ACINETOBACTER: МИКРОБИОЛОГИЧЕСКИЕ, ПАТОГЕНЕТИЧЕСКИЕ И РЕЗИСТЕНТНЫЕ СВОЙСТВА

Species of the genus Acinetobacter represent opportunistic bacteria with a growing clinical significance. In this literature review, we focus on the current role of Acinetobacter in infectious pathology and describe physiology, taxonomy, ecology, pathogenicity, and antibiotic resistance of these bacteria. Molecular pathogenesis and regulation of virulence factors in Acinetobacter spp. are described in detail. The majority of acinetobacterial infections are associated with A. baumannii and occur predominantly in an immunocompromised host. Usually, acinetobacterial infections are characterized by local purulent inflammation; in severe cases, meningitis and sepsis may develop. Antibiotic resistance of Acinetobacter is a major clinical problem; therefore we give special attention to laboratory testing of resistance as well as identification of Acinetobacter. In addition, treatment and prophylaxis of acinetobacterial infections are discussed.Представители рода Acinetobacter вошли в число наиболее актуальных возбудителей в клинике оппортунистических инфекций. Статья содержит анализ литературных данных, посвященных медицинскому значению ацинетобактерий. Изложена история их изучения и описаны современные взгляды на таксономию. Обобщены сведения об экологических и эпидемиологических характеристиках Acinetobacter. Подробно проанализированы молекулярные основы патогенности и механизмы регуляции вирулентности ацинетобактерий. При описании развития различных вариантов патологии, связанной с ацинетобактериями, подчеркивается, что Acinetobacter является условным патогеном, вызывающим инфекционный процесс только у иммунокомпрометированных пациентов. Наиболее часто развитие ацинетобактериальных инфекций человека связано с видом Acinetobacter baumannii. Как правило, ацинетобактериальные инфекции протекают по типу гнойно-воспалительного процесса, тяжелые клинические случаи связаны с менингитами и сепсисом. В обзоре рассматриваются вопросы (в т.ч. спорные), касающиеся антибиотикорезистентности Acinetobacter. Особое внимание уделено способам клинико-лабораторной диагностики и тестирования выделенных штаммов на чувствительность к антибиотикам. Описаны лечебно-профилактические подходы к борьбе с ацинетобактериальной инфекцией

Распространенность металло-β-лактамаз и эффлюкс-механизмов у карбапенемрезистентных госпитальных штаммов Pseudomonas aeruginosa, выделенных в г. Москве в 2012–2015 гг.

Background. Pseudomonas aeruginosa, the major nosocomial opportunistic pathogen, is an important cause of infectious morbidity and mortality among immunocompromised patients.Objective. To establish the role of metallo-β-lactamases (MBL) and efflux-mediated mechanisms in conferring carbapenem resistance in nosocomial isolates of P. aeruginosa.Methods. We analyzed carbapenem nonsusceptible nosocomial P. aeruginosa isolates obtained from pediatric and adult patients at three hospitals in Moscow in 2012–2015. Carbapenem susceptibility was assessed using the E-test. In addition, minimal inhibitory concentrations (MICs) of meropenem were tested by the broth microdilution method. The presence of MBL was determined using the EDTA-mediated suppression test. Efflux-dependent resistance was measured using an assay based on MIC modification by an ionophore carbonyl cyanide 3-chlorophenyl hydrazine (CCCP).Results. A total of 54 carbapenem nonsusceptible P. aeruginosa isolates was examined. The presence of an MBL was detected in 37 (69%) isolates, 29 (54%) isolates had efflux-mediated resistance. In 10 (19%) isolates neither MBL nor efflux activity was found. Five out of 6 isolates (83%) with highly active efflux were MBL-positive. Among isolates with low efflux activity, 74% (17/23) possessed MBL, whereas in isolates with no efflux the rate of MBL-positivity was 60% (15/25).Conclusion. The prevalence of MBL- and efflux-mediated carbapenem resistance in nosocomial P. aeruginosa is high. Moreover, our results reveal that several resistance mechanisms may combine at the isolate level. These data may contribute to the development of novel strategies in combating carbapenem resistance.Обоснование. Синегнойная палочка — Pseudomonas aeruginosa — входит в число наиболее актуальных возбудителей оппортунистических инфекций, являясь одной из главных причин госпитальной заболеваемости.Цель: проанализировать роль металло-β-лактамаз (МБЛ) и эффлюкс-механизмов в формировании карбапенемрезистентности у госпитальных штаммов P. aeruginosa.Методы. В качестве объектов исследования были использованы 54 изолята P. aeruginosa от детей и взрослых пациентов из трех госпиталей города Москвы, полученных в течение 2012–2015 гг. Для всех штаммов были определены минимальные подавляющие концентрации (МПК) меропенема. Все отобранные штаммы были протестированы на наличие МБЛ путем подавления их активности этилендиаминтетрауксусной кислотой. Оценка активности эффлюкс-систем производилась на основе определения степени подавления МПК под влиянием ингибитора эффлюкса карбонил-цианид-3-хлорфенилгидразона.Результаты. Было выявлено 69% (37/54) МБЛ-продуцирующих штаммов [МБЛ(+)], значимость эффлюкс-механизмов в формировании карбапенемрезистентности подтверждена у 54% (29/54) штаммов. В 19% (10/54) карбапенемрезистентных изолятов P. aeruginosa не обнаружено ни МБЛ, ни активности эффлюкс-систем. Распространенность МБЛ положительно коррелировала (rS =0,068) с активностью эффлюкса: среди бактерий с отсутствием эффлюкс-активности было 60% МБЛ(+)-штаммов, среди изолятов с умеренным эффлюксом — 74%, а в популяции с гиперэкспрессией эффлюкса 83% штаммов обладали МБЛ.Заключение. Полученные результаты иллюстрируют широкую распространенность важнейших механизмов карбапенемрезистентности — МБЛ- и эффлюкс-активности — и доказывают существование сложных сочетаний различных форм устойчивости у одного и того же штамма. Полученная информация может быть полезной для создания лечебно-профилактических методов борьбы с карбапенемрезистентностью

Observation Of A High-energy Cosmic-ray Family Caused By A Centauro-type Nuclear Interaction In The Joint Emulsion Chamber Experiment At The Pamirs

An exotic cosmic-ray family event is observed in the large emulsion chamber exposed by the joint at the Pamirs (4360 m above sea level). The family is composed of 120γ-ray-induced showers and 37 hadron-induced showers with individual visible energy exceeding 1 TeV. The decisive feature of the event is the hadron dominance: ΣEγ, ΣE(γ) h, 〈Eγ, 〈E(γ) h〉, 〈Eγ·Rγ〉 and 〈E(γ)·Rh〉 being 298 TeV, 476 TeV, 2.5 TeV, 12.9 TeV, 28.6 GeV m and 173 GeV m, respectively. Most probably the event is due to a Centauro interaction, which occured in the atmosphere at ∼700 m above the chamber. The event will constitute the second beautiful candidate for a Centauro observed at the Pamirs. © 1987.1901-2226233Bayburina, (1981) Nucl. Phys. B, 191, p. 1Lattes, Fujimoto, Hasegawa, Hadronic interactions of high energy cosmic-ray observed by emulsion chambers (1980) Physics Reports, 65, p. 151(1984) Trudy FIAN, 154, p. 1Borisov, (1984) Proc. Intern. Symp. on Cosmic rays and particle physics, p. 3. , TokyoRen, (1985) 19th Intern. Cosmic ray Conf., 6, p. 317. , La JollaYamashita, (1985) 19th Intern. Cosmic ray Conf., 6, p. 364. , La JollaTamada, (1977) Nuovo Cimento, 41 B, p. 245T. Shibata et al., to be publishedHillas, (1979) 16th Intern. Cosmic ray Conf., 6, p. 13. , KyotoBattiston, Measurement of the proton-antiproton elastic and total cross section at a centre-of-mass energy of 540 GeV (1982) Physics Letters B, 117, p. 126UA5 Collab., G.J. Alner et al., preprint CERN-EP/85-62Taylor, (1976) Phys. Rev. D, 14, p. 1217Burnett, (1984) Proc. Intern. Symp. on Cosmic rays and particle physics, p. 468. , Toky

Nuclear Interactions Of Super High Energy Cosmic-rays Observed In Mountain Emulsion Chambers

Here we present a summary of joint discussions on the results of three mountain experiments with large-scale emulsion chambers, at Pamir, Mt. Fuji and Chacaltaya. Observations cover gamma quanta, hadrons and their clusters (called "families"). The following topics are covered, concerning the characteristics of nuclear interactions the energy region 1014-1016 eV: (i) rapid dissipation seen in atmospheric diffusion of high-energy cosmic-rays; (ii) multiplicity and Pt increase in produced pi-mesons in the fragmentation region; (iii) existence of large-Pt jets, (iv) extremely hadron-rich family of the Centauro type; (v) exotic phenomena in the extremely high energy region beyond 1016 eV. © 1981.1911125(1977) Acta Univ. Lodz ser. II, (60)(1973) 13th Int. Cosmic-ray Conf., 3, p. 2228(1975) 14th Int. Cosmic-Ray Conf., 7, p. 2365(1979) AIP Conf. Proc. no. 49, p. 334(1979) 16th Int. Cosmic-ray Conf., 6, p. 344(1979) 16th Int. Cosmic-ray Conf., 7, p. 6816th Int. Cosmic-ray Conf. (1979) 16th Int. Cosmic-ray Conf., 7, p. 284(1979) 16th Int. Cosmic-ray Conf., 7, p. 294(1979) 16th Int. Cosmic-ray Conf., 13, p. 87(1979) 16th Int. Cosmic-ray Conf., 13, p. 92(1979) 16th Int. Cosmic-ray Conf., 13, p. 98(1979) AIP Conf. Proc. no. 49, p. 94(1979) AIP Conf. Proc. no. 49, p. 145(1979) AIP Conf. Proc. no. 49, p. 317(1979) 16th Int. Cosmic-ray Conf., 6, p. 350(1979) 16th Int. Cosmic-ray Conf., 6, p. 356(1979) 16th Int. Cosmic-ray Conf., 6, p. 362Nikolsky, Proc. 9th Int. High-energy Symp. (1978) CSSR, 21. , ToborMiyake, (1978) Proc. 19th Int. Conf. on High-energy physics, p. 433Vernov, (1977) Physica, 3, p. 1601Khristiansen, (1978) JETP Lett., 28, p. 124(1973) 13th Int. Cosmic-ray Conf., 3, p. 2219Izv. Acad. Nauk USSR, ser Phys. (1974) Izv. Acad. Nauk USSR, ser Phys., 38, p. 918(1975) 14th Int. Cosmic-ray Conf., 7, p. 2365(1979) 16th Int. Cosmic-ray Conf., 7, p. 68Dunaevsky, Urysson, Emelyanov, Shorin, Tashimov, (1975) FIAN preprint no. 150Dunaevsky, Urysson, Emelyanov, Shorin, Tashinov, (1979) Acta Univ. Lodz ser. II, (60), p. 199Ivanenko, Kanevskya, Roganova, (1978) JETP Lett., 40, p. 704Ivanenko, Kanevsky, Roganova, (1979) 16th Int. Cosmic-ray Conf., 7, p. 101Ivanenko, Kanevsky, Roganova, (1979) 16th Int. Cosmic-ray Conf., 7, p. 198Wrotniak, (1977) Acta Univ. Lodz ser. II, (60), p. 165Krys, Tomaszevski, Wrotniak, (1979) 16th Int. Cosmic-ray Conf., 7, p. 182Krys, Tomaszevski, Wrotniak, (1979) 16th Int. Cosmic-ray Conf., 7, p. 186Fomin, Kempa, Khristiansen, Levina, Piotrowska, Wdowczyk, (1977) 15th Int. Cosmic-ray Conf., 7, p. 248Fomin, Kempa, Khristiansen, Levina, Piotrowska, Wdowczyk, (1979) 16th Int. Cosmic-ray Conf., 13, p. 82Azimov, Mullazhanov, Yuldashbayev, (1979) 16th Int. Cosmic-ray Conf., 7, p. 262Azimov, Mullazhanov, Yuldashbayev, (1977) Acta Univ. Lodz ser. II, (60), p. 275Kasahara, Torri, Yuda, (1979) 16th Int. Cosmic-ray Conf., 13, p. 70Kasahara, Torii, Yuda, (1979) 16th Int. Cosmic-ray Conf., 13, p. 79Shibata, (1979) 16th Int. Cosmic-ray Conf., 7, p. 176H. Semba, T. Shibata and T. Tabuki, Suppl. Prog. Theor. Phys., to be publishedZhdanov, Roinishvilli, Smorodin, Tomaszevski, (1975) FIAN preprint no. 163Lattes, Fujimoto, Hasegawa, Hadronic interactions of high energy cosmic-ray observed by emulsion chambers (1980) Physics Reports, 65, p. 152Ellsworth, Gaisser, Yodh, (1981) Phys. Rev., 23 D, p. 764Baradzei, Smorodin, (1974) FIAN preprint nos. 103, 104Baradzei, Smorodin, (1977) Acta Univ. Lodz ser. II, (60), p. 51Zhdanov, (1980) FIAN preprint no. 140H. Semba, T. Shibata and T. Tabuki, Suppl. Prog. Theor. Phys., to be publishedShibata, (1980) Phys. Rev., 22 D, p. 100Slavatinsky, (1980) Proc. 7th European Symp. on Cosmic rays, , Leningrad, to be published(1979) AIP Conference Proc. no. 49, p. 145Azimov, Abduzhamilov, Chudakov, (1963) JETP (Sov. Phys.), 45, p. 40713th Int. Cosmic-ray Conf. (1973) 13th Int. Cosmic-ray Conf., 5, p. 326Acharya, Rao, Sivaprasad, Rao, (1979) 16th Int. Cosmic-ray Conf., 6, p. 289Ellsworth, Goodman, Yodh, Gaisser, Stanev, (1981) Phys. Rev., 23 D, p. 771Bariburina, Guseva, Denisova, (1980) Acta Univ. Lodz, 1, p. 9415th Int. Cosmic-ray Conf. (1977) 15th Int. Cosmic-ray Conf., 7, p. 184(1979) AIP Conf. Proc. no. 49, p. 33

QUALITY OF LIFE IN CHILDREN WITH CHRONIC DIARRHEA

The results of evaluation of quality of life in children from 1 to 3 years old with chronic diarrhea in exacerbation or remission with QUALIN questionnaire is presented in this article. Authors used two types of questionnaire: doctors' and parents'. Obtained data was compared to indices of healthy children. Proved, that children in early age with chronic diarrhea, as in exacerbation, as in remission, have significantly lower rates of quality of life compared to healthy coevals.Key words: children, quality of life, QUALIN questionnaire, chronic diarrhea.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2):16-19)</span

QUALITY OF LIFE IN CHILDREN WITH CHRONIC DIARRHEA

The results of evaluation of quality of life in children from 1 to 3 years old with chronic diarrhea in exacerbation or remission with QUALIN questionnaire is presented in this article. Authors used two types of questionnaire: doctors' and parents'. Obtained data was compared to indices of healthy children. Proved, that children in early age with chronic diarrhea, as in exacerbation, as in remission, have significantly lower rates of quality of life compared to healthy coevals.Key words: children, quality of life, QUALIN questionnaire, chronic diarrhea.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2):16-19

The usefulness of zhukovsky double balloon in obstetric hemorrhage

Objective:To evaluate the effectiveness of the use of a modified Zhukovsky double (vaginal and uterine) balloon to improve the results of treatment in women with obstetric hemorrhage.Methods:We conducted an observational controlled study including 701 puerperas, which were divided into two groups: The main group consisted of 508 women, who underwent a combined management, that is, traditional (transfusion of fresh frozen plasma, erythrocyte mass, uterotonics, hemostatic agents), surgical hemostasis in cases of caesarean section, and insertion of a double Zhukovsky balloon; while the comparison group included 193 patients, who were managed traditionally. The main group and the comparison group were divided into subgroups according to the main etiology of obstetric hemorrhage: IA and IB - postpartum; IIA and IIB - placenta accreta; IIIA and IIIB - postpartum hysterectomy.Results:The most frequent causes of massive obstetric hemorrhage were atony of the uterus (39.2%), placenta previa (29.1%), and placental abruption (11.5%). Of the 508 balloon insertions, 345 (70.7%) were inserted for hemorrhage during cesarean section and 148 (29.3%) for obstetric hemorrhage after spontaneous delivery. Among the obstetric hemorrhage at caesarean section, lower segment bleeding prevailed (78.1%), caused mainly by placenta previa, placenta accreta, placental abruption, polyhydramnios, and uterine scar defects. Combined management, including surgical hemostasis and insertion of vaginal and uterine balloon of Zhukovsky, reduced blood loss by 1.5 times and the number of hysterectomies by 6.72 times compared to controls.Conclusion:The use of a modified Zhukovsky double balloon in the management of obstetric hemorrhage may reduce the number of hysterectomies and the amount of blood loss. Copyright © 2019 The Chinese Medical Association, published by Wolters Kluwer Health, Inc

APPLICATION EXPERIENCE OF CETIRIZINE SYRUP IN THE TREATMENT OF ATOPIC DERMATITIS AMONG CHILDREN

The article gives the findings of the scientific research, whose purpose was to study the impact of cetirizine syrup (Zodiac, Zentiva, Czech Republic) on the run of atopic dermatitis among 36 children aged between 2 and 6 years old. The work shows that introduction of the medication into the complex therapy of atopic dermatitis among children provides a fast clinical effect. Cetirizine syrup is well tolerated by the children.Key words: atopic dermatitis, children, cetirizine, treatment