Staphylococcus aureus is a universal bacterial pathogen, which is able to develop the resistance to new antibiotics, by means of virulence factors, whose main function is the spread of diseases by inhibiting the immune factors of host defense. Its wide spread at in-patient departments and also the presence of clinical probationary wards Staphylococcus aureus, resistant to methicillin at out-patient departments, deprive the doctors of effective means for control of the infection. Complications caused by MRSA lead to hospitalization and indices of lethality. The aim of the paper is to analyze the main factors of S. аureus virulence and ways the of its interaction as a result of etiological and pathogenetic treatment. Complexity of treatment of bacterial infections is determined by alternative ways of prevention and treatment of diseases to which bacteria are not able to develop resistance. Along with general mechanisms that form antibiotic resistance, S. aureus produces many individual virulence factors that model the immune response, affecting the survival of the microorganism. The virulence factors produced by S. aureus are diverse and have the ability not only to cause cell lysis, but also to stimulate tissue rejection and destruction. It is important to determine that many specific factors of virulence caused by S. aureus, have ability to change both congenital and adaptive immune reactions including inhibition of complement activation, neutrophils neutralization, phagocytes inhibition. Strategies for inhibiting virulence factors can range from using small inhibitor molecules or full-fledged antibodies to creating toxoids and virulence proteins. Great interest is focused upon those inhibitors that have cross-reactivity with respect to multiple virulence factors, as well as inhibitors, the main target of which is a global regulator with multi-purpose activity, for example, agr operon. Active research into the specific alternative antivirulent treatments for severe diseases caused by S. aureus can potentially settle a number of problems and difficulties of post-antibiotic era.
Введение. Острые респираторные заболевания занимают одно из ведущих мест среди инфекционных болезней детского возраста. Сегодня большое количество исследований проводится в направлении усовершенствования методов лечения инфекционной патологии, в частности изучения эффективности и расширения возможностей применения в практической медицине бактериоцинов, основным источником которых являются грамположительные бактерии. Бактериоцины представляют собой антимикробные пептиды, обладающие широким противомикробным спектром действия. В частности, Streptococcus salivarius K12 является микроорганизмом, продуцирующим бактериоцины I класса (лантибиотики), способные интенсивно подавлять рост Streptococcus pyogenes, Streptococcus pneumonia, Haemophilus influenza и Moraxella catarrhalis, которые являются основными этиологическими факторами респираторных инфекций у детей. Цель. Изучение эффективности и безопасности применения препарата Бактоблис® (саше) на основе Streptococcus salivarius K12 и витамина D3 в комплексном лечении острых тонзиллитов, риносинуситов, стоматитов и отитов у детей. Материалы и методы. Проведено открытое нерандомизированное клиническое исследование при участии 55 пациентов в возрасте от 3 до 7 лет с острой респираторной инфекцией верхних дыхательных путей (риносинуситы, тонзиллиты), воспалением слизистой полости рта исреднего уха. В основную группу вошли 35 детей, которые в течение 10 дней в комплексном лечении получали Бактоблис® на основе Streptococcus salivarius K12 (SsK12) в форме саше. Группу контроля составили 20 детей, которым назначали стандартную терапию без респираторного пробиотика (SsK12). Оценка эффективности лечения проводилась на основании изучения динамики регресса клинической симптоматики в ходе 10-дневного курсового применения. Результаты. Полученные результаты четко показывают эффективность комплексного лечения детей основной группы - достоверное улучшение течения острого риносинусита, тонзиллита и стоматита (р<0,01) и более быстрый регресс клинической симптоматики. Полученный эффект в виде уменьшения продолжительности заболевания в среднем на 2 дня, скорее всего, реализуется за счет колонизации слизистой ротовой полости и носоглотки штаммом Streptococcus salivarius K12 и вытеснения патогенной микрофлоры. Заключение. Бактоблис® в форме саше способен достоверно уменьшить длительность острой респираторной патологии, а также частоту применения антибактериальных препаратов у данной категории пациентов, что расширяет возможности использования Streptococcus salivarius K12 в комплексном лечении заболеваний дыхательных путей и лор-органов у детей в периоде обострения. Introduction. Acute respiratory diseases occupy one of the leading places among infectious diseases of childhood. Today, a large number of studies is carried out in the direction of studying the effectiveness and expanding the possibilities of using probiotics in practical medicine, particularly lantibiotics. In particular, Streptococcus salivarius K12 is a microorganism that produces the class I bacteriocins (lantibiotics) that can intensely inhibit the growth of Streptococcus pyogenes, Streptococcus pneumonia, Haemophilus influenza, and Moraxella catarrhalis that are significant etiological factors of respiratory infections in children. Purpose. To study the efficacy and safety of using the drug Bactoblis® (sachet) based on Streptococcus salivarius K12 and vitamin D in the complex treatment of acute upper respiratory tract diseases in children. Materials and methods. An open non-randomized clinical study was conducted with the participation of 55 patients aged from 3 to 7 years with acute respiratory infections of the upper respiratory tract (rhinosinusitis, tonsillitis, stomatitis, otitis media). The main group included 35 children, who received SsK12 in complex treatment for 10 days. The control group consisted of 20 children, who were prescribed the standard therapy without probiotic. The children of the main group, along with the main therapy, received Bactoblis® in the form of sachet based on Streptococcus salivarius K12. Evaluation of the effectiveness was carried out on the base of studying the dynamics of regression of clinical symptoms during a 10-day course of use. Results. The obtained results clearly show the effectiveness of complex treatment of children in the main group, which is characterized by a significant improvement of the course of sinusitis, tonsillitis and stomatitis (p<0.01) and is manifested by a more rapid regression of clinical symptoms. The resulting effect in the form of decrease of duration of the disease by 2 days on average is implemented due to colonization of the oral mucosa and nasopharynx with the Streptococcus salivarius K12 strain and displacement of pathogenic microflora. Conclusion. Bactoblis® in the form of sachet is able to reliably reduce the duration of acute respiratory pathology, as well as the frequency of use of antibacterial drugs in this category of patients, which expands the possibility of using Streptococcus salivarius K12 in the complex treatment of diseases of the respiratory tract in children during exacerbation.
У статті розглянуті показання до застосування у клінічній практиці малоінвазивного експрес-методу інтрагастральної рН-метрії у дітей, що дозволяє діагностувати кислотоутворюючу та кислотонейтралізуючу функції шлунка при функціональній диспепсії, а надалі використовувати даний метод як індикатор ефективності антисекреторної терапії та стратифікації диференційованих рекомендацій у плані корекції секреторних порушень при функціональній диспепсії у дітей.
Introduction: Nowadays anti-microbial therapy of ventilator-associated pneumonia caused by is one of the most topical issue as a consequence of widespread multiresistant strains of causative agent and their biological peculiarity of actively formation of resistance to new antibacterial drugs. The aim is to describe modern approaches to therapy of ventilator-associated pneumonia causative agent of which is presented by Pseudomonas aureginosa . Materials and methods: An analysis and summing up of results of scientific investigations described in medical publications concerning the issues of therapy of ventilatorassociated pneumonia caused by Pseudomonas aureginosa was done. Conclusions: Despite the development of modern approaches to anti-microbial therapy of ventilator-associated pneumonia caused by Pseudomonas aeruginosa, which are also concerned with such controversial issues as correct choice of antibacterial drug, its optimal dose, and duration of this therapy, the problem of treatment of hospital-acquired infections of respiratory airways caused by Pseudomonas aeruginosa has been discussable yet and requires the further study.
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