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BACKGROUND: The frequency of bronchopulmonary dysplasia (BPD) in preterm infants with a "ventilator-associated" pneumonia (VAP) ranges between 7 to 50%. OBJECTIVE: To investigate the features of the etiological structure of neonatal pneumonia complicated by BPD, and to determine the sensitivity of pathogens to antibiotics. METHODS: A retrospective chart review of 194 preterm infants with VAP, birth weight from 780 to 2820 g and gestational age from 27 to 37 weeks was conducted. A microbiological study of washings from the respiratory tract was conducted by standard qualitative and quantitative methods. RESULTS: Respiratory tract infections caused by E. coli (with hemolytic properties), Enterococcus spp. (with hemolytic properties), Pseudomonas aeruginosa, Stenotrophomonas maltophilia, various types of mycoplasmas, Staphylococcus aureus, and Candida krusei were found 4- 13 times more frequent in preterm infants with BPD than in preterm infants without BPD and more mature infants with or without this complication. BPD developed 7- 11 times more frequent in preterm infants with prolonged VAP and change in pathogens than in preterm infants with VAP without change of agent. BPD developed 5- 7 times more frequent in preterm infants with the association of pathogens than in preterm infants with a monoinfection. Massive colonization of respiratory tract pathogens by 1- 3 days of life (lg4 colony forming units in 1 ml and above) was an unfavorable prognostic factor for the development of VAP, complicated by BPD. CONCLUSION: The reduction in the frequency of BPD is might be possible with timeous and adequate antibacterial therapy of VAP.

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A relationship between enteric microbiocenosis and severity of type 1 diabetes mellitus was detected. Microbiological analysis showed II-IV degree dysbacteriosis in all diabetic children. Long-term therapy with probiotics aimed at eradication of opportunistic microflora resulted in recovery of microbiocenosis, which was paralleled by improvement of the clinical status, regression of complications in children who were ill for a long time, and prevention of complications in children with newly detected diabetes. These results indicate the leading role of chronic enteric toxic infectious process in the development of complications of type 1 diabetes. The significance of infection in the pathogenesis of other noninfectious diseases in man is discussed.

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Clinical efficacy of netilmicin was evaluated at 22 newborns (body weight from 1000 to 3600 g, delivery on pregnancy period from 28 to 41 weeks) with pneumonia caused by artificial pulmonary ventilation. Pneumonia was moderate at 13 patients and severe at 9 patients. Microorganisms isolated from tracheobronchial aspirates were mainly (in 19 cases of 22) susceptible to netilmicin. The usage of netilmicin in combination with cephalosporins was effective at the main part of the newborns and resulted with the full recovery of 11 newborns (all the patients with moderate pneumonia), in 9 cases improvement was registered (including 7 newborns with severe pneumonia). Newborns with severe pneumonia had a slow pathogens elimination.

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The effect of netilmycin, amikacin, ceftazidime and cefotaxime on adhesion of Lactobacillus spp. (14 strains), Escherichia coli (21 strains), Klebsiella pneumonia (15 strains), Enterococcus sp. (18 strains), Candida albicans (15 strains) was investigated. The strains were isolated from respiratory tract and feces of the newborns. Antibiotics were used in the following subtherapeutic and therapeutic concentrations: netilmycin--1.2 and 12.0 micrograms/ml, amikacin--1.8 and 18 micrograms/ml, ceftazidime--7.5 and 75 micrograms/ml, cefotaxime--6.5 and 75 micrograms/ml. Adhesion of C. albicans was investigated with buccal epithelium cells, adhesion of other microorganisms--on formalinized human erythrocytes (1(0)Rh(+)). It was shown that antibiotics in subtherapeutic and therapeutic concentrations inhibited adhesion of the most strains. Cefalosporins demonstrated maximum inhibitory activity. The number of the strains inhibited by cefalosporins and by aminoglycosides enhanced along with antibiotics concentrations enhancement from subtherapeutic to therapeutic concentrations.

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The efficacies of bifacid and bifidumbacterin were studied comparatively in the correction of intestinal biocenosis in 60 newborns with infectious inflammatory diseases and intestine disfunction treated with massive doses of antibacterial drugs. The study showed that the use of bifidumbacterin was accompanied by significant disturbances in the biocenosis and by development of the intestinal syndrome. The protective action of the drug was observed after a short-term use only of one antibiotic and when the course of the bifidum therapy was continued after discontinuation of the treatment with antibacterial drugs. The use of bifacid was accompanied by a rapid (by the 2nd or the 5th day fo the treatment) and stable normalization of the stools and a marked improvement of the patient general state. The clinical efficacy of bifacid was much higher than that of bifidumbacterin. At the background of the bifacid therapy there was observed correction of the intestinal microflora composition due to normalization of the count of Bifidobacterium, Lactobacillus and Colibacillus as well as to eradication of opportunistic pathogens.

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The comparative study of the effectiveness of immune immunoglobulin and bifidumbacterin for the correction of dysbiotic microflora in the intestine of premature born children with infectious inflammatory diseases. Immune lactoglobulin was administered orally to 37 children in a dose of 500 mg/kg twice a day for 1-3 weeks. The preparation facilitated the rapid and stable normalization of disturbances in the intestinal biocenosis in 86.5% of newborns. The elimination of opportunistic lactose-negative enterobacteria, Pseudomonas aeruginosa hemolytic forms of Escherichia from the digestive tract and the stimulation of the multiplication of lactic acid bacteria were noted. The treatment of newborns with immune lactoglobulin was found to give a more pronounced corrective effect with respect of intestinal microflora than the use of bifidumbacterin according to the traditional scheme.

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The majority of the enteric bacteria and aerobic and anaerobic cocci causing postventilation pneumonia in newborns were susceptible to gentamicin, carbenicillin, ampicillin and cephalosporins. The strains of Pseudomonas aeruginosa were mainly susceptible to gentamicin and carbenicillin. Bacteroides were susceptible to metronidazole, ceftazidime and lincomycin. 70.8 per cent of the causative agents of the pneumonia were polyresistant to at least 6 antibiotics.

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The present work shows that choline-containing phospholipids (lysophosphatidylcholine and lyso-1-alkyl-sn-glycerophosphocholine) inhibit the adhesion of some strains: Bacterium bifidum 1, B. adolescentis MC-42, B. longum B. 379M, Staphylococcus aureus P 209 and Klebsiella pneumoniae 52. Phosphatidylcholine produces no effect on the adhesiveness of these strains, while platelet activation factor stimulates adhesiveness only in strain S. aureus 209. The stimulating or inhibiting action of phospholipids on the adhesive process of microorganisms depends on the species of bacteria and on the concentration of reagents.

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The composition of and method for preparation of nutrient medium for the isolation of Lactobacilli from biologic material are described. The medium is simple to prepare, consists of only Soviet reagents, this making it available for laboratories in this country.

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The authors have modified the method for studies of the microorganism adhesive properties in the presence of breast milk; this modification is based on the ability of bacterial cells to adhere to the surface of human red cells of I (0) Rh (+) blood group. The study has revealed significant differences in the adhesion characteristics of S. aureus 209, B. bifidum I, and B. adolescentis MC-42 strains in the presence of breast milk of women with normal babies and of those whose babies suffered from intestinal dysfunctions.

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An analysis of wound complications in 699 patients after operation has been made. Microbiological examinations of the wound exudate have shown that the content of "seromas" and "hematomas" is infected with aerobic and anaerobic nonsporulating microflora in 80% of the cases. "Seromas" and "hematomas" were proved to be typical cases of suppuration of operative wounds.

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The paper is concerned with formation of intestinal biocenosis in premature infants and with approaches to the correction of its disorders with the aid of biphilin, a special mixture prepared from sour milk. Ninety newborns showed the derangement of biocenosis of various intensity by the 6th to the 10th day of life. Application of biphilin for 2 to 6 weeks as part of the multimodality treatment of such children made the intestinal microflora return to normal.

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Contamination of the operative wounds with aerobic and nonsporulating anaerobic microflora is known to take place in the process of operation. Lower degree of the contamination of the operative wounds by the end of operations results in lower incidence of suppurations. It can be achieved in pure and conventionally pure operations of a less traumatic character by the application of preoperative gentamycin electrophoresis onto the operation field, while in conventionally pure operations of great traumatism and contaminated operations--by active irrigating drainage.

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