inflammatory diseases of the maxillofacial region (phlegmons and abscesses), who were divided into 2 groups: the main group — 30 patients who underwent a course of complex application of broadband electromagnetic therapy and low — frequency alternating electrostatic field and the control group — 30 patients who were treated with drug therapy (antibiotics, metronidazole group drugs, antihistamines, multivitamins, detoxification therapy, local treatment of the wound process), which served as the background in the main group. Objective: to develop and scientifically substantiate the complex application of broadband electromagnetic therapy and low-frequency alternating electrostatic field in patients with inflammatory diseases of the maxillofacial region. Results. In a comparative aspect, the dynamics of the indicators of the leukocyte intoxication index (LII) and the main indicators of the morphological picture of the blood before and after treatment in patients with HIA CHLO under the influence of the developed complex was studied. Conclusion. The developed complex, which includes a low-frequency alternating electrostatic field and broadband electromagnetic therapy, contributes to the formation of pronounced anti-inflammatory and detoxifying effects in patients with inflammatory diseases of the maxillofacial region due to a significant reduction in endogenous intoxication, which allows us to recommend it for inclusion in complex therapeutic and rehabilitation programs after surgical interventions to accelerate the time of purulent wound cleansing and reduce the length of hospital stay.

О РАЗВИТИИ АНТИБИОТИКОРЕЗИСТЕНТНОСТИ В АСПЕКТЕ ПОЛИКЛИНИЧЕСКОЙ СЛУЖБЫ

Background. Antibiotic resistance is a worldwide problem that is the main cause of the increase in the number of purulent-inflammatory diseases and postsurgical complications. Aim. The aim of the present study was to monitor antibiotic resistance of microorganisms isolated in the course of microbiological study in otorhinolaryngological and surgical patients of the outpatient department of a single preventive health institution. Material and methods. A statistical analysis of the results of microbiological studies, excretions of patients undergoing outpatient treatment in surgical and otorhinolaryngological departments of outpatient clinic No1 of the state budget institution «City Clinical Hospital No 7» of Tver is presented. We processed 280 findings of microbiological studies of ear, nose, pharynx and wound surface cultures for 2019. Results and discussion. It was found that the spectrum of dominant microorganism species in 2019 detected during swabbing of surgical and otorhinolaryngological patients treated in the outpatient clinic included gram-negative Escherichia coli and Klebsiella pneumonia and gram-positive Staphylococcus aureus and Streptococcus pyogenes microorganisms. Among the microorganisms presented, strains with multiple resistance to the action of antimicrobial drugs were identified. According to the total number of resistant microorganisms it was found that among antibacterial drugs, antibiotics of Aminopenicillin class, including those protected by protease inhibitors, as well as fluoroquinolones of the 2nd generation have the lowest clinical efficacy in the given medical institution. Conclusion. The findings of the present study indicate a rapid rate of spread of resistance genes among nosocomial strains of microorganisms, which necessitates continuous monitoring of antibiotic sensitivity by various specific laboratory methods. The results of laboratory studies should be used when prescribing antibiotic therapy for a particular patient, and the results of this study should be considered when selecting an empirical antibiotic, since they reflect the resistance of the most common pathogens. Key words: antibiotic resistance, antibiotics, cephalosporins, fluoroquinolones.

Ретроспективний аналіз етіологічної структури гнійно-запальних захворювань переднього відрізка ока

Актуальність. Запальні захворювання органа зору посідають провідне місце (34,5–40,2 %) серед захворювань очей. Мета: дослідити сучасну структуру збудників гнійно-запальних процесів переднього відрізка ока, їх чутливість до антибіотиків. Матеріали та методи. Проведено ретроспективний аналіз результатів бактеріологічних досліджень 43 хворих із гнійно-запальними процесами переднього відрізка ока та його допоміжного апарату, яких обстежували і/або лікували у Вінницькій і Житомирській обласних клінічних лікарнях протягом 2013 року. Результати. Етіологічна структура гнійно-запальних процесів ока була представлена грампозитивними (89,7 %), а саме: S.epidermidis (55,2 %), S.aureus (20,8 %), S.viridans (5,2 %), Е.faecalis (3,4 %), S.heamoliticus (1,7 %), S.pneumoniae (1,7 %), C.hofmannii (1,7 %), і грамнегативними бактеріями: Acinetobacter spp. (5,2 %), E.coli (3,4 %), E.gergoviae (1,7 %). Staphylococcus spp. були малочутливими до пеніцилінів (50,0–78,1 %), цефалоспоринів (50,0–71,9 %), макролідів (50,0–58,3 %), мали варіабельну чутливість до ципрофлоксацину (66,7–78,1%); офлоксацину (75,0–87,5 %), моксифлоксацину (75,0–84,4 %), гентаміцину (66,7–90,6 %), тобраміцину (66,7–93,8 %). Грамнегативним бактеріям була притаманна низька антибіотикочутливість. Висновки. Грампозитивні мікроорганізми є провідними збудниками гнійно-запальних процесів переднього відрізка ока (89,7 %), мають варіабельну чутливість до антибіотиків. Грамнегативні збудники стійкі до більшості досліджуваних антибіотиків.

Influence of the degree of bacteriuria on perinatal results for asymptomatic urinary tract infection

The objective: to conduct a comparative analysis of the outcomes of pregnancy, childbirth and the postpartum period in women with varying degrees of asymptomatic bacteriuria (AB) and to assess its role in the development of perinatal complications. Materials and methods. To identify the features of the course of childbirth and the postpartum period in BB, a comprehensive clinical study of 182 pregnant women was carried out, divided into 3 groups. Group I (main) included 85 pregnant women with asymptomatic bacteriuria >105 CFU/ml («severe» bacteriuria), group II included 52 pregnant women with АB 102–104 CFU/ml («moderate» bacteriuria) who did not receive treatment. Group III (control) consisted of 45 pregnant women without urinary tract infection. Statistical analysis of the research results was carried out using computer processing of the data obtained using the «Excell-5.0» and «Statistica» programs. Results. The age of the surveyed ranged from 16 to 42 years, while the average age was the same in the studied groups. In the first group it was 27.2±0.63 years, in the second group – 26.2±0.75 years, in the third (control) – 26.7±0.42 years. Premature birth was observed significantly more often in АB. Thus, pregnancy against the background of asymptomatic infection urinary tract ended in premature birth in 10.6% and 11.5% of observations in women of groups I and II, which did not exceed the general population indicator, however, in comparison with healthy patients, it increased in 4.8 and 5 times, respectively (p<0.05). Conclusion.The results of our study showed that АB affects the development of preterm labor, premature rupture of membranes, increases the frequency of pathological births, caesarean sections and pyoinflammatory diseases in the postpartum period. In pregnant women with asymptomatic infection urinary tract, regardless of the severity of bacteriuria, it is advisable to use antibiotic therapy to reduce intranatal and postnatal complications, reduce the severity and duration of recurrent infection urinary tract and reduce purulent-inflammatory diseases of puerperium.

From theory to practice: immunotherapy of purulent-inflammatory diseases and purulent-septic complications

Lack of anti-infective protection is one of the reasons for the occurrence of purulent-inflammatory diseases of the skin, soft tissues and purulent-septic complications in the postoperative period. Immunocorrective therapy is extremely relevant in surgical practice, and it can be used both for the prevention and treatment of postoperative complications. In this regard, special attention should be paid to low molecular weight fragments of peptidoglycan of cellular bacteria muramyl peptides.
 The study included 65 patients with purulent inflammatory diseases, of which 35 men aged 2355 years with chronic recurrent pyoderma (ostiofolliculitis, folliculitis, sycosis, furunculosis), and 30 patients aged 18 to 65 years with purulent inflammatory diseases of soft tissues, mainly abscesses and phlegmons of various localization without pronounced concomitant pathology. The examination included 26 patients with purulent-septic complications in the postoperative period. The patients included in the study were divided into 2 equal groups: 1 is the main group, in which patients received intramuscularly Polimuramil 200 mg daily for 5 days in addition to treatment; Comparison group 2, in which patients received only standard treatment. The clinical symptoms of pyoderma were assessed from day 0 to day 7, then on day 14, after 1 and 6 months of the study. Blood samples were taken from all patients for hematological and immunological studies. The timing of the appearance of granulations was monitored daily.
 The inclusion of Polimuramil in the complex treatment of pyoderma accelerated the regression of the main clinical manifestations of the disease and promoted the induction of stable remission. In patients with soft tissue infections, Polimuramil increased the degree of regression of the depth and area of the wound and accelerated the appearance of granulations. The clinical efficacy of Polimuramil in patients with purulent-septic complications in the postoperative period correlated with a decrease in CRP and procalcitonin levels. The study confirms the effectiveness of Polimuramil in the treatment of purulent-inflammatory diseases and purulent-septic complications in the postoperative period and its high immunomodulatory potential (8 figs, 2 tables, bibliography: 5 refs).

Development of a Method of Analysis of Ofloxacin in the Complex Preparation "Ofloxazol"

Introduction. The creation of new effective antibacterial drugs for the treatment and prevention of purulent-inflammatory diseases is an urgent task of modern pharmacy. Active use in the treatment of purulent infection is found by chemotherapeutic agents from the class of fluoroquinolones, which include ofloxacin.Aim. Development of a method for the quantitative determination of ofloxacin in the complex preparation "Ofloxazol".Materials and methods. For the analysis, the substance ofloxacin, titanium-containing gel "Tizol", solutions of ofloxacin on 95 % ethanol, hydrochloric acid 0.01 mol/l, ointment under the conditional name "Ofloxazol" containing 0.5 % of the drug in the gel "Tizol" were used. The study was carried out by near-UV spectrophotometry.Results and discussion. When studying the absorption spectra, it was found that for the quantitative spectrophotometric analysis of ofloxacin, it is rational to use the wavelength range of 275-320 nm (λmax = 294 nm). Statistical processing of the analysis results showed that the relative error of quantitative determination does not exceed ±1.66 %. The sensitivity of the determination of ofloxacin is 0.245 mcg/ml at A(min) = 0.02. The developed method is validated. Its specificity, linearity, correctness and precision are confirmed. According to the calibration schedule, the content of ofloxacin in the soft dosage form is determined, it is in the range of 0.0483-0.0562 g, which corresponds to the permissible deviations.Conclusion. The conducted studies allowed us to develop and propose a method for the quantitative determination of ofloxacin in the ointment "Ofloxazol", obtained on a titanium-containing basis. The method allows you to evaluate the quality of manufacturing the dosage form, including setting the content of the drug with an error that does not exceed the standard deviations.

The state of humoral antibacterial immunity in purulent-inflammatory diseases of the abdominal cavity

We have studied the level of antibacterial antibodies to E coli. Rg. mirabilis, Ps. aeruginosa, Bact. fragilis, St. aureus, as well as to the endotoxin of grammatical bacteria (glycolipid - HLP) by enzyme immunoassay in plasma in patients with varying degrees of prevalence of the pyoinflammatory process in the abdominal cavity.

ЭТИОПАТОГЕНЕТИЧЕСКИЕ АСПЕКТЫ ОСТРОЙ ОДОНТОГЕННОЙ ИНФЕКЦИИ

Subject. A review of the literature on the topical problem of dentistry — the etiology and pathogenesis of acute odontogenic purulent-inflammatory diseases is presented. The purpose of the research is to study the materials of publications. dedicated to the etiopathogenetic aspects of acute odontogenic infection. Methodology. The etiology and pathogenesis of acute odontogenic purulent-inflammatory diseases are described in detail, in the light of modern concepts. Results. The unfavorable factors influencing the increase in the frequency of acute odontogenic purulent-inflammatory diseases and the worsening of the clinical course are presented. It is noted that these diseases are explained by the effect of microbial associations, one of the frequent representatives of which are anaerobic bacteria, which significantly worsen the clinical picture of the disease. All theories of the pathogenesis of jaw osteomyelitis (vascular, allergic and neuro-trophic) are considered. At the same time, it was noted that the vascular, allergic and neuro-reflex components in the emergence and development of osteomyelitis of the jaws are realized against the background of a decrease in the level of general immunological and specific reactivity of the whole organism, as well as the failure of local immunity. Particular importance is attached to disorders of the systems of neuroregulation and microcirculation. It is noted that sensitization and neuroreflex effects on the inflammation focus are factors contributing to the transition of the reversible phase of inflammation (osteitis) to the irreversible one (osteomyelitis), and microcirculation disorders in the inflammation focus are characterized as the main stage in the chain of pathophysiological processes leading to irreversible changes. Attention is drawn to the fact that in recent years, great importance in maintaining homeostasis in acute odontogenic pyoinflammatory diseases has been given to the antioxidant system, which is directly involved in the regulation of the molecular mechanisms of nonspecific resistance of the organism to the damaging action of various pathogenic factors. Findings. The results of the review indicate that knowledge of the peculiarities of the etiology and pathogenesis of acute odontogenic pyoinflammatory diseases is necessary for correct diagnosis, timely and adequate treatment, prognosis and prevention of complications. However, it should be recognized that this problem continues to remain relevant to this day due to the complexity of its study.

РОЛЬ ИММОБИЛИЗОВАННЫХ МЕТАЛЛООРГАНИЧЕСКИХ СОЕДИНЕНИЙ В КОМПЛЕКСНОМ ЛЕЧЕНИИ ГНОЙНО-ВОСПАЛИТЕЛЬНЫХ ПРОЦЕССОВ КОЖИ И МЯГКИХ ТКАНЕЙ

Objective. To study the current Russian and foreign literature dedicated to the problem of application of organometallic compounds immobilized on drugdelivery in the treatment of purulent-inflammatory disease of the skin and soft tissues. Methods. The modern Russian and foreign literature, available in the Pubmed, Medline, Springer, Scopus, e-LIBRARY databases were reviewed according to the problems of purulent-inflammatory diseases, skin and soft tissue infections, the integrated approach to the treatment of purulent-inflammatory diseases, synthesis, immobilized organometallic compounds. Results. The observational study of the specificrecent achievements in the modification of antimicrobial biomaterials is presented. Metal ions havea broad range of antimicrobial activity (especially on proliferation and remodeling), possess by bacteriostatic and bactericidal effect, demonstrate multiple inhibitory effects against bacterial strains and havebeen proveneffectivein improvingwoundhealing in all its phases. Natural products and especially biologically active metals such as silver, copper, zinc and germanium, are believed to be an alternative for the development of perspective biomaterials with antimicrobial properties. In recent years, new approach for the production and application of therapeutic and diagnostic drugs based on the immobilization or grafting of drugsubstances on polymer carriers has been developed. At present, namely the immobilized compounds that have opened the way to the creation of prolonged-action drugs with low toxicity and allergenicity. Conclusion. Template synthesis of new organometallic drug compounds is considered to be a promising direction in the wound infection treatment, which requires further experimental and clinical study.

Scar tissue development using an acoustic medical diagnostic device in patients with purulent inflammatory wounds of the face and neck

The paper presents evidence of the effectiveness and safety of using the acoustic method for predicting scar formation in patients with purulent inflammatory diseases of the face and neck. An acoustic medical diagnostic device was used to develop a prognostic criterion for assessing scar formation in these patients, and factors influencing the scarring process have been determined. Results of this study demonstrated that it is possible to determine the type of scarring at the early stage of wound healing in patients with purulent inflammatory diseases in the face and neck area using an acoustic medical diagnostic device that allows the assessment of the scarring type, prescribing adequate treatment, and taking preventive measures against pathological scarring of tissues.

Adequate mucociliary clearance as a factor in the prevention and control of purulent-inflammatory pathology of the ENT organs

Purulent-inflammatory diseases of the upper respiratory tract and ENT organs are an urgent problem of modern clinical medicine. The high prevalence of this pathology is due to the active effect of pathogenic microflora on the mucous membrane of the respiratory tract, the increasing role of opportunistic and atypical microorganisms in the genesis of infection of the upper respiratory tract, as well as disorders in the mucociliary clearance. Limitations in the mobility of cilia of ciliated cells, as well as their partial or complete absence, a change in the composition of mucous secretions and a slowdown in the speed of mucus movement are the mechanisms that determine the possibility of an acute inflammation focus on the mucous membrane of the upper respiratory tract, and also increase the risk of developing chronic inflammatory diseases of the ENT organs. The accumulated data on the peculiarities of the existence of microbial biocenoses in the human body, as well as the steady widespread growth of the problem of antibiotic resistance, dictate the need to search for new solutions in the treatment of purulent-inflammatory pathology of the ENT organs. A well-established principle of therapy for such conditions is the topical use of combined drugs that combine mucolytic and antibacterial components that actively affect the main links in the pathogenesis of acute and chronic inflammation of the upper respiratory tract. These tasks are most effectively solved by the drug, which contains the mucolytic N-acetylcysteine, which potentiates the effect of another component – the antibiotic thiamphenicol. An important aspect in favor of choosing this drug as a monotherapy or combination therapy for purulent-inflammatory diseases of the upper respiratory tract is a convenient form of release for aerosol administration.

The basic principle of pathogenetic therapy of purulent-inflammatory pathology of ENT organs

The nature of the clinical manifestations of purulent-inflammatory diseases of the ENT organs is determined, first of all, by the localization of the process, and in addition, by the severity of the reactions of general and local inflammation. In this regard, the authors of the article propose to consider the main factors of pathogenesis that determine the sequence and relationship of the stages of the inflammatory response: edema, redness, fever, pain and dysfunction. A special role in the implementation of the regulatory mechanisms of inflammation belongs to active molecules, the so-called inflammatory mediators. The authors of the article consider the main cellular and plasma mediators, concluding that most of the effects they carry out are accompanied by a violation of the integrity of the vascular wall, exudation, edema and tissue swelling. A similar reaction is, in general, nonspecific and is observed in a number of inflammatory diseases of the ENT organs, such as acute rhinitis, allergic rhinitis, acute sinusitis, eustachitis, acute otitis media. This circumstance allows the authors to conclude that a local therapeutic effect is necessary on this particular link of pathogenesis. To this end, the authors of the article propose the use of nasal decongestants, drugs with an alpha-adrenomimetic effect, which effectively relieve swelling of the nasal mucosa and facilitate nasal breathing. In clinical practice, preparations based on xylometazoline have proven themselves well.

Local immunity and microflora of the reproductive tract of gynecological patients before and after immunomodulatory therapy.

Immunomodulatory drugs are widely used as drugs for the treatment of inflammatory diseases of microbial etiology in clinical medicine. The authors evaluated the effectiveness of the therapeutic effect of the Cycloferon immunomodulator in the treatment of chronic purulent-inflammatory diseases of the reproductive tract using clinical, microbiological and immunological parameters. It was shown that under the influence of immunomodulatory therapy, the restoration of the qualitative and quantitative composition of the normoflora was observed with the elimination of etiologically significant microorganisms. The immunocorrective effect of therapy on the indices of local immunity was established: the concentration of lactoferrin increased in the cervical secretion, the level of cytokines IL-1β and γ-IFN normalized, the amount of secretory IgA increased significantly, which contributed to the enhancement of local protective reactions, as well as the clinical efficacy of therapy, which was manifested in the reduction and/or disappearance of pain syndrome and the absence of relapse for 2 or more years. Conducted researches allow us to speak of immunotropic drugs as a promising direction in the treatment of inflammatory processes of the reproductive tract, a significant advantage of which is rational immunomodulation directly in the focus of inflammation, the availability of treatment, the absence of side effects with adequate therapeutic regimens, which makes it relevant to further study this direction of immunocorrection and its implementation into wide clinical practice.

SPECTRUM OF PATHOGENS CAUSING PURULENT INFLAMMATORY DISEASES IN SURGICAL PATIENTS

This article for the first time describes the frequency rate of detecting various surgical infections depending on the number of pathogens and the spectrum of the microorganisms found in surgical patients of the Poltava Regional Clinic Hospital, Ukraine. The objectives include the identification of the etiological spectrum of pathogens causing purulent inflammatory diseases in inpatients of the surgical unit. Materials and methods. On the basis of the bacteriological laboratory, we studied 121 biological samples taken from the patients of the surgical unit. Microflora isolation was performed on nutrient media by bacteriological method. Microorganisms isolated from various biosubstrates were identified using API biochemical test systems (BioMerieux, France). Based on the findings obtained, the occurrence rate of certain pathogens and their associations was calculated (%). Results and discussion. The study demonstrated the prevalence of mono-infections, which make up 67%, caused by Staphylococci, mainly S. Aureus in the surgical patients. In general, gram-negative bacteria are prevalent, among which Klebsiella and Acinetobacter are found out as the most prevalent pathogens; among Gram-positive microorganisms, Enterococci were identified more often in association with other bacteria. Conclusions. The study has shown among the causative agent resulting in diseases requiring surgical treatment, gram-negative bacteria predominate, among which Klebsiella and Acinetobacter are the most often detected. Among gram-positive cocci, Enterococci are typically detected in the association with other bacteria; most often, this pathogen is isolated in monoculture, mainly represented by staphylococci.

Efficacy comparative characteristics of antiseptic DECASAN Yuria-Pharm and CUTASEPT G in the treatment of purulent inflammatory diseases of various localization

Background: High mortality because of various infectious complications (immediate cause in 42.5 % of cases), the ever-increasing frequency of purulent inflammatory diseases, as well as the growth of microbial resistance to anti-bacterial drugs, force to seek a solution to the problem among local antiseptics. Aim: to compare the effectiveness of antiseptics DECASAN Yuria-Pharm and CUTASEPT G in the treatment of puru-lent inflammatory diseases of different localization.Materials and methods: The study involved 30 patients with purulent inflammatory diseases of various localiza-tions. Patients were divided into two groups, according to the chosen tactics of local antiseptic therapy, in patients of the first study group (n = 15; mean age – 49.73 ± 6.35 years) antiseptic treatment was performed with a drug based on 0.02 % decamethoxine (Decasan). In the second group (n = 15; mean age – 51.4 ± 5.14 years) treatment was performed with a disinfectant (skin antiseptic) “Cutasept G”. Collection of material for microbiological examination (bacteriological culture) was performed before treatment, 3 and 5 days after treatment. Probability analysis was performed according to Student’s t-test. A statistically significant difference between the indicators was considered when the probability of validity of the null hypothesis was less than 5 % (p <0.05).Results: Analyzing the results of bacteriological examination of both groups, in the first, where Decasan was used and in the second, with the use of Cutasept G, it was found that at the beginning of treatment there was a pronounced microbial colonization of wounds, not significantly different among patients in both groups (p <0.05). Microbio-logical observation of the course of purulent-inflammatory process in the dynamics showed a significantly slowed down process of microbial purification in the second group (Cutasept G), the condition for 5 days was lg (8.8 ± 0.4) CFU/ml. At that time for patients of the first comparison group the number of microorganisms in 1 ml of wound contents, expressed in lg, was (4.8 ± 0.4) CFU/ml, which does not exceed the critical level. The obtained values were significantly higher than with Cutasept G (p <0.05), which was twice higher than the level of microbial colonization compared to the treatment of wounds with 0.02 % decamethoxine solution (p <0.001).Conclusions: The use of antiseptic 0.02 % decamethoxine for 5 days provides a reduction in the number of oppor-tunistic pathogens lg (4.8 ± 0.4) CFU/ml, which is 1.9 times lower (p <0.05) compared with the use of Cutasept G, creating conditions for the settlement of normal microbiotic skin (Corynebacterium spp., S. epidermidis). Antiseptic Dekasan is characterized by good healing properties due to its high antimicrobial activity, isotonicity, which makes it possible to use it successfully in patients with purulent inflammatory diseases of various localizations. In addition, the use of Dekasan promotes rapid cleansing of wounds from purulent-necrotic contents and formation of granula-tion tissue in them.

In vitro phenotypic re-orientation of functionally important neutrophil subpopulations and their microbicidal activity in the children with purulent inflammatory diseases influenced by glucosaminil muramildipeptide

Numerous studies over last decade have shown that functional capacity of neutrophil granulocytes (NG) determines the course and outcome of many diseases. Identification of phenotypic variants of functionally significant NG subpopulations is a new approach allows us to assess the adequacy or deficiency of NG involvement into infectious inflammation processes at molecular level. An opportunity of reorienting a deficient NG subpopulational phenotype in purulent inflammatory diseases due to the rearrangement of the receptor set induced by various immunotropic substances may serve as a key to recovery of normal NG functioning. Our aim was to study the effect of glucosaminylmuramyldipeptide (GMDP) under in vitro conditions upon the phenotypic profile of four functionally significant subpopulations, i.e., CD62L + CD63 - NG, CD62L + CD63 + NG and CD64 - CD32 + CD16 + CD11b + NG, CD64 + CD32 + CD16 + CD11b + NG, along with assessment of expression density of appropriate membrane molecules and NG microbicidal activity in the children with purulent inflammatory diseases. 90 samples of peripheral blood (PC) were taken from children 2 to 4 years old, including 12 children with minor purulent infection (MPI), and 7 children were studied as conditionally healthy controls. Their peripheral blood was incubated for 60 minutes at 37 °C with GMP (10 -6 g/l). Using flow cytometry technique, the relative numbers of some NG subpopulations, i.e., CD64 - CD16 + CD32 + CD11b + NG, CD64 + CD16 + CD32 + CD11b + NG, CD62L + CD63 - NG, CD62L + CD63 + NG were evaluated, and the phenotype features of each subpopulation were investigated according to the density of appropriate membrane molecule expression (MFI). In parallel, phagocytic and microbicidal activity of NG was tested in these study groups. The obtained data indicate for presence of for distinct NG subpopulations, both in healthy children and in children with MPI. We have revealed phenotypic transformation of the four studied NG subpopulations from MPI patients including disturbed phagocytic and microbicidal functions of the cells. Using of this in vitro system, we have shown that the transformed phenotype of the four functionally significant NG subpopulations of MPI patients was re-arranged under GMDP treatment. At the same time, the number of CD62L + CD63 + NG and CD64 - CD32 + CD16 + CD11b + NG subpopulations was increased, along with decreased amounts of CD64 + CD32 + CD16 + CD11b + NG and CD62L + CD63 - NG subpopulations, being accompanied by restoration of microbicidal activity of NGs. The obtained data allow us to accomplish current understanding of immunotropic effects of GMDP, and to extend the potential scope of its experimental and clinical application. The new data on GMDP effects revealed by in vitro system, i.e. phenotype rearrangement of functionally significant NG subpopulations CD64 - CD16 + CD32 + CD11b + , CD64 + CD16 + CD32 + CD11b + , CD62L + CD63 - , CD62L + CD63 + in atypical purulent inflammatory diseases in children, may be used in the future in order to develop innovative strategies of immunotherapy aiming for correction of NG dysfunction in children with MPI.