A study of antibiotic and disinfectant susceptibility of Elizabethkingia meningoseptica

For the local health service, Elizabethkingia meningoseptica remains a relatively new and little-known pathogen, whereas in many countries of Europe, Asia and other continents it is considered as a potential causative agent of nosocomial infections, especially in premature infants and immunocompromised patients. An analysis of the literature data, as well as our results indicate that E. meningoseptica should be considered as a potential pathogen, which is characterized by a unique profile of susceptibility to antimicrobial agents (AMP) and disinfectants. This article presents the results of a study of susceptibility to AMP and disinfectants of three isolates of E. meningoseptica, isolated during an investigation of an outbreak in one of the perinatal centers of the Russian Federation, where three cases of sepsis with a fatal outcome in premature infants caused by co-infection with Acinetobacter baumannii and E. meningoseptica were recorded between January and February 2016.

[Phenotypic and molecular genetic properties of Escherichia coli clinical strains isolated from patients with urological diseases]

OBJECTIVE

Microbiological and molecular genetic characterization resistance profiles of Escherichia coli strains isolated in a pilot single-center clinical study from patients of the urological department in Yaroslavl in 2016-2017.

MATERIALS AND METHODS

Clinical strains of E. coli (n=18) were isolated from the urine of women aged 23-84 years. The mobility of bacteria, colicinogenicity, and sensitivity to lactobacilli antagonism, biofilm formation, and susceptibility to antimicrobials were evaluated. The antibiotic resistance genes were identified.

RESULTS

The E. coli strains had a wide heterogeneity in mobility, colicinogenicity, and biofilm formation. They were sensitive to Lactobacillus acidophilus antagonism, as well as to nitrofurantoin, meropenem, fosfomycin and the main functional classes of disinfectants and antiseptics, but are resistant to beta-lactams, fluoroquinolones and aminoglycosides. The mcr-1 gene providing resistance to colistin was identified in two strains.

CONCLUSIONS

Analysis of genetic antibiotic resistance determinants revealed the genetic diversity of clinical E. coli strains. The obtained data on the strain sensitivity to antibacterials and disinfectants can be used by clinicians in choosing the optimal antibiotic therapy and treatment of abiotic surfaces in urological departments.

[Is it Possible to Improve Results in the Conservative Treatment Strategy in Patients With Acute Coronary Syndrome?]

Almost 60% of patients with acute coronary syndrome (ACS) without ST segment elevation are not subjected to revascularization procedures. This review analyzes the reasons for the choice of the conservative tactics of patients with ACS. The possibilities of improving outcomes by using modern medicines. Particular attention is given to drugs that affect energy metabolism in cardiomyocytes ischemia and reperfusion, provides data on the effect of L-carnitine on the high-risk markers, and decrease the incidence of adverse outcomes in patients with ACS.

[New approaches in the regulation of blood phagocytes and reduction in the formation of oxygen radicals in patients with heart failure]

AIM

The purpose was to study the effect of actovegin on the formation of reactive oxygen species by blood phagocytes of patients with heart failure and on SK-N-SH neuron necrosis.

MATERIALS AND METHODS

The generation of superoxide anion (O2-*) were recorded on whole blood samples (50-100 μl). Change lucigenin-dependent hemiluminescence determined on a hemi-luminometer "Biotoks-7". As a stimulator of the phagocyte. phorbol ester (PMA, 1 μm) was used. Necrosis of neurons induced by hydrogen peroxide was determined by fluorescence of propidium iodit.

RESULTS

Blood phagocytes of heart failure patients are initially pre-activated (primed). These cells spontaneous generated oxygen radicals. Actovegin dosa-dependent decreased radicals level and radical induced by PMA (1 μm). After PMA maximal inhibitory effect of actovegin observed in doses higher than 2-3 mg/ml. The impact of actovegin on the viability of human SK-N-SH neurons in the presence hydrogen peroxide (100 μm) was studied in vitro. Under these conditions hydrogen peroxide triggered radical-dependent neurons necrosis Actovegin dosa-dependent decreased of neuron death.

CONCLUSION

Actovegin inhibits spontaneous and induced formation of reactive oxygen species generated by blood phagocytes of patients with heart failure. Actovegin suppressed necrosis of human SK-N-SH neuroblastoma cells caused by hydrogen peroxide. It is assumed that actovegin protects_cells of arious organs and tissues, including blood cells and neurons that die as a result of ischemia and inflammation by reducing levels of react.ive-oxygenspecies.

[Calf blood hemodializate reduces neurotoxic effect of hydrogen peroxide on human neuroblastoma cells]

OBJECTIVE

Our aim was to study the effect of calf blood gemodializat on apoptosis and intracellular signaling pathways of neuroblastoma cells SK-N-SH human.

METHODS

Apoptosis was recorded by fluorescent microscopy using Hoechst 33342. Necrosis cells was monitored by propidium iodide. The fluorescence of the cells was recorded on a fluorescence inverted microscope Keyence BZ8100 (Japan). Formation of reactive oxygen species (ROS) in the cells of SK-N-SH was determined using nitroblue tetrazolium by absorbance at 620 nm on a plate reader "Uniplan".

RESULTS

When adding hydrogen peroxide to the background of the calf blood gemodializat been decreasing apoptosis of these cells with 43 to 17% relative to apoptosis in the presence of a hydrogen peroxide. Under these conditions, the calf blood gemodializat significantly reduced ROS formation in human neuroblastoma cells SK-N-SH by the action of hydrogen peroxide. In these cells, we investigated the influence of calf blood gemodializat on apoptosis and intracellular signaling pathway involving mitogen-activated protein kinase (p38MAPK), extracellular regulatory kinase (ERK), phosphatidylinositol 3-kinase (PI-3K) and-Jun-N-terminal kinase (JNK) using their selective inhibitors.

CONCLUSION

It was shown that the mechanism of the protective effect of calf blood gemodializat against peroxide-induced apoptosis in SK-N-SH dominant role is played by p38 MAPK and PI-3K.

[Substances from pyrolised tissues of reptile carcases differently modulate immunity of mammals of both sexes]

Substances with gender action on immunity were detected in water soluble hydrolised matter from reptile carcases. The gender action was shown on isolated blood neutrophils, whole blood and in vivo by the antiviral activity on experimental animals, contaminated with three types of viruses: Herpes simplex type 1, the virus of encephalomyocarditis and the virus of hepatitis of mice. The possible mechanism of the inhibitory action on the male immunity was associated with the protein kinase cascade, including protein kinase C, activated by phorbolmyristate in the cells of the immune system.

ROLE OF MEDICATIONS WITH NEGATIVE CHRONOTROPIC EFFECT IN THE TREATMENT OF PATIENTS WITH CORONARY HEART DISEASE AND HEART FAILURE

The study aim was to assess the importance of adequate administration of medications with negative chronotropic effect in the improvement of clinical course and prognosis among patients with coronary heart disease (CHD) and heart failure. The possibility and appropriateness of combination therapy with β-adrenoblockers (β-AB) and an If channel blocker ivabradine is justified. The authors analyse current real-world trends in the administration and dose titration of these medications among ambulatory Russian patients. Russian doctors need to be more active in the treatment of patients with CHD and heart failure and better understand the need for and benefits of dose titration of medications with negative chronotropic effect, as well as the importance of combination therapy for the improvement of clinical course, prognosis, and quality of life. 

MECHANISMS OF COMBINED ACTION OF ACE INHIBITORS AND CALCIUM ANTAGONISTS IN ARTERIAL HYPERTENSION

This review presents the modern views on the effectiveness of water-soluble angiotensin-converting enzyme (ACE) antagonists and calcium antagonists (CA), as monotherapy or as fixed-dose combination therapy, in the treatment of arterial hypertension (AH). The results of the X-ray structural analysis of crystal ACE-lisinopril complexes suggest a highly selective, strong inhibitory effect of lisinopril on various ACE forms of the hormonal renin-angiotensin-aldosterone system and tissue renin-angiotensin systems. The association between specific action mechanisms and therapeutic effects in hypertension is analysed for a third-generation CA amlodipine. The benefits of a fixed-dose combination medication Ekvator (amlodipine 5 mg plus lisinopril 10 mg) in hypertension are described, including its synergetic protective effects. 

[Genetic determinants of antibacterial resistance among nosocomial Escherichia coli, Klebsiella spp., and Enterobacter spp. isolates collected in Russia within 2003-2007]

Nosocomial bacterial isolates collected within 2003-2004 (n=411) and 2005-2007 (n=422) were highly resistant to cephalosporins III-IV and antibacterials of other groups (aminoglycosides, fluoroquinolons, chloramphenicol, and co-trimoxazole). Genes encoding TEM, SHV, CTX-M, OXA-2, and AmpC types of beta-lactamases (BLs) in the E. coli, Klebsiella spp., and Enterobacter spp. isolates were detected using polymerase chain reaction (PCR). Prevalent CTX-M-type BLs were detected in 85% of the E. coli, 87% of the Klebsiella spp., and 38% of the Enterobacter spp. isolates of the first strain collection and in 94% of the E. coli, 91% of the Klebsiella spp., and 38% of the Enterobacter spp. isolates of the second one. Genes belonging to three subtypes of blacTx-M genes were identified: bla(CTX-M-1) (228 bla(CTX-M-15) and six bla(CTX-M-3) of the first strain collection; 275 bla(CTX-M-15), three bla(CTX-M-3), and one bla(CTX-M-22) of the second one), bla(CTX-M-2) (one bla(CTX-M-5) of the first strain collection and one bla(CTX-M-2) of the second one), bla(CTX-M-9) (17 bla(CTX-M-14) and one bla(CTX-M-9) of the first strain collection; seven bla(CTX-M-14) and one bla(CTX-M-9) of the second one). Three isolates of the first strain collection and one isolate of the second one carried two genes belonging to two different subtypes, i.e., bla(CTX-M-15) and bla(CTX-M-14) simultaneously. The bacterial isolates had high levels of associative resistance to ciprofloxacin, co-trimoxazole, gentamicin, amikacin, and chloramphenicol associated with the resistance gene cassettes aadA1, aadA2, aadA5, aadB, aacA4, aac(6')Ib; dfrA1, dfrA5, dfrA12, dfrA17, cmlA1, ereA2, and catB8 in the class 1 integrons and the resistance gene cassettes dfrA1, sat1, and aadA1 in the class 2 integrons.

[Genetic environments of bla(CTX-M) genes located on conjugative plasmids of Enterobacteriaceae nosocomial isolates collected in Russia within 2003-2007]

The study showed that bla(CTX-M) genes were present in the genomes of 71% of cephalosporin resistant Enterobacteriaceae nosocomial isolates (n=833) collected in Russian hospitals within 2003-2007, including 91% of E.coli, 90% of Klebsiella spp., 38% of Enterobacter spp., 31% of Citrobacter spp. (n=9), and 36% of the other Enterobacteriaceae species. The genes belonging to the following subtypes (clusters) were identified: bla(CTX-M-1) (529 bla(CTX-M-15) genes; 25 bla(CTX-M-3) genes; 1 bla(CTX-M-22) gene, 1 bla(CTX-M-23) gene, and 1 bla(CTX-M-34) gene); bla(CTX-M-2) (1 bla(CTX-M-2) gene, and 4 bla(CTX-M-5) genes), and bla(CTX-M-9) (2 bla(CTX-M-9) genes, and 28 bla(CTX-M-14) genes). It was shown that bla(CTX-M) genes were located on high-molecular weight (60-160 bp) conjugative plasmids belonging mainly to the incompatibility groups IncF, IncL/M and IncA/C (bla(CTX-M-15) gene); IncL/M(bla(CTX-M-3) gene); and IncF, IncL/Mand IncI1-ly (CTX-M-14 gene). The gene environments of bla(CTX-M) genes were shown specific for the subtype of the genes. A mobile genetic element ISEcp1 (in some cases deleted or inserted by IS26, IS1, IS10, resTn2, or resTn3 sequences, in direct or reverse position) were detected upstream of bla(CTX-M-3), bla(CTX-M-14), and bla(CTX-M-15) genes. A special characteristic was the sequence between ISEcp1 and bla(CTX-M) gene: 48 bp for bla(CTX-M-15) (except 1 E.coli isolate having such a sequence deleted by 3 bp); 127 bp for bla(CTX-M-3); 42 bp for bla(CTX-M-14). Downstream of bla(CTX-M) and bla(CTX-M-15) genes in the major bacterial isolates orf477 mucA and Delta orf477-Delta mucA sequences were detected respectively. Two isolates had additional Delta orf3 insertion inside of Delta orf477-Delta mucA sequence. Insertion sequence IS903 (intact or deleted) was detected downstream of bla(CTX-M-14) gene. Unlike the others, bla(CTX-M-2) and bla(CTX-M-9) genes were located inside of ISCR1 mobile element, downstream of class 1 integron and orf513 sequence.

[Pathogenetic aspects of intoxication syndrome in the clinical picture of infectious diseases]

Pathogenetic mechanisms of intoxication syndrome in patients with infectious diseases are considered in the context of current general pathologic concepts. All major components of pathogenesis are discussed in terms of the authors' original observations and literature data. Bacterial endo- and exotoxines are believed to be the main inductors of intoxication. Results of original studies suggest an important contribution of Shiga toxins to specific clinical manifestations of infectious diseases. A novel interpretation of the role of intoxication syndrome in the development of infectious diseases is proposed.

[Calcium 2+ Response of Lymphocytes to Standard Test-Substances in Patients With Ischemic Heart Disease and Heart Failure]

Changes of [Ca 2+]i were studied in peripheral blood lymphocytes of patients with ischemic heart disease and heart failure. Basal [Ca 2+]i and its changes under action of mitogenes (PHA, Con A; 10 mcg/ml), butylhydroxyquinone (BHQ; 9-14 mcM) and arachidonic acid (3-10 mc/M) were measured. Patients with heart failure had pronounced changes of kinetics and amplitude of Ca 2+ response of lymphocytes to mitogenes, significantly higher amplitudes of responses to BHQ (in patients with stage IIB and III heart failure), as well as additional increment of [Ca 2+]i in response to rachidonic acid during action of optimal concentrations of BHQ. This data allowed to propose presence of supplementary inositol triphosphate insensitive calcium depots in cells of patients with heart failure. Furthermore it was possible to assume lowering of sensitivity of Ca 2+ ATP-ase of plasmatic membranes to its natural regulators.

[Regulating activity of plasma membranous Ca2+ channels in PC-12 pheochromocytoma cells with chemicals and pharmaceutic agents]

The activity of the voltage-operated Ca2+ channels (VOC channels) and store-operated Ca(2+)-channels (SOC channels) was studied on rat pheochromatocytomic cells PC-12 by using the fluorescence calcium dye Fura-2. The VOC channels were transferred in their open state by depolarizing the plasma membranes of the cells through addition of high KCl concentrations (50 mM). The SOC channels were activated by treating the cells with tapsigargine, a special inhibitor of Ca2+ ATPase in the intracellular Ca2+ stores. Verapamil effectively inhibited the activity of the VOC channels (IC50 = 0.6 micron), but failed to affect the SOC channels. Arachidonic acid reduced the level of [Ca2+]-induced TG (200 nM) at a concentration of 3-10 microns). The movement of Ca2+ along the SOC channels was electrogenic. The depolarization of the plasma membrane of PC-12 cells caused no release of Ca(2+) from the intercellular Ca2+ stores. It is concluded that PC-12 cells are a suitable model to study the activity of different Ca2+ channels and search for chemical compounds that affect the potential-dependent and potential-independent Ca2+ channels.

[The clinical and experimental evaluation of the pharmacological efficacy of the new antidiarrheal preparation ftorazol]

A clinical trial of the new antidiarrheal drug of antisecretory action fluorasol was studied with patients with salmonellosis and food toxic infections. 65 patients had moderate and 53 severe symptoms. It was established that fluorasol was superior to basic rehydration therapy in relieving diarrheal syndrome irrespective of severity of acute intestinal infections. Clinical effects on intoxication were not registered. Antidiarrheal activity of fluorasol was confirmed on the model of experimental diarrhea on isolated loops of the rat small intestine. Liquid secretion into the lumen of small intestinal isolated loops in the presence of fluorasol substance fell twofold compared to control loops.

[The effect of sodium nitroprusside and nitro-containing vasodilators on rat liver microsomal mono-oxygenases]

It has been shown in vitro that sodium nitroprusside (SN) causes a concentration-dependent suppression of the enzymatic activity of aminopyridine demethylase-APDM(IC50 = 1.86 x 10(-4) M) and ethoxycoumarin O-deethylase-ECOD(IC50 = 1.46 x 10(-4) M) in hepatic microsomes of Wistar rats, which is related to different isoforms of cytochrome P-450. The inhibiting effect of other nitro compounds (nitroglycerin and isosorbide dinitrate) in relation to APDM is less marked than that of SN. These compounds have practically no effect on ECOD activity. It is assumed that the degree of the inhibiting effect of SN, nitroglycerin, and isosorbide dinitrate is connected with the mechanism of NO release.

[Creation of genomic DNA libraries for Pseudomonas mallei and Pseudomonas pseudomallei]

The genomic libraries of P. mallei and P. pseudomallei species were constructed in Escherichia coli. The chromosomal DNA of P. pseudomallei C-141 strain has been cloned into the cosmid vector pHC79 and the broad host range plasmid vector pES154. The chromosomal DNA of P. mallei [symbol: see text]-5 strain has been cloned into the plasmid vector pSUP202. The recombinant clones of the genomic libraries were screened by the enzyme-linked immunoadsorbent assay (ELISA) to detect the production of Pseudomonas antigens: 28 clones were positive. Twelve recombinant strains demonstrated specific antigenic determinants of P. mallei and P. pseudomallei by immunoblotting. Cloned proteins of P. mallei and P. pseudomallei have molecular weights from 30 to 70 kD. A new method for introducing foreign genes into Pseudomonas genomes is offered. P. mallei strains with the chromosomally integrated plasmids pSM are universal recipients for ColEI-based cloning vectors.

[Effect of induction of enzymes of the cytochrome p-450 system on the survival of rats after acute hemorrhage]

The effect of acute hemorrhage on the functional status of microsomal cytochrome P-450-dependent hepatic monoxygenases and the impact of induction of these monoxygenases on the survival of posthemorrhagic male Wistar rats. Acute blood loss of the rats, which caused 50% deaths led approximately to a double decrease in the hepatic activity of 77-ethoxycoumarin-O-deethylase (ECOD). Induction of hepatic monoxygenases by phenobarbital in a dose of 80 mg/kg for 3 days, which caused a 2.4-fold increase in the activity of ECOD as compared with the controls, prolonged the survival rate of posthemorrhagic rats from 50 to 85%.

[The effect of Sandimmun on the rate of oxygen consumption by lymphocytes]

Experiments on male Wistar rat thymocytes have demonstrated that cyclosporin A, an active substance of the immunodepressive agent sandimmune given in concentrations of 1 to 10 micrograms/ml, has no effects on cellular oxygen consumption rates measured by the polarographic technique by using a Clarke electrode. At the same time cyclosporin A suppressed thymocyte respiration stimulated by the oxidative phosphorylation release 2,4-DNP (40 micrograms/M) by 18 and 56% when given by concentrations of 2 and 10 micrograms/ml, respectively. The relationship between the adverse effects clinically observed and the findings was also examined.

[Pseudomonas mallei and Pseudomonas pseudomallei: introduction and maintenance of natural and recombinant plasmid replicons]

Comparative analysis of recipient activity of Pseudomonas mallei, Pseudomonas pseudomallei, and Pseudomonas cepacia strains towards naturally occurring and recombinant plasmid replicons was carried out. Autonomic broad host range vector plasmids based on RSF1010(IncQ) and pSa(IncW) replicons as well as integrative vectors based on pSUP202(Co1E1) replicon have been constructed. The study has shown that naturally occurring plasmids RSF1010(IncQ), pSa(IncW), R15(IncN), and RP4(IncP) are being efficiently transferred and stably maintained in investigated Pseudomonas strains. However, recombinant plasmids with the mini-replicon pSa which are stable in Escherichia coli have shown segregative instability in Pseudomonas strains, whereas derivatives of plasmid RSF1010 demonstrated different stability depending on the type of insertion. Plasmid pSUP202 derivative integrative vector pSM525 is efficiently introduced and stably maintained in P. mallei C-5 strain. Two vector systems for genetic manipulations in P.mallei and P.pseudomallei cells have been developed.

[Corneal wound healing in rabbits as affected by substances changing the cyclic nucleotide level]

A rabbit corneal deepthelization model was used to study in vivo the effects of agents changing the level of cyclic nucleotides on the time of its corneal epithelial wound healing. Cholera toxin (CT) and thermostable E.coli toxin (ST toxin) were employed as agents elevating the level of cAMP and cHMP. The studies showed that a healing process in rabbits could be divided into 4 periods, depending on the epithelization rate. CT instilled in doses of 0.25-2.00 micrograms per year reduced the healing of an epithelial defect by 10 hours, increased the epithelization rate 2-fold at hours 4 to 20, but failed to affect in the remaining periods. It is suggested that by elevating the intracellular cAMP level in this period, CT accelerates migration of epithelial cells, while ST toxin increasing the level of cHGP fails to affect the time of corneal wound epithelization. It is concluded that it is promising to search for new drugs for accelerating the healing of corneal wounds among the agents elevating the level of intracellular cAMP.

[The effect of sandimmun on the activity of mixed-function mono-oxidases in the liver microsomes]

The effects of the immunodepressant--the drug sandimmune--on hepatic microsomal monooxygenase activities were studied. The agent was found to produce some inhibiting activity against hepatic microsomal 7-ethoxycoumarine deethylase in male Wistar rats in vitro and in vivo experiments. When given in a dose of 50 mg/kg, sandimmune produced no statistically significant effect on the duration of hexanal-induced sleep in mice. The findings suggest that the agent has slight effects on the tested activities.