[Opportunistic bacteria--a cause of hospital infections].
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Biomedical subjects
Publications and source records attributed to S D Voropaeva.
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The clinical trials of cefuroxim in the treatment of patients with various postnatal diseases and postoperative complications caused by Staph. aureus, E. coli, Klebsiella or Proteus showed its high efficacy. No adverse reactions of the drug were observed in any of 24 patients. The drug was rapidly absorbed on its intramuscular administration. Its therapeutic concentrations in the blood, milk and urine persisted for 8 hours after a single administration. Cefuroxim may be recommended for the treatment of patients with moderately severe infections. The single dose is 750 mg administered every 8 hours. However, in patients with severe postoperative complications cefuroxim should be used in combination with antibiotics preventing directed selection of the microorganisms resistant to cefuroxim (nonsporulating anaerobic bacteria, Ps. aeruginosa).
The time course of gentamicin transplacental penetration was studied in women during labor. It was found that the transplacental penetration of the antibiotic was high and its levels in the fetus blood were only slightly lower than those in the mother blood. The concentration of the antibiotic in the placenta and amniotic fluid was also rather high. The experiments with rats showed that the levels of gentamicin penetration into the fetus depended on the pregnancy period: at earlier periods (13 days) the level of gentamicin transplacental penetration was 5.8 times higher than that at later periods (21 days). In high doses gentamicin produced an embryotoxic effect, therefore in treatment of pregnant women with gentamicin its therapeutic doses should not be exceeded.
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The activity of propolis and its combinations with antibiotics against antibiotic resistant strains of Staphylococcus aureus was studied. It was found that staphylococcae strains resistant to benzylpenicillin, tetracycline and erythromycin were mainly sensitive to propolis. It is concluded that there was synergism in the effect of propolis and antibiotics with respect to antibiotic resistant strains of Staphylococcus aureus.
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Relationship between the etiological structure of hospital infections and antibacterial therapy was analysed. It was found that the wide use of antibiotics in medical practice changed the etiology of hospital infections in direction of predominance of gramnegative conditionally pathogenic bacteria, which are characterised by high resistance to antibiotics. Data on changing of staphylococcal sensitivity to antibiotics during the recent years are presented. The causes of this process are analysed.
Some properties of hospital staphylococcal strains isolated from the patients with purulent postnatal mastitis were studied. It was found that all the strains of the phage type 80.81 widely distributed in the obstetric hospitals were polylysogenic and polyresistant to antibiotics. The resistance markers in most of the isolates were located on the plasmids. Elimination of the plasmids carrying the antibiotics resistance markers resulted in a simultaneous change in the strain lysogenic spectrum while the phage type and fermentative properties, such as production of plasmocoagulase, DNAase and lecithinase did not change. The capacity for hemotoxin production was lost simultaneously with antibiotic resistance in 1 out of 17 cultures tested.
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The experiments on gravid rats showed that generalized staphylococcal infection in the female rats resulted in intrauterine infecting of the fetus and had a negative effect on its antenatal development: increased embryonal death rate, decreased weight gain, etc. In case of staphylococcal septicemia the amniotic waters were a peculiar reservoir of the causative agent where it accumulated in larger amounts than in the fetus tissues. Efficiency of oxacillin in daily doses of 144 and 72 mg was shown in treatment of the rat intrauterine infection. High sensitivity of the infected embryons to higher doses of the drug was found.
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A total of 80 patients with postnatal purulent mastitis were treated with gentamicins. The main causative agent was Staph. aureus resistant to the traditionally used antibiotic and sensitive to gentamicin, fusidin, rifampicin and semisynthetic penicillinase-stable penicillins. Gramnegative bacteria contaminated the purulent foci after opening. Gentamicin was highly effective in treatment of postnatal purulent mastitis in cases with mixed Staphylococcus-Proteus infection.