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Microbiological landscape at pyo-inflammatory disease
most immunization vaccine recipients and is designed to the average by the immunological activity of the child.
According to our research in the vaccination of children undergone sepsis assessment of immunity against vaccine-preventable diseases has revealed the inadequacy of the immune response to antigens introduced in all surveyed groups of children, reflected in the high frequency and low titers of seronegative results. As a consequence, this category of children can make risk data on the incidence of infections, breaking prosperous epidemiological situation in the population. This dictates the need for control over the intensity of post-vaccination immunity to these infections in these children, as they are not allocated to the risk by an inadequate (not effective) vaccination.
The effectiveness of vaccination of this category of children is caused by the influence of many factors - ante-intranatal and postnatal, registration which is necessary for a rational choice of further tactics of different immunization antigens. The necessary and the main condition for effective immunization of this category of vaccinated children is the
individual approach. The immunological individualization of vaccination is correction of the immune response to vaccines using different means and methods for immunization with the aim of producing a sufficient immune at each immunized human. It is possible to use different doses and schedules of vaccination and additional means of immunomodulation of the immune response for this correction. The findings suggest the need to develop approaches to improve the activity of the pediatric service by individualization immunization in this category of children.
Conclusions.
1. Immunization of children who undergone sepsis against diphtheria and tetanus in the standard calendar dates of preventive vaccinations, there was a high frequency of seronegative results and low antibody titers.
2. The children who undergone from sepsis it was identified the most significant range of risk factors influencing the formation of seronegative and the low responses to vaccination.
References:
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2. Briko N.I. Assessment of the quality and effectiveness of immunization // J. Physician. - 2012. - №12. - P. 57-75.
3. Galitskaya M.G., Namazova-Baranova L.S. Features of vaccination of children with chronic diseases // J.The physician -2012. - P. 25-30.
4. Immunoprophylaxis of infectious diseases in Uzbekistan // Sanitary norms, rules and hygienic standards of the Republic of Uzbekistan (San PIN)№ 0239-07 Supplement №2 - Tashkent, 2013 - 28 p.
5. Lviv II Improving the efficiency of active immunization against diphtheria and measles in children with the syndrome of violations of anti-defense: Dis. ... PHD. - M., 2004. - 162 p.
6. Harith S.M., Chernyaeva T.V., Lakotkina E.A., Voronin O.L. The tactics of immunization of weakened children // Handbook for practitioners - St. Petersburg., 2007. - 112 p.
Muminova Nigora Hairitdinovna, Associate Professor of the Tashkent Institute of postgraduate training of doctors, Republic of Uzbekistan
E-mail: [email protected]
Microbiological landscape at pyo-inflammatory disease
Abstract: In the postnatal period there is an activation of opportunistic microflora owing to weakening of protective forces of an organism. Developing of inflammatory postnatal diseases is promoted by the following factors: change of a biocenosis of a vagina, a condition of an immunodeficiency at women by the end of pregnancy, character of a course of childbirth, existence of a wound surface (soft fabrics of the patrimonial channel, a uterus); horioamnionit in childbirth.
Keywords: pyo-inflammatory disease, microorganisms, pregnancy.
Pyo-septic diseases (PSD) continue to be one of the ac- gynecological nosology. After cesarean section operation 60% tual problems of modern obstetrics. The introduction of ob- of postpartum women there some form of septic diseases. stetric practice over half a century ago, antibiotics contributed From septic obstetric complications worldwide die every
to a sharp reduction in the frequency of postpartum infectious year about 150000 women. Septic complications in the post-diseases. However, in the last decade around the world are see- partum period, as the cause of maternal mortality continue to ing an increase of postnatal infections. The frequency of septic lead, ranking 1-2 place, sharing it with obstetric hemorrhage diseases in postpartum women up to 10% of all obstetric and [1; 3].
Section 7. Medical science
Predisposes to the development of an infectious process, many pregnancy complications: anemia, preeclampsia, placenta previa, pyelonephritis. The above-mentioned invasive methods of investigation status of the fetus, surgical correction of cervical incompetence increase the risk of postpar-tum infectious diseases.
In 9 out of 10 cases of puerperal infection as such transmission path does not exist, since the activation of its own pathogenic flora. In other cases, infection occurs outside hospital strains resistant in violation of the rules of aseptic and antiseptic. It should be emphasized as a relatively new way of infection — intra-amniotic associated with the introduction of invasive obstetric practice research methods (amniocentesis fetoscopy, cordocentesis).
The aim of our study was to investigate microbioceno-sis vagina and cervix in pregnant and postpartum women with the pyo-septic diseases (PSD) and working conditions the starting antibiotic therapy in pregnant and postpartum women at high risk of generalization of infection.
Materials and methods: The research is based on clinical and laboratory examination of 122 pregnant and postpartum women with NHS with varying degrees of generalization of infection were divided two groups:
— 1 group consisted of 98 women with Pyo- septic diseases treatment for our proposed algorithm, comprehensive diagnosis and treatment;
— In the 2nd group — 24 women treated with PSD traditional ways.
Microscopy was carried out by a conventional method, staining smears performed Gram. Linked immunenzyme analysis (ISA) was performed on «Labsystem Multiskan MCC/340» (Finland), which allow op-mined by specific antibodies IgG and IgM-antibody using the immunenzyme test system of the company "Vector-Best" (Russia) and «Human» (Germany).
The research is based on clinical and laboratory examination of 122 pregnant and postpartum women with PSD varying degrees of generalization of infection were divided two groups:
— 1 group consisted of 98 women with Pyo- septic diseases treatment for our proposed algorithm, comprehensive diagnosis and treatment;
— In the 2nd group — 24 women treated with PSD traditional method.
Microscopy was carried out by a conventional method, staining smears performed Gram. Linked imunofer-mentny analysis was performed on «Labsystem Multiscan MCC/340" (Finland), which allowed to determine specific antibodies IgG and IgM-antibody by enzyme immunoassay system company "Vector-Best" (Russia) and «Human» (Germany).
Results and discussion:
The criteria for evaluation of contamination were selected the following indicators: the average amount of leukocytes in the field of view, the type of flora, abundant flora.
The growth of microorganisms was observed in 1-group — 95 (96.9%) of pregnant women, all pregnant women 2 groups, indicating that the growth of contamination of the vagina and of course on the state of the microbial landscape of the cervical canal, which affects the process of in-trauterine infection of the fetus.
In the first group from the contents of the lower tract secretions were identified 248 strains of microorganisms.
The two groups were seeded mainly facultative anaerobes. Most of the family group consisted of intestinal bacteria: E.coli in 55 crops, enterokokki- 35, Klebsiella-25. It should be noted that these pathogens were sown in patients with PSD combined urinary tract infection (UTI) in the acute phase or patients are chronic carriers.. These women pointed to episodes of UTI before and during the current pregnancy. Taking into account the history of the previous and current pregnancy and the type of agent in septic conditions make it easier to assign the appropriate antibiotic, and also monitor the progress of treatment, especially if the woman came out of the house in the postpartum or postoperative periods.
The second frequency band is also common pathogens in gold amounted to 21 (21.1%) and Staphylococcus koagulo-zanegative in 27 (28.4%) cases. These pathogens were often found in patients who received acute respiratory infections, with community-acquired pneumonia, with prenatal outpouring of water and made up 21.1% and 16.6% and 16.6% and 12.5% respectively in the two groups.
Also non-haemolytic streptococci were sown in two groups with a shutter 29.4% and 8.3%, a — haemolytic streptococcus 20% and 12.5%, streptococc group B occurs at 11.5% and 8.3% in the two groups, respectively. In the analysis of pathological cases, it was found that these bacteria are found mainly in patients admitted to the postpartum period, where a history of childbirth, women indicated prenatal outpouring of water, as well as during their current pregnancy was complicated by repeated threats of abortion, polyhydramnios or oligohydramnios, indicating the presence of recurrent infections.
Yeast fungi of the genus Candida Albicans were sown in 23.1% and 16.7% of crops. These were mostly patients who conducted several courses of antibiotic therapy, were either no or little-tive effectiveness. Given the presence of the pathogen, we will include in the complex treatment of fungicides and probiotics.
97 and 59 women were tested for infection TORCH-infection enzyme immunoassay method. In cases where a patient with PSD picture of the had viral aggression, we were determined to confirm the diagnosis IgM form in other cases, were tested for chronic (IgG).
According to the frequency of occurrence of the TORCH infections stood herpes simplex virus (HSV), which has been identified in the two groups of 80.4% and 69.4%, respectively. The chronic form of chlamydia and ureaplasma almost 3 times more than was revealed in patients of group 1 compared with group 2. Gardnerella deemed opportunis-
