Implant-associated infections are the most costly problem in modern orthopedics due to the continued increase in the occurrence of antibiotic-resistant bacterial strains that requires the development of new effective antimicrobials. A non-randomized, prospective, open-label, with historical control study on the use of combined phage/antibiotic therapy of periprosthetic joint infection (PJI) was carried out. Forty-five adult patients with deep PJI of the hip joint were involved in the study, with a 12-month follow-up after one-stage revision surgery. Patients from a prospective study group (SG, n = 23) were treated with specific phage preparation and etiotropic antibiotics, whereas patients from a retrospective comparator group (CG, n = 22) received antibiotics only. The rate of PJI relapses in the SG was eight times less than that in the CG: one case (4.5%) versus eight cases (36.4%), p = 0.021. The response rate to treatment was 95.5% (95% confidence interval (CI) = 0.7511–0.9976) in the SG and only 63.6% (95% CI = 0.4083–0.8198) in the CG. The odds ratio for PJI relapse in patients of the SG was 0.083 (95% CI = 0.009–0.742), which was almost 12 times lower than that in the CG. The obtained results support the efficacy of the combined phage-antibiotic treatment of PJI.

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Staphylococci are capable of penetrating many hu man tissues and organs, causing superficial and deep purulent infections, respiratory and urinary tract in fections, food poisoning and intoxication. Last years, coagulasenegative staphylococci were the cause of infection in many cases. Infectious agents, namely Staphylococcus epidermidis, Staphylococcus haemolyticus, and Staphylococcus hominis, were detected more often as nosocomial infections. A particular danger of these infections is a high virulence and pathogenicity of bacterial strains and their resistance to various anti biotics. Methicillinresistant staphylococci are espe cially difficult to treat. The correct identification of staphylococci and their sensitivity to antibiotics are important for clinical diagnosis and appointment of adequate drug therapy. Rapid and accurate identifica tion of Staphylococcus species and detection of their sensitivity to antibiotics is quite important. The aim of this study was to study staphylococci isolated in Novo sibirsk from human, animal and environmental sam ples. A collection of 100 staphylococcus strains was analyzed. Staphylococcus species were identified by sequencing the 16S rRNA gene. Eleven staphylococcus species were identified. Among the strains obtained from hospitalized patients, Staphylococcus aure us do Стафилококки способны поражать практически любые органы и ткани организма человека, вызывая поверхностные и глубокие гнойные инфекции, поражения дыхательных и мочевыводящих пу тей, а также провоцировать пищевые отравления и интоксикации. В последние годы участились случаи заболеваний, возбудителями которых оказываются коагулазонегативные стафилококки. Такие виды, как Staphylococcus epidermidis, Staphylococcus haemolyticusb и Staphylococcus hominis значительно чаще выявляются при внутри больничных инфекциях. Особая опасность этих патогенов заклю чается в повышенной вирулентности и патогенности штаммов, а также в их частой устойчивости к различным антибиотикам. Осо бенно трудно поддаются лечению заболевания, вызванные мети циллинрезистентными стафилококками. Правильная идентифика ция стафилококков и их чувствительности к антибиотикам важна для постановки клинического диагноза и назначения адекватной лекарственной терапии. В связи с этим востребованы методы бы строго и точного определения видов стафилококков для оценки их патогенных свойств и наличия метициллинрезистентности. Цель данного исследования -характеризация стафилококков, в том числе и по устойчивости к антибиотикам, изолированных в г. Новосибирске из образцов, полученных от людей, животных и из окружающей среды. Проанализирована коллекция из 100 штам мов стафилококков. Видовая идентификация стафилококков про ведена по результатам секвенирования гена 16S рРНК. Выявлено 11 видов стафилококков. Среди штаммов, полученных от больных из стационаров, доминировали Staphylococcus aureus (79.1 %), Staphylococcus epidermidis составили около 12.5 %. Среди внебольнич ных штаммов S. aureus и S. epidermidis выделены примерно в рав ных соотношениях. Обнаружение к...

Background: The problem of bacterial colonization of implants used in medical practice continues to be relevant regardless of the material of the implant. Particular attention deserves polymeric implants, which are prepared ex tempore from polymethyl methacrylate, for example - duting orthopedic surgical interventions (so-called "bone cement"). The protection of such implants by antibiotic impregnation is subjected to multiple criticisms, therefore, as an alternative to antibiotics, lytic bacteriophages with a number of unique advantages can be used - however, no experimental studies have been published on the possibility of impregnating bacteriophages into polymethyl methacrylate and their antibacterial activity assessment under such conditions.Aims: to evaluate the possibility of physical placement of bacteriophages in polymethylmethacrylate and to characterize the lytic antibacterial effect of two different strains of bacteriophages when impregnated into polymer carrier ex tempore during the polymerization process in in vitro model.Materials and methods:  First stage - Atomic force microscopy (AFM) of polymethyl methacrylate samples for medical purposes was used to determine the presence and size of caverns in polymethyl methacrylate after completion of its polymerization at various reaction  temperatures (+6…+25°C and +18…+50°C).The second stage was performed in vitro and included an impregnation of two different bacteriophage strains (phage ph20 active against S. aureus and ph57 active against Ps. aeruginosa) into polymethyl methacrylate during the polymerization process, followed by determination of their antibacterial activity.Results: ACM showed the possibility of bacteriophages placement in the cavities of polymethyl methacrylate - the median of the section and the depth of cavities on the outer surface of the polymer sample polymerized at +18…+50°C were 100.0 and 40.0 nm, respectively, and on the surface of the transverse cleavage of the sample - 120.0 and 100.0 nm, respectively, which statistically did not differ from the geometric dimensions of the caverns of the sample polymerized at a temperature of +6…+25°C.The study of antibacterial activity showed that the ph20 bacteriophage impregnated in polymethyl methacrylate at +6…+25°C lost its effective titer within the first six days after the start of the experiment, while the phage ph57 retained an effective titer for at least 13 days.Conclusion: the study confirmed the possibility of bacteriophages impregnation into medical grade polymethyl methacrylate, maintaining the effective titer of the bacteriophage during phage emission into the external environment, which opens the way for the possible application of this method of bacteriophage delivery in clinical practice. It is also assumed that certain bacteriophages are susceptible to aggressive influences from the chemical components of "bone cement" and / or polymerization reaction products, which requires strict selection of bacteriophage strains that could be suitable for this method of delivery.

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