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The content of empirically selected bacteriophage mixtures, produced by Microgen for the prevention and treatment of staphylococcal and pseudomonade infections, was investigated by negative stain electron microscopy. The main population of phages was shown to belong to the groups suitable for therapeutic purposes based on bioinformatics analysis of known genomes of Pseudomonas and Staphylococcus phages. However, the phage morphology studies did not always reveal the exact correspondence of the phage to the exact group. Therefore, we suggest group genotyping of the therapeutic bacteriophages on thebasis of genetic conservative locus.

Aim: Study sensitivity of nosocomial microbes--causative agents of post-operative infectious complications in surgical profile patients to bacteriophages., Materials and Methods: Microbe isolates from biosubstrates of 223 surgical patients served as material. Microbes were isolated from blood, urine, wounds, intravascular catheters, abdominal cavity drainage, discharge of pharynx, trachea (343 strains). Phagolysability of strains was determined by Ott method., Results: A good lysability of Pseudomonas aeruginosa, Klebsiella, Escherichia coli by specific complex and monophages and lower--of staphylococci and enterococci was found in the presence of 83% methicillin-resistant staphylococci strains and 94% Gram-negative bacteria strains producing extended spectrum beta-lactamases., Conclusion: Continuation of use of various bacteriophage preparations against Gram-negative bacteria and implementation of measures to adopt phage preparations to staphylococci and enterococci are perspective considering multiple resistance of microbes to antibiotics.

The sensitivity of 239 isolates obtained from patients with postoperative infectious complications to phagolysis was determined. Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli were found to have the highest sensitivity to phages. Variations in the sensitivity of the same cultures to phages from different producers and even from the same producer were established. The sensitivity of cultures to phages may serve as an additional criterion of the biological properties of strains and their marker.

Results of clinical and laboratory evaluation of the treatment with pyobacteriophage in tablets of the patients with burn wounds are presented. It was shown that phagotherapy provided more rapid cure of pyoseptic complications, temperature normalization, wounds purification and lower lethality Bacteriological analysis of wound secretions revealed that after the treatment staphylococci and streptococci were cultured 2 times rarely, Proteus spp. Were isolated 1.5 times rarely, E. coli was not isolated. The amount of positive haemocultures also diminished. Investigation of immunologic status demonstrated statistically significant normalization of immunity on cell level. Phagocytosis level didn't change while in control group (without bacteriophage use) it became lower. Antibody level enhanced but less extensively than in control group. The results of trial demonstrates positive effect of phagotherapy use at the patients with burns.

Urinary infection is the most commonly encountered hospital infection. Antibacterial therapy promotes selection and dissemination of polyresistant microorganism strains, development of intestinal dysbacteriosis, reduction of intestinal contamination resistance. Clinical and bacteriological efficacy of urinary infection treatment with bacteriophage preparations (pyocyanic, proteus, staphylococcal, coliphage, combined pyobacteriophage) was studied. Sensitivity of the infective agent phage isolated from urological patients was tested before treatment. The preparations were adapted to recently isolated agents from urological patients to raise phage sensitivity of the strains. A total of 293 strains were studied. Phage sensitivity made up 68.9%. Bacteriophage preparations were used both locally and orally in 46 patients with acute and chronic urogenital inflammation. Bacteriological efficacy amounted to 84%, clinical one to 92%. It is inferred that phagotherapy is effective and safe therapeutic modality in the treatment of urinary infection in monotherapy and in combination with antibiotics.

In a maternity hospital with the decentralized system of infant care the presence of the group B streptococcal colonization of puerperants (13.0 +/- 4.5%), newborn infants (25.0 +/- 4.4%) and medical staff (16.9 +/- 3.2%) was established. The strains isolated in this hospital belonged to 13 different serotypes and antigenic combinations with type 1 a/c dominating among them (28.7 +/- 4.8%). Group B streptococci were found to be transmitted by the vertical way in one out of two colonized mother-child pairs, in all other cases the nosocomial spread of streptococci occurred.

Analysis of clinical material from cardiosurgical and cardiotherapeutic patients and that from neonates with pyoseptic infections, hospitalized in Moscow and Gorky, has demonstrated the etiologic significance of coagulase-negative Staphylococci (CNS). Since many strains did not belong to S. aureus, S. epidermidis, or S. saprophyticus, they were species-identified in accordance with the classification by W. Kloos and K. Schleifer (1975). A variety of CNS species was observed, and their role in the development of pyoseptic infections shown, the contribution of S. epidermidis and S. haemolyticus being the greatest here. Besides S. aureus, S. xylosus was often isolated from purulent foci. A certain specificity in CNS spectrum, related to the hospital profile, was revealed. A brief modified scheme of CNS classification was developed, based on analysis of about 700 strains, in accordance with the classification of W. Kloos and K. Schleifer, that included the tests available for practical laboratories.

Based on the results of clinico-bacteriological and immunological studies carried out in the early neonatal period in 65 neonates afflicted with pyoinflammatory diseases and in their mothers, diagnostic criteria for intrauterine and early neonatal infection were elaborated. The significance played in this process of the character and level of microbial colonization of the amniotic fluid, placenta, labor tract of the mother, intrauterine antigenic stimulation of the fetus, changes in the peripheral blood and inflammatory alterations in the placenta was defined. Clinical, bacteriological and immunological prognostic criteria for the risk of the development of pyoinflammatory diseases in neonates were elaborated.

A study was made of the establishment of biocenosis in the early neonatal period in healthy full-term neonates born to healthy mothers and in children belonging to a group at risk with an aggravated anamnesis but with no history of pyoinflammatory diseases. The study was related to bacterial colonization of the mother, amniotic fluid and placenta as well as to the immune status of the lying in woman and fetus. In 37% of children belonging to the group at risk, the minimal signs of intrauterine infection were discovered.

In the bacteriological survey of 410 patients with purulent mastitis Staphylococcus aureus was found to be the main etiological factor of the disease. In most cases the strains of phage group I, phage type 80 were isolated. In unilateral mastitis during the acute period staphylococci were isolated from the the milk samples taken from the affected mammary gland in 77.4% of cases, and from the milk samples from the healthy mammary gland in 62.3% of cases. The strains isolated from the milk of both mammary glands and the surgical wound were identical. By the time of clinical convalescence staphylococci could be isolated from the milk of the affected and healthy mammary gland in 21.8% and 10.1% of cases, respectively, and from the surgical wound in 31.5% of cases.

Formulae for the calculation of the count of microorganisms isolated from natural bacterial biocenoses of a child's body have been derived. The authors suggest a variant of simplified drip method for the computation of microorganism colonies in solid media. The described method helps cut down the nutrient media consumption at least 3-fold and is time-saving.

A study of the circulation of toxigenic and nontoxigenic diphtheria bacilli was carried out in several carrier state foci under conditions of a natural course of the epidemic process. There were 2623 persons under observation. A total of 32158 analyses were carried out, and 2271 strains were isolated and studied. No formation of the toxigenic variants of diphtheria bacillus as a result of phage conversion was revealed in the foci of carrier state despite the wide spread in them of nontoxigenic lysosensitive cultures capable of acquiring the toxigenic properties under experimental conditions, and of the cultures which had converting corinephages. Thus, autonomy of the circulation of the toxigenic and nontoxigenic diphtheria bacilli occurred in the carrier state foci; the leading role in the change of the diphtheria bacillus type belonged to reinfection.

Over the period 1983-1985, investigators from the Institute of Hygiene and Epidemiology, Prague, and the Central Research Institute of Epidemiology, USSR Ministry of Public Health, Moscow, carried out a joint study of drug resistance in S. aureus strains in relation to their enterotoxigenic properties and phage group specificity. Altogether 277 strains were explored which had been isolated at random from the clinical material from infant and adult inpatients. Most of the isolated strains featured multiple resistance to antibiotics: PNC (77.9%), CMP (52.7%), TET (21.6%), ERY (17.6%) and LIN (11.9%). The strains isolated from infants were most frequently resistant to TET and ERY. No correlation was found between the incidence of antimicrobial drugs resistance and toxigenic properties of the isolated strains.