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Objective - to study the species composition of microflora and its sensitivity in patients with odontogenic maxillary sinusitis. The study included 230 patients of both sexes aged 18 to 70 years, who were treated at the Moscow Regional Scientifics Research and Clinical Institute named after M. F. Vladimirsky with a diagnosis of Odontogenic maxillary sinusitis. Of these, there were 155 patients with odontogenic sinusitis, complicated by perforation of the maxillary sinus and the presence of an oro-antral fistula, and 75 patients with maxillary aspergillosis. All patients underwent microbiological examination of smears and flushes from the maxillary sinus cavity with the determination of the species composition and antibiotic sensitivity. In the majority of the patients with perforative forms of odontogenic maxillary sinusitis, coccal flora (streptococci and various species) was detected, in a smaller number compared to it - facultative and obligate anaerobes, pathogenic fungi (Candida). A comparative analysis of the microflora, depending on the duration of the maxillary sinus perforation, showed that the rhinogenic microorganisms (Moraxella spp.) were found only in intraoperative perforations (up to 20% of cases). The presence of obligate anaerobes (Fusobacterium spp. Bacteroides spp.) was typical for long-existing perforations. In patients with maxillary aspergillosis facultative and obligate anaerobes were found less frequently and in a smaller variety than in patients with perforative maxillary sinusitis. There were no cases of sinus contamination by pathogenic fungi of the genus Candida in this group. At the same time, rhinogenic microgranisms (Moraxella spp.) were detected with a higher frequency (up to 27.3%) in this group of patients.

The Purpose of the Study: to evaluate the effect of different types of direct current transcanal effects on the root canal microbiota. The study involved 91 volunteers aged 18 to 65 years, in 48 (53%) no periapical lesions were detected, in 43 (47%) periapical lesions. For determination of the optimal parameters of dosage an apex-phoresis, that provides antibacterial effect, clinical strains the facultative anaerobic of bacteria was used, after collection from root canal of teeth. The most pronounced antimicrobial action in which an electrode placed in the cavity of the tooth is connected to the plus of a current source - are transcanal anodalgvanization and apex-phoresis. For transcanal anodalvanization, these are copper ions, and for apex-foreses, a combination of silver ions and copper ions. Both methods showed high antibacterial activity against all representatives of anaerobic microbiota. The obtained data are confirmed with a molecular and genetic method of identification of the hardly cultivated virulent anaerobic bacteria using the diagnostic kit for PCR 'Multident-5'.

A wide spectrum of aerobic-anaerobic associations were found at bacteriological examination of 138 samples of the middle urine portion from 46 healthy women aged 17-25 years (22 sexually inactive and 24 active). Facultative-anaerobic (corinebacteria and coagulase-negative staphylococci) and non-clostridial anaerobic bacteria (peptococci and propionibacteria) predominated in both groups. The majority of facultative anaerobic bacteria had marked adhesive and antilysosyme activity indicating a pathogenic potential. Experimental and clinical trials are necessary to study the role of non-clostridial-anaerobic bacteria in development of acute and chronic infections of the kidney and urinary tract.

The liquid phase of different units of an underground gas storage (UGS) in the period of gas injection was studied with respect to its hydrochemical composition and characterized microbiologically. The presence of viable aerobic and anaerobic bacteria was revealed in the UGS stratal and associated waters. An important source of microorganisms and biogenic elements in the ecosystem studied is water and various technogenic admixtures contained in trace amounts in the gas entering from the gas main in the period of gas injection into the storage. Owing to this fact, the bacterial functional diversity, number, and activity are maximal in the system of gas treatment and purification and considerably lower in the observation well zone. At the terminal stages, the anaerobic transformation of organic matter in the UGS aqueous media occurs via sulfate reduction and methanogenesis; exceptionally high rates of these processes (up to 4.9 x 10(5) ng S(2-)l(-1) day(-1) and 2.8 x 10(6) nl CH4 l(-1) day(-1), respectively) were recorded for above-ground technological equipment.

The microbic pattern of osteomyelitic foci were analyzed in patients with chronic osteomyelitis on the AB Expression Analyzer by the 'BioMerieux" anaerobic cultivation and identification system (France). The osteomyelitis-focus microcenosis was shown to be of the mixed anaerobic-aerobic nature. Anaerobic microorganisms were isolated in 65.4% of examined patients and made 34% of the isolated bacterial cultures, which is indicative of an important role of anaerobes in the development and persistence of the purulent-inflammatory process in chronic osteomyelitis. Thus, it is feasible to prescribe the antibacterial drugs, which are active in respect to both aerobic and anaerobic bacteria.

Analytical, research and design efforts were made to modify the technology of anaerobic fermentation of plant and animal wastes. Results were publication of a register of wastes of a middle size Russian town, development of a simulator of natural food wastes, and development and testing of a laboratory prototype of original system for anaerobic degradation of natural food wastes. It was shown that association of Clostridia and lactobacilli is best to initiate and implement the first phase of biodegradation of natural wastes.

A method of postoperative treatment of the anaerobic infection of the lower extremity soft tissues is proposed which consists in the wide opening of the wounds with a simple device. Fixation of the extremity in the device is provided by the intracutaneously conducted and strained extension wires. Due to the effect of decompression of the tissues, gaping wounds and extension of the skin margins, there appear conditions for subsiding the inflammation, effective control, management of the wounds and closing of them by secondary sutures to form a linear cicatrix. The authors succeeded in shortening the time of preparing the wound for closure and obtaining better results.

Under analysis are specific features of the clinical course and treatment of infectious complications of the abdominal wall wounds in 209 patients after destructive forms of appendicitis. The microflora of the purulent wound contained gram-negative bacteria in combination with anaerobic nonclostridial flora. The electrochemically activated solution of potassium chloride EHAR-anolit and the endoscopic method were used in complex treatment of the purulent wounds. The recommended method of treatment makes the period of healing the wounds shorter and improves the results of treatment.

The specific features of the development and natural history of nonclostridial anaerobic infection (NACI) were studied in 125 cancer patients with various site tumors. It was shown that after surgery for malignant abdominal and genital tumors, NCAI might develop in the late postoperative period despite antibacterial antianaerobic prevention and even long-term antianaerobic therapy. NCAI treated with antianaerobic therapy was found to run long with aggravations and remissions in patients undergone surgery and drug therapy for genital cancer. Radiation therapy is a risk factor for NCAI in patients with malignant genital neoplasms. The risk factors for NCAI in skin cancer patients are tumor ulceration, second infection, and resolution. The most severe problem is likely anaerobic bacteremia in cancer patients. Anaerobic bacteremia appears to be more common than we thought and this issue requires further in-depth study.

The paper reviews recent-years' papers and the data of their own investigations on a role of obligate anaerobic microbes in obstetric and gynecological abnormality. The fact that secondary pelvic inflammatory processes caused chiefly by non spore-forming anaerobes is ascertained. There is evidence that obligate anaerobic bacteria are involved in the abnormality directly unassociated with the development of an inflammatory process: preterm labor, premature discharge of amniotic fluid, intranatal fetal hypoxia, respiratory distress syndrome and hyaline membrane disease of the premature newborn. Among vaginal infections the key role is played by bacterial vaginosis which is, from the pathophysiological point of view, now a severe derangement of the vaginal environment system with greatly prevalent obligate anaerobic bacteria and without lactoflora. Complications associated with this abnormality are noted.

The etiological pattern of non-clostridial anaerobic infection, its natural history and drug therapy in patients with its various types were studied and analyzed at the Surgery Research Center, Russian Academy of Medical Sciences. Peritonitis and cholangitis were examined in detail. Multimodality treatment of patients with acute peritonitis caused by a combination of aerobic and anaerobic pathogens by using hyperbaric oxygenation and therapy with directly acting antibiotics was found to enhance its efficiency, decrease therapy duration, prevent inflammation progression, and reduce mortality rates from 25.64 to 8.8%. The application to the techniques of preliminary decompression and the developed regimens of antibacterial therapy and hyperbaric oxygenation in the multimodality treatment for suppurative cholangitis noticeably yielded better therapeutical results, reduced mortality rates from 5.7 to 0% and these patients' hospital stay.

The authors had 80 patients, most of them (90%) of an old age, with anaerobic paraproctitis. Delayed hospitalization was encountered in 62 cases, in 16 of these cases an erroneous diagnosis had been established. Severe concomitant diseases complicated the course of anaerobic paraproctitis in 80% of cases (in each group of three patients one had diabetes mellitus). The authors describe characteristic clinical manifestations and the course of various forms of anaerobic paraproctitis, the results of bacteriological examination, and the order in which the surgical treatment is applied. They suggest a scheme of drug therapy which is maximally approximated to cleansing of a microbial cenosis, including ultraviolet irradiation of the blood. All these measures allowed the mortality rate to be decreased from 33.3% to 17.7%.

A method of active outstripping incisions with special reference to the localization of the primary anaerobic focus and possible pathways of the spreading of purulent exudate is proposed on the basis of experiences with surgical treatment of 14 patients with acute anaerobic paraproctitis and investigations of topographical-anatomical localization of cellular spaces in the pararectal area.

For the treatment of patients with chronic and exacerbated periodontitis trichopol and lincomycin were used as well-known effective antibacterial drugs in anaerobic non-clostridial infection. Zinc-eugenol paste was added. The results were favourable.

Qualitative and quantitative composition of associations of the agents of odontogenic infection were studied making use of present-day bacteriologic methods and of analysis of the microflora sensitivity to trichopol and nitazole, imidazole derivatives. The microflora was found to be represented by associations with the predominance of obligate and facultative anaerobes. The anaerobes were found highly sensitive to trichopol, both in vivo and in vitro, and even more so to nitazole, the drug manufactured in this country.

Based on clinical observations of pyo-necrotic lesions of the foot in patients with diabetic mellitus and on an analysis of their personal operations performed on these patients the authors support the tendency to local necrotomies. Two original operations are proposed: ablation of the great toe with a preliminary transection of the tendon of the long flexor and radical operation of the deep phlegmon of the foot with the dissection of plantar aponeurosis and short flexors of the toes. These methods allow the general amount of amputations and lethality to be decreased.

In 12 patients with anaerobic sepsis, extracorporeal connection of donor spleen, its sections and transfusion of perfusates of xenospleen were used in the complex treatment. A positive result--reduction of intoxication, improvement of general state, normalization of immunologic indices--has been obtained.

A tampon made of the new spongy polyvinyl-formal AQUIPOR 3500/40 is suggested for quantitative studies of mixed anaerobic-aerobic microflora. Comparison of the adsorption characteristics, the preservation of the tested pathologic material during the collection and transportation of the material, and the potential antibacterial characteristics of the suggested tampon and the traditional cotton wool tampons has shown the advantages of the new tampon, that permits standardization of the investigation by the quantitative bacteriologic method and preserves both aerobic and anaerobic microorganisms viable. This tampon may be used in studies of purulent wound and periodontal pocket microflora.

A patient with penetrating wound of the eye is described, whose wound has been contaminated with anaerobic infection. Clinical picture of anaerobic panophthalmitis has been rather typical, with the infection penetrating into soft tissues of the orbit. Evisceration of the eyeball was performed. Multiple-modality treatment was carried out. The infectious process has not progressed beyond the orbit. The diagnosis has been confirmed bacteriologically.

Under analysis is an experience with the treatment of 78 patients with various purulent diseases of soft tissues caused by non-clostridial anaerobic microorganisms in a pure form or in combination with aerobic microflora treated with using low frequency ultrasound. The ultrasound was found not to alter the antimicrobial properties of antibacterial drugs. The degree of bacterial dissemination of the wounds was reliably lower. By the end of the treatment (on the 10-11th days) no growth of microflora was found in 25.7% of the examined patients. The sensitivity of anaerobic microorganisms to antibiotics not only became higher in the process of treatment with ultrasound but there appeared strains sensitive to other antibiotics.

The authors had under observation 318 patients who were subjected to operation and suffered from various inflammatory diseases of the bile tract; perivesical and cholangiogenic abscesses of the liver were found in 33 of them. Bacteriological tests of the contents of the abscesses demonstrated most frequently the presence of Bacteroides fragilis as a monoculture in cholangiogenic abscesses and associations of anaerobic and aerobic bacteria in perivesical abscesses. Early operation with obligatory consideration for the anaerobic component of the microflora is recommended.