Assessment of the infectious factor in transurethral surgery of benign prostate hyperplasia

Performing surgical interventions for benign prostate hyperplasia against the background of chronic urinary tract infection or prostatitis can adversely affect the course of the postoperative period and mediate the development of complications. Therefore, it is important to understand the pre- and postoperative bacterial status of the patients in various endourological surgical techniques and its relationship with possible infectious complications. This review raises the problem of insufficient knowledge regarding the clinical structure of infections during transurethral surgery, assessment of their relationship with the course of the underlying pathology and the severity of symptoms

Risk factors, antibiotic prophylaxis, and treatment of urinary tract infection in transurethral surgery for benign prostatic hyperplasia

Discussion of risk factors for infectious complications in the general population of patients undergoing transurethral resection of the prostate, antibiotic prophylaxis and therapy has been going on for decades. Up to date, the problem of the manifestation of bacteriuria in clinical infectious processes at various periods, as well as the factors of the introduction of bacterial agents with their further subclinical circulation in the urinary and reproductive systems, seems to be little discussed. The insufficient knowledge of these issues is confirmed by a small number of studies covering mainly electrosurgical mono and bipolar technologies as the most common and studied over a long period of their existence. This review raises the problem of insufficient knowledge of the clinical structure of infections during transurethral surgery, assessment of their risk factors, antibiotic prophylaxis regimens and therapy

METHODS FOR THE PREVENTION OF INSOLVENCY OF COLORECTAL ANASTOMOSIS AT RESTORING CONTINUITY OBSTRUCTIVE BOWEL AFTER RESECTION

Purpose: To improve the results of restorative surgical treatment of patients after obstructive resection of the distal colon. Materials and methods: The analysis of surgical treatment results at 30 patients who had operations on restoring the intestinescontinuity after obstructive resections of distal segments of a large intestine has been carried out (operations of Hartmann type).Results: The algorithm of defining the timeframes and way of operations on restoring large intestine continuity has beendeveloped. The priority value in the choice of length and functional condition of a postcolostomic stump medical tactics, changesof its microflora, as well as function of the rectal locking apparatus has been established.Summary: The obtained results (93,3% of favorable outcomes without complications) allow to recommend the offered tactics(including preventive methods of anastomosis incompetence and transanal decompression of the intestines) for wide practicalapplying

VIRUS-MICROBIAL ASSOCIATIONS IN CHRONIC SUPPURATIVE OTITIS MEDIA

Purpose: To research of certain peculiarities of the virus-microbial assotiations of middle ear in chronic suppurative otitis media (CSOM).Materials and Methods: Microflora in the middle ear of 102 patients aged from 20 to 70 years with chronic suppurative otitis media were studied by microbiological and genetic (PCR) methods.Results: Microbiotic mixed infection was detected in 62,5% patients and microbiotic monoinfection–in 37,5% patients. In microbiotic monoinfection the frequency of occurance of herpes and papilloma viruses was 19,4% and in microbiotic mixed infection - 32,2%.Chlamydiae were detected only in mixed infection (16,7%). Presence of mycoplasms in middle ear in microbiotic monoinfection was 13,7 times less (p<0,01) than in mixed infection.Summary: The obtained results are allowed to recommend broadened microbiological analysis with application PCR to put into practice to increase the level of diagnostics and to make choice of an adequate treatment of CSOM

ROLE OF BACTERIA AND MICROSCOPIC FUNGI IN AETIOLOGY OF CHRONIC SUPPURATIVE OTITIS MEDIA

Purpose: To research of spectrum of agents and their biological characteristics in chronic suppurative otitis media (CSOM).Materials and Methods: Вacterial and fungous flora in the middle ear of 102 patients aged from 20 to 70 years with CSOM were studied by microbiological and genetic (PCR) methods. To determine adhesive activity of agents was used rapid method Brilis V.М. and antilysozyme activity – method Bukharin O.V.Results: The majority of cases of CSOM were caused by different species of staphylococci with prevalence S.aureus, S.epidermidis. Mycoplasms, mould and yeast-like fungi took up the second position among the pathogens. Non-clostridial anaerobes and chlamidiae were occurred less frequently. In most cases (>90%) agents of CSOM were possessed of adhesive and antilysozyme activities. Among them more 70% strains had the high and middle level of expression of these signs.Summary: Traditional microbiological method of diagnostics is not an informative, because it leave out of account the role mycoplasms, chlamidiae and non-clostridial anaerobes in forming of disease. Main strains of agents of CSOM are possessed of significant adhesive and antilysozyme activities. These signs influence on gravity and duration of course of disease

The microbial load and the severity of morphological changes in the prostate during infection with various titers of uropathogens: a comparison of data from an animal model study

Introduction. It has been established in an animal model that coagulase-negative staphylococci (Staphylococcus haemolyticus) and anaerobes (Peptococcus niger) cause the development of an acute inflammatory process in the prostate when inoculated with 103 CFU/ml. At the same time, data have been published indicating the pathogenic potential of these microorganisms on a titer of 102 CFU/ml. But it was confirmed for the model of acute obstructive pyelonephritis. In addition, the characteristics of the formation of the inflammatory response at different times were determined, which require detailed verification and comparative characteristics with those during infection with a causative uropathogen (Escherichia coli).Objective. Based on the results of the experiment, to carry out: 1) an evaluation of the relationship between the dynamics of microbial load and the degree of pathomorphological changes in prostate tissues during infection with various uropathogens in a titer of 103 CFU/ml; 2) an evaluation of the degree of microbial load and severity of histological changes in prostate tissues on follow-up day 7 with transurethral infection with various uropathogens in a subpathogenic titer of 102 CFU/ml; 3) a fundamental comparative analysis of the indicators of contamination and the severity of inflammatory changes on follow-up day 7 after the inoculation of various uropathogens in titers of 102 and 103 CFU/ml.Materials and methods. The animal model was performed using the FELASA and ARRIVE guidelines. Lab animals: 20 New Zealand rabbits. Uropathogens: E. coli, S. haemolyticus, and P. niger. Infectious titers: 102.3 cfu/ml. Uropathogen inoculation technique: topical transurethral. Randomization: all laboratory animals were divided into 4 groups depending on the uropathogen (3 experimental, 1 control). Follow-up periods: day 1, 3, 7 and 14 for a titer of 103 CFU/ml, and day 7 for a titer of 102 CFU/ml. At the end of the follow-up, euthanasia and autopsy were performed with the extraction of the urogenital organ complex. Hereafter, biopsies were taken from various parts of the prostate. Cultural and histological studies of prostate tissues were carried out using standard methods. The results were analyzed using Statistica 10.2 (StatSoft Inc., Tulsa, OK, USA) and GraphPad Prism 9 (GraphPad Software Inc., Graphpad Holdings LLC, San Diego, CA, USA) programs through descriptive and nonparametric statistics.Results. Bacterial contamination of prostate tissue was determined in all cases of infection with differences (p < 0.05) in some indicators between the E. coli and P. niger groups at different observation periods, but only in the case of inoculation of the test titer of 103 CFU/ml. Histological evaluation of prostate tissues after inoculation with 103 CFU/ml verified the presence of acute destructive changes in the prostate from the follow-up day 1, which were more pronounced in the S. haemolyticus and E. coli groups. However, similar characteristics of the development of the inflammatory process in the form of hyper-eosinophilic infiltration in the early stages and pronounced congestion of the prostatic glands were identified in the S. haemolyticus and P. niger groups. Comparison of trends in dynamic changes of microbial load (rise / decline) and severity of pathological changes (increase / resolution) in prostate tissues in established follow-up periods showed the presence of relative synchronization of trends (from days 1 to 7) in the S. haemolyticus and P. niger groups, and complete synchronization in the E. coli group. When comparing the median microbial load of the prostate on the follow-up day 7, no intergroup (p > 0.05) differences were found both in cases of infection with a titer of 103 CFU/ml, and when compared with the data on contamination for a test titer of 102 CFU/ml, at the same time observations. At once, when E. coli and S. haemolyticus were infected at a subpathogenic titer of 102 CFU/ml, inflammatory changes were recorded that had a mild diffuse character, in relation to those after inoculation of these pathogens in a titer of 103 CFU/ml. In turn, P. niger induced the development of low-intensity focal alteration in isolated areas of prostate tissues.Conclusions. Detailed analysis of culture and histological data showed that E. coli, S. haemolyticus and P. niger have significant pathogenic potential at titer of 103 CFU/ml. In turn, when the titer decreases to 102 CFU/ml, E. coli and S. haemolyticus retain their pathogenic potential, but the severity of the inflammatory reaction is significantly reduced. It was also found that a change in bacterial contamination affects the severity of the inflammatory process in all groups during seven follow-up days at a given test titer

Treatment of post-COVID-19 patients with chronic recurrent prostatitis: efficacy of recombinant interferon α-2b medications

Introduction. The tactics of managing and treating patients with chronic recurrent bacterial prostatitis (CRBP) in some cases is a difficult-to-treat condition for a practicing urologist. This circumstance occurs because the disease has several predisposing factors, a complex and multifaceted pathogenesis, and certain difficulties in diagnosis and treatment.Objective. To study the effectiveness of recombinant interferon α-2b medications in post-COVID-19 patients with chronic recurrent prostatitis against the background of antibiotic multi-drug resistance of microorganisms verified in prostate secretion.Materials and methods. The treatment of 52 post-COVID-19 patients with CRBP was analyzed, divided into three therapy-dependent groups. Group 1 patients (n = 18) received antibiotic therapy (ABT): Levofloxacin 500 mg q.d. PO for 28 days. Group 2 patients (n = 18) underwent combined therapy: ABT supplemented with recombinant interferon α-2b with an antioxidant complex of vitamins E and C (“Viferon®” rectal suppositories) 3.000.000 IU b.i.d. PR q12h for 28 days. Group 3 patients (n = 16) received monotherapy with recombinant interferon α-2b with an antioxidant complex of vitamins E and C (“Viferon®”rectal suppositories) 3.000.000 IU b.i.d. PR q12h for 28 days. The follow-up period was 6 months with monitoring of clinical and laboratory parameters assessed before treatment, after 1, 3 and 6 months from the start of therapy.Results. Based on the monitoring of the clinical picture and laboratory parameters, after 1 follow-up month, there was a significant decrease in the symptoms of the disease in all study groups. However, after 3 and 6 follow-up months, this trend was observed only in patients of groups 2 and 3 receiving recombinant interferon alfa-2b with an antioxidant complex (vitamins E and C).Conclusions. Strengthening the standard CRBP-therapy with recombinant interferon α-2b with an antioxidant complex of vitamins E and C makes it possible to normalize both clinical and laboratory parameters in most patients

СРАВНИТЕЛЬНЫЙ АНАЛИЗ БАКТЕРИАЛЬНОЙ ПОПУЛЯЦИИ ПРОСТАТЫ ПРИ РАКЕ И ДОБРОКАЧЕСТВЕННОЙ ГИПЕРПЛАЗИИ ПРОСТАТЫ

A bacteriological study of prostate biopsy specimens was conducted in patients with prostate benign hyperplasia (PBH) and in those with prostate cancer (PC). It revealed a wide range of aerobic (Corynebacterium sp., Enterococcus sp., E. coli, S. haemolyticus, S. hominis) and nonclostridial anaerobic (Bacteroides sp., Bifidobacterium sp., Eubacterium sp., Propionibacterium sp., Рeptococcus niger, Peptostreptococcus sp., Prevotella sp., Veilonella sp., Fusobacterium sp., Capnocytophaga ochracea, Streptococcus parvulus) bacteria. Differences were seen in the detection rate of these microorganisms and in the level of tissue infectivity in PBH and PC. The average seeding of the prostate biopsy specimens and the detection rate of different types of bacteria in PBH were greater than those in PC; moreover, some bacteria were undetectable in PC at all.Проведено бактериологическое исследование биоптатов предстательной железы (ПЖ) у пациентов, имеющих доброкачественную гиперплазию предстательной железы (ДГПЖ) и рак предстательной железы (РПЖ). Выявлен широкий спектр аэробных (Corynebacteriumsp., Enterococcussp., E. coli, S. haemolyticus, S. hominis) и неклостридиально-анаэробных (Bacteroidessp., Bifidobacteriumsp., Eubacteriumsp., Propionibacteriumsp., Рeptococcusniger, Peptostreptococcussp., Prevotellasp., Veilonellasp., Fusobacteriumsp., Capnocytophagaochracea, Streptococcusparvulus) бактерий. Определены различия в частоте обнаружения данных микроорганизмов и уровне инфицированности ткани при ДГПЖ и РПЖ.Средний уровень обсемененности биоптатов простаты и частота выделения различных видов бактерий при ДГПЖ превышают таковые при РПЖ, причем некоторые бактерии при РПЖ не обнаруживаются вовсе

Биологические свойства грамнегативных бактерий, верифицированных в моче пациенток с рецидивирующей неосложненной инфекцией нижних мочевых путей

Uncomplicated infections of the lower urinary tract are more often recorded in women and are characterized by recurrent severe course. The lack of effective approaches to the management of this cohort of patients and the insufficient knowledge of the qualitative characteristics of uropathogens hinder the successful treatment of these infections. The purpose of this project is to study the biological properties of representatives of Gram-negative bacteria isolated from the urine of patients with recurrent uncomplicated lower urinary tract infection at various levels of bacteriuria.We present here the results of the one-stage cohort study of 62 patients 20-50 years old with recurrent uncomplicated lower urinary tract infection. The level of bacteriuria, genes of virulence factors, hemolytic, adhesive and anti-lysozyme activities were determined for the Gram-negative bacteria isolated from the urine of patients.Representatives of Gram-negative microorganisms (62 strains) were isolated from the urine of all patients. Their bacteriuria levels ranged from 102 to 108 CFU/ml. A wide range of the virulence factor genes with the prevalence of papGII, feoB, fyuA, were found in all strains regardless of the degree of bacteriuria. Twenty significant (p<0.05) coefficients of mutual contingency between different pairs of genes were found. We found that the hemolytic activity of Enterobacteriaceae is statistically significantly associated with papA, feoB, fyuA, kpsMII, and usp, while the anti-lysozyme activity is associated with papA, afa, and usp.The detection of genotypic and some phenotypic traits expressed in various variations in all Gram-negative bacteria regardless of their bacteriuria levels creates a potential risk for recurrent of the lower urinary tract infection. Consequently, even the minimal levels of bacteriuria become clinically significant. Therefore, in bacteriological diagnostics it is necessary to determine all levels of bacteriuria, including the minimum level (102 CFU/ml), since isolated microorganisms at this level have not only adhesive and anti-lysozyme activities, but also contain genes encoding the virulence factors. Неосложненные инфекции нижних мочевых путей чаще регистрируются у женщин и характеризуются рецидивирующим тяжелым течением. Отсутствие эффективных подходов по ведению данной когорты пациенток и недостаточная изученность качественных характеристик уропатогенов препятствуют успешному лечению этих инфекций. Цель настоящего исследования — изучить биологические свойства представителей грамнегативной микробиоты, выделенной из мочи паци­енток с рецидивирующей неосложненной инфекцией нижних мочевых путей, при различных уровнях бактериурии.Проведено когортное одномоментное исследование 62 пациенток в возрасте 20–50 лет с рецидивирующей неосложнен­ной инфекцией нижних мочевых путей. У грамнегативных бактерий, выделенных из мочи пациенток, определяли уровень бактериурии, гены факторов вирулентности, гемолитическую, адгезивную и антилизоцимную активности.У всех пациенток из мочи выделены представители грамнегативных микроорганизмов (62 штамма). Уровни бактери­урии колебались от 102 до 108 КОЕ/мл. У всех штаммов обнаружены гены факторов вирулентности в широком диапазоне с превалированием papGII, feoB, fyuA независимо от степени бактериурии. Обнаружено 20 достоверных (p<0.05) коэффи­циентов взаимной сопряженности между различными парами генов. Гемолитическая активность энтеробактерий значимо связана с papA, feoB, fyuA, kpsMII и usp, антилизоцимная – с papA, afa и usp.Таким образом, наличие генотипических и некоторых фенотипических признаков в различных вариациях экспрессии у всех представителей грамнегативных бактерий при всех уровнях бактериурии создает потенциальный риск развития очередного рецидива инфекции нижних мочевых путей. Поэтому даже минимальные уровни бактериурии являются кли­нически значимыми. Таким образом, при бактериологической диагностике необходимо определять все уровни бактери­урии, включая минимальный (102 КОЕ/мл), так как выделенные микроорганизмы при данном уровне обладают не только адгезивной и антилизоцимной активностями, но и имеют гены факторов вирулентности