Vol 60, No 1-2 (2015)
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ORIGINAL PAPERS
V. V. Gostev,
O. S. Kalinogorskaya,
L. N. Popenko,
T. V. Chernenkaya,
Z. S. Naumenko,
T. M. Voroshilova,
YU. A. Zakharova,
O. E. Khokhlova,
A. N. Kruglov,
M. G. Ershova,
I. V. Molchanova,
S. V. Sidorenko
3-9 1068
Abstract
The results of the multicentre trial on estimation of MRSA antibiotic susceptibility to 17 antibiotics are presented. 474 nonrepeting isolates of MRSA (mecA+), collected in 2011-2014 in 10 cities of the Russian Federation were used in the trial. The antibiotic susceptibility was determined by the method of serial microdilutions in broth with estimation of the MICs in accordance with the international standards CLSI 2014 and EUCAST 2014. The highest levels of the MRSA resistance were stated against ciprofloxacin - 92% (MIC50 32 mcg/ml), gentamicin - 85% (MIC50 128 mcg/ml), erythromycin - 54% (MIC50 32 mcg/ml) and clindamycin - 45% (MIC50 0.03 mcg/ml), as well as against rifampicin - 38% (MIC50 0,06 mcg/ml). The frequency of MRSA isolated at the vancomycin dose of 2 mcg/ml equaled 26%. No correlation of the decrease in susceptibility to vancomycin and rifampicin was observed. In 5% of MRSA isolated from infected surgical wounds in patients with bone infection or sepsis, there was observed a decrease in the susceptibility to ceftarolin (MIC 2-4 mcg/ml). Co-trimoxasole, I'usidic acid (MIC50 0.06 mcg/ml) and mupirocin (MIC50 0.5 mcg/ml) showed high antibacterial activity, 93-98% of the isolates being susceptible to the drugs. No resistance to linezolid and tigecycline was detected. By the associate resistance spectrum, most of the MRSA isolates were characterized by resistance to drugs of 3-7 groups (56%). The phenotypes with simultaneous resistance to drugs of 8-10 groups amounted to 6%. As a whole, 70 variants of associate resistance combinations were detected.
GUIDELINES FOR PRACTITIONERS
10-18 395
Abstract
The surveillance of the serotype pattern and antibiotic resistance of S.pneumoniae in various geographical regions is required for the validity of rational etiotrophic therapy of pneumococcal infections and the choice of the optimal vaccines for their prophylaxis. 250 S.pneumoniae isolates from children with acute otitis or pneumonia and healthy carriers in St.Petersburg in 2010-2013 were investigated. The analysis of the serotype pattern of the pneumococci showed that 13-valent conjugate vaccine was the most active (86.1% of pneumococci causing pneumonia and 86.4% of pneumococci causing acute otitis). The isolates were higly resistant to beta-lactams and macrolides. By the EUCAST criteria, the decrease in the susceptibility to penicillin, cefotaxime, erythromycin and ceftarolin was observed in 32.4%, 14%, 33.2 and 6% of the isolates respectively. 22.4% of the isolates showed associate resistance to penicillin and erythromycin.. No resistance to moxifloxacin was detected. The frequency of resistance to tetracycline, co-trimoxasole and chloramphenicol in various patients ranged within 30-50%. The prevalence of the antibiotic resistance was mainly characteristic of the isolates serotypes 19A, 19F, 14 and serogroup 6.
19-26 108780
Abstract
Rengalin is a release-active combination antitussive drug based on antibodies to bradykinin, to histamine and morphine. It acts at various mechanisms of cough reflex by modifying endogenous target molecules and their interaction with receptors. The drug's efficacy, as demonstrated previously in experimental and clinical studies, is mediated by specific release-activity obtained as a result of the production process. Methods. Efficacy and safety assessment of rengalin in the treatment of cough induced by acute upper respiratory tract infections (URIs) in comparison with a complex codeine-containing drug (codelac®) was performed as part of a multicenter, randomized clinical trial involving 143 patients. All the participants presented with dry/non-productive cough caused by URIs (pharyngitis, laryngitis, tracheitis, tracheobronchitis, bronchitis). The duration of cough varied between 12 hours and 7 days. Rengalin was administered in 73 patients receiving 2 tablets 3 times daily for initial three days, and half reduced doses - for the subsequent four days; codelac® was administered in 70 patients who were given 1 tablet 3 times daily for the entire treatment period (7 days). Primary efficacy endpoints were time to cough resolution and reduction in the severity of the cough (scored using a Cough Severity Scale). One patient in Rengalin group and three patients in Codelac group were withdrawn from the study. The article presents treatment outcomes obtained for 139 participants who completed the study in accordance with the protocol (Per Protokol-analysis). The data analysis was based on a non-inferiority (or comparability) statistical design for efficacy endpoints. Results. The antitussive effect of rengalin was significantly comparable (р<0.025) with that of codelac®; the time to complete resolution of cough (both daytime and nocturnal) was 7.2+1.0 days (versus 7.0+1.1 in the group of codelac). Rengalin's efficacy was evidenced by a sufficiently reduced cough severity in the initial few days after treatment onset. As a result of the entire 7-day treatment, the severity score was reduced by 3.1+09 (versus 3.1+1.0 in the group of codelac; р<0.05), totaling 0.2+0.5 point in both groups at the end of the administration period. The frequent non-productive/dry cough was fully resolved in 76% of patients. All the participants in Rengalin group achieved either convalescent outcomes or significant improvement; none of the patients developed secondary bacterial complications. Positive changes in the patients' state over the week were finally confirmed by evaluating the total quality of life scores, including physical and mental component scores (SF-36 questionnaire), and total sleep quality scores, which were comparative between patients treated with rengalin and codelac® (р<0.025). At the end of the administration period, the effect of rengalin was rated by the physician investigators as 'pronounced'. The Clinical Global Impression Scale-Efficacy Indices (CGI-EI) in the groups of rengalin and codelac were comparable, equating a score of 3.7+0.5 (р<0.025). The safety outcomes of rengalin treatment were assessed across all 143 randomized patients. The drug's high safety profile was confirmed by the absence of adverse events that could be reliably related to the study treatment, and by monitoring of laboratory variables. Rengalin demonstrated good tolerability and favorable compatibility with other medications for URIs with concomitant pathology. The patients showed 100% treatment compliance. Conclusions. Rengalin is a new efficacious and safe drug indicated for the treatment of URI-induced cough. The severity of daytime and nocturnal cough begins to decrease as soon as on the first day after rengalin administration, with severity reduction observed throughout the whole treatment period. At the completion of the 7-day administration, cough severity is reduced by almost 100% and its changes are comparable with the outcomes of treatment with codelac®. By targeting various cough reflex mediators, rengalin enables achieving an antitussive effect in the early days after URI onset (in dry, irritative cough episodes), and a pro-tussive effect at later points of treatment. Rengalin promotes resolution of URI-induced cough without development of secondary bacterial complications.
S. A. Rumyantseva,
E. V. Silina,
N. A. Gomboeva,
V. A. Stupin,
YU. D. Vasiliev,
A. L. Kovalenko,
E. N. Kabaeva
27-34 351
Abstract
Two hundred twenty one patients aged 32-93 years with brain infarction, admitted to a Vascular Neurology Center in the first 3-48 hours (mean 6 hours) after the onset of the symptoms of stroke with computed tomography (CT) verified diagnosis were enrolled in the study. According to the timing of the CT-verification the patients were divided into 2 groups: «early» visualization (EV 50.2%) and «late» visualization (LV, 49.8%). In the EV group the lesion was visualized by CT on the admission (3-6 hours after the admission), in the LV group it was visualized only when CT was repeated 2-3 days after the admission. The patients in the LV group demonstrated increased severity of the underlying pathology, increased mortality and unfavourable functional outcomes correlating with the stroke lesion volume vs. the EV group. There was observed pathophysiological correlation of the blood enzymatic spectrum and acid-base balance parameters, explaining the late lesion visualization by delayed and more pronounced intracellular energy synthesis stabilization mechanisms failure in the aerobic and anaerobic glycolysis cycles.
DRUG STANDARDIZATION AND CONTROL
35-38 476
Abstract
The influence of the rate of administration was examined during the test «Abnormal toxicity» on the quality control of ceftriaxonе in a comparative experimental study on the basis of the methodologies Rus. Ph. XII and Eur. Ph. Recommendations are issued for conducting study entitled «Abnormal toxicity» for the formulations of ceftriaxonе.
REVIEWS
39-46 372
Abstract
Streptomycetes, soil-dwelling mycelial bacteria, can form biofilms as indigenous components of the environment. The biofilms formed by streptomycetes exist in different ecological niches, in natural, medical, industrial environments. The biofilm-forming streptomycetes affect water quality, human health, associate with deterioration of artworks and historical monuments. The review should be of interest for researchers of the biofilm mode of streptomycetes growth.
47-52 421
Abstract
At present endoprosthetics of the joints is considered as a progressive and everdeveloping method in the surgical treatment of patients with affection of the locomotor system of any genesis. Hence, increasing of the number of endoprosthetic results in increasing of the number of patients with periprosthetic infection. Polymorphism of the clinical picture and inspecificity of the diagnostic tests often cause a delay in the diagnosis of the joint prosthetic infection (JPI) and consequently the late treatment. The contemporary data on the etiology, epidemiology, clinical picture and diagnosis of JPI are presented. The importance of cooperated treatment of JPI, i.e. combination of the surgical management and etiotropic antibacterial therapy is indicated. The choice of the concrete treatment method is defined by the patient state, comorbid pathology, the infection severity and duration.
ABSTRACTS
ISSN 0235-2990 (Print)