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The microbiological monitoring of obstetric institutions revealed essential changes in the microbiological structure of hospital purulent septic infections in newborns and parturient women during the period of 1987-1992. An increase in the role of gram-negative microflora, mainly the representatives of the family Enterobacteriaceae, was registered. The specific proportion of gram-negative microorganisms in the etiology of hospital infections increased from 43.7% to 95.1% in newborn infants and from 33.3% to 61.3% in parturient women, which differently affected on the structure of the main nosological forms of these diseases.

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The efficacies of detection of S. aureus by the bacteriologic method and enzyme immunoassay test system based on F(ab)2 fragments of purified antistaphylococcal antibodies were compared. Washings off the nasal mucosa and salivary samples from 20 normal subjects (medical staff) were examined. The number of findings of S. aureus by the detection of its a-hemotoxin in primary samples was much higher and the time of analysis two times shorter with enzyme immunoassay.

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Pyocinovar and serovar characteristics of 91 P.aeruginosa strains isolated from patients and the environment in a hospital for premature children, a child survey hospital and a neonatological hospital. The leading epidemiological markers of P.aeruginosa strains, among them pyocinovar 883722, serovar 6 (a hospital for premature children), pyocinovar 888888, serovar 4 (a child surgery hospital), pyocinovars 888888 and 861322 (a neonatological hospital).

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As revealed in the realization of the epidemiological surveillance of hospital infections caused by methicillin-resistant S. aureus (MRSA) in different types of hospital, MRSA strains causing purulent inflammatory diseases belong to different clones. The complex marking of MRSA made it possible to determine the presence of the same clone in different hospitals and to detect the outbreaks of hospital infections caused by different clones of MRSA in one hospital. It was found necessary to supplement the commercial international phage-typing set with pages permitting the detection of the specific system of restriction-modification in MRSA.

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The microbiological surveillance of pneumococci according to the Protocols for the International Surveillance of Pneumococci Resistant to Penicillin and Other Antimicrobial Agents developed by Prof. M. Jacobs (USA) and Prof. P. Appelbaum (USA) made it possible for the first time in Russia to detect the strains with moderate resistance to penicillin. It is necessary to revise the current Russian recommendations for the laboratory diagnosis of pneumococcal infection and the determination of antibiotic susceptibility so as to participate in the united programme of the International Surveillance of Penicillin Resistance in Streptococcus pneumoniae.

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Investigation of 108 P. aeruginosa strains isolated from various clinical material revealed that 54.63% of them belonged to serogroups 2, 5, 16, 18, 20 and 12.96% to serotype 4. Five strains were polyagglutinated. Monocultures of P. aeruginosa were isolated from 55% of patients, in the majority of cases (31 out of 36) these strains were isolated from the urine. Bacterial associations were more frequently detected in discharge from wounds (11 out of 21), in the material obtained by bronchoscopy (9 out of 15), and in the throat (5 out of 6). Assessment of antibioticograms of the isolated P. aeruginosa strains permitted us characterize polymixin, forte ceftazidime, and biseptol as effective agents.

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In the approbation of the enzyme-linked immunosorbent assay (ELISA) system on the basis of F(ab)2 fragments of antistaphylococcal antibodies on 307 cultures of the representatives of the genera Staphylococcus, Pseudomonas and Proteus high sensitivity, specificity and effectiveness of ELISA for the quantitative and qualitative evaluation of the alpha-hemolytic activity of S.aureus were established. The ELISA system has made it possible to additionally detect alpha-hemolysin in 62% of S.aureus strains classified with as nontoxigenic strains using hemolysis test in Petri dishes. The sensitivity limit of this method is 0.0005 binding units or 1.0 ng in terms of protein content. The use of the ELISA system may be recommended for the study of the toxigenic properties of staphylococci.

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A comprehensive intraspecies typing of the cultures of MRSA collected during inspection of drug resistance in causative agents of intrahospital infections was performed. The following parameters were investigated: antibiotic resistance, toxin production, sensitivity to the phages of the International Set and the phages of an experimental collection providing the isolation of strains with definite specificity of the restriction-modification system. Different clones of methicillin resistant S. aureus were found to be circulating on the territory of the CIS.

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