The article Is devoted to the study of biological properties of antibiotic-resistant bacteria Propionibacterium acnes and their sensitivity to antibacterial cationic peptides varnerin and hominin. P.acnes Ac-1450 strain resistant to rifampicin and tetracycline were obtained by selection. With the help of the Kirby-Bauer disk diffusion test, it is shown that the acquisition of resistance to these antibiotics is accompanied by a decrease in the sensitivity of bacteria to a number of other antibacterial drugs. As a result of the determination of the minimum inhibitory concentrations of cationic peptides, it has been established that the sensitivity of antibiotic-resistant P.acnes strains to varnerin and hominin is maintained at the sensitivity level of the parent strain. Antibiotic-resistant bacteria show a more pronounced ability for adhesion and biofilm formation in comparison with the bacteria of the parent strain, however, the formation of biofilms can be effectively suppressed by staphylococcins. Analysis of the curves of the formation intensity of P.acnes biofilms, depending on the content of peptides in the medium, made it possible to establish concentrations that inhibit the growth of biofilms by 50%. Despite the fact that the values obtained were 5-12 times higher than the MIC values for planktonic culture of P.acnes, staphylococcins are promising drugs for combating infections caused by propionic bacteria.

The article presents the results of a microbiological study of wound fluid from 97 patients with diabetes mellitus. Of 126 isolated strains, the leading pathogens were bacteria of the genus Staphylococcus (54%), Enterococcus (14%), and Streptococcus (13%). The leading pathogen among gram-negative bacteria was Escherichia coli (5%). Nonfermentative gram-negative bacteria amounted for 3% and were represented by Pseudomonas aeruginosa (2%) and Asintobacter (1%) bacteria. High activity of amoxiclav, imipenem and cefoperazone/sulbactam in the majority of both gram-positive and gram-negative cultures was noted. Sensitivity to fluoroquinolones ranged from 75% to 100%. Levofloxacin and moxifloxacin were the most active. To treat 14 patients, we used an intraarterial method of continuous infusion of levofloxacin (500 mg/day) and sequential administration of isoximere bromide (polyoxidonium - PO, 12 mg/day) through a permanent implanted catheter device. Complex therapy led to a rapid regression of clinical manifestations of the infectious and pain syndromes followed by granulation and epithelization of the wound. Undesirable effects are not recorded in any patient throughout the course of therapy (10-12 days).

The article analyzes the results of a microbiological examination of 336 patients with various forms of non-lactating mastitis. The causative agent was identified in 321 (95.5%) patients. Monoculture was identified in the majority of observations (84.4%), microbial associations were found in 15.6% of cases. Staphylococcus aureus had prevailed as the causative agent (69.7% of cases). Microflora composition depended on the form of the disease: S.aureus was isolated from the samples in 86.1% of cases of acute form of non-lactating mastitis, in 69.8% of cases of subacute form, and in 57.4% of patients with chronic form of non-lactating mastitis. The role of gram-negative microorganisms and microbial association is constantly evolving. The frequency of isolation of multiple antibioticresistant strains of microorganisms depended on the duration of the disease, the previous intake of antibacterial drugs and the clinical course of the disease. In acute forms of non-lactating mastitis methicillin-resistant S.aureus (MRSA) was isolated in only 2% of cases among all isolated S.aureus, while in subacute and chronic forms of the disease the frequency of MRSA isolation dramatically increased to 11.7% and 23.4% of all strains of staphylococci, respectively.Microbiological monitoring of wound fluid in the treatment of patients with non-lactating mastitis in combination with rational antibiotic therapy and adequate surgical intervention is the key to successful treatment of this category of patients.

Purpose ofthe study: To increase the effectiveness and safety of chemotherapy for tuberculosis patients based on knowledge ofpatient's genotypic characteristics through molecular genetic methods of research.Methods: A total of 95 people aged 12 to 50 took part in the study. In the treatment regimen, the patients of the main group were treated with isoniazid, pyrazinamide and rifampicin. Adverse hepatotoxic reactions in the form of clinical manifestations and (or) increase in the level of ALT and AST were observed in 23 patients. Hepatoprotective therapy with drugs Carsil, Phosphogliv was received by all patients.To conduct laboratory tests, genomic DNA was isolated from whole blood and the polymerase chain reaction was performed in real time. In the study group the presence of genotypes belonging to the genes listed below was considered as possible predictors of hepatotoxicity: rs1801279, rs1799931, rs1799930, rs1799929, rs1801280, rs1208, rs1041983, rs1045642, rs74837985.To predict the development of hepatotoxicity with the use of antituberculosis drugs, the method of logistic regression analysis was used depending on the presence or absence of specific genotypes in the genome of the examinee. Results: As a result of the logistic regression analysis two statistically significant models were obtained. The first model reflects the association of the antituberculous-drugs hepatotoxicity with the AA genotype of the rs1799931 gene and the AA and AG (allele A) genotypes of the rs1799930 gene. The second model reflects the connection of the antituberculousdrugs hepatotoxicity manifestation with the TT and CT (allele T) genotypes of the rs1041983 gene. Conclusions: The presence of the AA genotype of the rs1799931 gene and the AA and AG (allele A) genotypes of the rs1799930 gene as well as the presence of the TT or CT (allele T) genotype of the rs1041983 gene, which determine the activity of the NAT2 enzyme, significantly increases the risk of hepatotoxicity during therapy with antituberculous drugs in patients with pulmonary tuberculosis.

The purpose of the study was to evaluate the dynamics of the peroxidative homeostasis processes (lipid peroxidation and antioxidant protection) in the moderate gastrointestinal form of salmonellosis during complex therapy including reamberin. Seventy patients with moderate salmonellosis were examined: 35 patients of the control group received basic therapy, 35 patients of the main group received reamberin (intravenously, 1.5% - 500 ml per day, for 5 days) in addition to the basic therapy. The efficacy of therapy was assessed according to the dynamics of clinical symptoms relief and laboratory data: the level of diene conjugates (DCo), diene ketones (DKe), plasma and erythrocytes malonic dialdehyde (MDApl, MDAer), plasma and erythrocyte catalase (Cpl, Cer) and superoxide dismutase (SOD). It is established that an imbalance in the prooxidant and antioxidant system remains in the phase of clinical recovery from salmonellosis. The inclusion of reamberin in the complex pathogenetic therapy made it possible to more effectively cope with the clinical symptoms of the disease and the parameters of peroxide homeostasis, as evidenced by a decrease in lipid peroxidation products (DCo, DCe, MDApl, MDAer) and an increase in the activity of antioxidant enzymes (Cpl, Cer, SOD). The inclusion of reamberin in the treatment of patients with salmonellosis should be considered pathogenetically and clinically justified and promising.

The purpose of the study was to analyze validity and effectiveness of simultaneous application of bacterial probiotics and antibacterial antibiotics during antimicrobial therapy. Materials and methods. The review includes materials of foreign and domestic researchers published in modern periodical and monographic literature. Results. The conceptual material of the main terms and definitions of «ideal» antibiotics and probiotics is presented. The dominant role of bacterial probiotics in the group of medical probiotics in the Russian pharmaceutical market was established. A comparative assessment of the data on the passportization, identification, and sensitivity to antibiotics of a number of commercial probiotic cultures was carried out. The article considers theoretical and practical joint use of antibiotics, probiotics, and metabiotics during antimicrobial therapy. Conclusion. The current practice ofjoint use of probiotics and antibiotics in the process of antimicrobial therapy is extremely limited and indicates the presence of serious circumstances that reduce the effectiveness of probiotic therapy. One of the directions that exclude this situation is the use of metabiotics in the form of medications.

Various test methods are used to detect and quantify bacterial endotoxins: a gel-clot test, which is arbitral and is based on the formation of a gel, and photometric (instrumental) tests that determine the intensity of the color or turbidity in the test solutions. In this article we consider the features of modern methods for detecting bacterial endotoxins, their advantages and disadvantages. Based on information analysis and practical experience, the main criteria for choosing a method for determining pyrogenic impurities are established. The gel-clot test and photometric determinations of bacterial endotoxins are sufficiently reliable and reproducible. The choice is left for the analyst when all necessary equipment and reagents are available.Instrumental methods are used in rare case due to their high sensitivity, which allows to avoid the influence of interfering factors in the LAL-test.

The main objective of this study was to analyze the adverse drug reactions (ADRs) associated with the use of levofloxacin. We analyzed ADR reports submitted to the Russian Spontaneous Report Database from 2009 to 2017. A significant difference in the number of spontaneous reports between different brands of levofloxacin was detected. Almost three quarters (74.1%) of all ADRs occurred in adults (18-64 years of age). Approximately 24% of reported ADRs were serious including two fatal cases. The most frequently reported reactions to levofloxacin involved the skin disorders (32.5%), hypersensitivity reactions (30.8%), gastrointestinal disorders (29.0%), general disorders and administration site conditions (26.3%). The results obtained may indicate a different profile of drug safety, even within the same international nonproprietary name.

The review article presents the materials of recent years dedicated to the analysis of modern data about the possible aspects of the use of deoxyribonucleic acid (DNA) and oligodesoxinucleotides (natural and synthetic) from pro - and eukaryotes for the prevention and treatment of infectious diseases.The authors focus on bacterial DNA with a high content of CpG motifs, as well as on unmethylated CpG oligonucleotides (CpG-ODN), which stimulate the system of innate and adaptive immunity. Due to the absence of pronounced toxicity and good tolerance of the macroorganism, these compounds are of great interest for medical use, in particular as adjuvants. At the same time, the authors note the need to develop effective CpG-ODN delivery systems in tissues and target cells.With respect to CpG-motives of eukaryotic DNA, the possibility of their use as a basis for effective adjuvants, immunomodulators, antiviral and antibacterial compounds is considered.

The problem of acute tonsillitis caused by Group A Beta-Hemolytic Streptococcus (GABHS) still remains relevant. This article provides data showing the revival of highly virulent GABHS infection and an increase in the incidence of complications (acute rheumatic fever, toxic shock syndrome), and substantiates the need for rational antibiotic therapy of this pathology. The drugs of choice for the treatment of acute forms of GABHS tonsillitis are penicillins and cephalosporins of the first generation, and macrolides in case of intolerance to beta-lactam antibiotics. In the presence of chronic relapsing GABHS tonsillitis, when the probability of colonization of the source of infection by microorganisms producing beta-lactamases is high enough, inhibitor-protected penicillins or cephalosporins of II-III generation are used. Lincosamide antibiotics are used in the treatment of acute and chronic GABHS tonsillitis as reserve drugs.