Saratov JOURNAL of Medical and Scientific Research

Bondarenko A.S.

Saratov State Medical University n.a. V.I. Razumovsky, Deputy Dean of Department of General Medicine and Department of Clinical Psychology

Bioflm formation by Staphylococcus strains isolated from various biological materials at infectious complications following total knee replacement

Year: 2019, volume 15 Issue: №2 Pages: 261-266
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Bondarenko A.S., Mamonova I.A., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

Objective: to study Staphylococcus spp. Strains bioflm forming ability in vitro. These strains are infectious agents for implant-associated infection in patients following total knee replacement depending on the biomaterial under study. Material and Methods. Bioflm forming ability in vitro of 275 Staphylococcus spp. strains has been studied. Bioflm formation was performed using modiefed method of G. D. Christensen. Results. Bioflm forming ability was discovered in 51.2 % of the studied strains, at that it was reliably (p<0.05) higher forcoagulase-positive staphylococci compared to coagulase-negative ones. Staphylococcus strains isolated from sonication fuid obtained after removed prothesiscom- ponents ultrasonication and soft tissue bioptates were chatracterised with high ability for bioflm forming. This ability was reliably (p<0.05) higher than in strains isolated from wounds and aspirate. Interspecies diferences were observed in a group of strains isolated from bioptates: optical density of the S. epidermidis stains extracts was reliably (p<0.05) higher than that of S. aureus strains. Conclusion.Bioflm forming ability of Staphylococcus spp. strains isolated from patients with implant-associated infection depends on the biomaterial under study thus defning the most informative methods of microbiological study.

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The methods of deep periprosthetic infection diagnostics in the area of knee joint

Year: 2018, volume 14 Issue: №3 Pages: 607-610
Heading: Traumatology and Orthopedics Article type: Review
Authors: Shpinyak S.P., Babushkina I.V., Maksyushina T.D., Galashina E.A., Chibrikova Yu.A., Bondarenko A.S., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The data on the methods and promising areas of investigations potent to improve diagnostic tactics in patients with infectious complications after total knee replacement is presented.

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The role of skeletal tissue remodeling markers in the patho-genesis of implant-associated inflammation after primary knee arthroplasty

Year: 2018, volume 14 Issue: №3 Pages: 515-518
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Galashina Е.А., Bondarenko A.S., Ulyanov V.Yu., Klimov S.S.
Organization: Saratov State Medical University
Summary:

Aim: to reveal certain mechanisms of the pathogenesis of implant-associated inflammation by the level of resorption and bone tissue genesis markers in patients who underwent primary knee arthroplasty. Material and Methods. Main group consisted of 40 patients with implant-associated inflammation; first comparison group — of 20 patients with primary aseptic loosening of knee joint implant components; second comparison group — of 20 patients who underwent primary knee arthroplasty without complications in post-operative period; control group — of 20 conventionally healthy individuals. The levels of soluble receptor activator of nuclear factor kappa-B ligand and bone morphogenetic protein-2were defined in blood serum of all subjects by ELISA. Results. In patients of main group we observed more pronounced increase of soluble receptor activator of nuclear factor kappa-B ligand content and significant decrease of bone morphogenetic protein-2 content in blood serum; patients of first comparison group demonstrated activation of soluble receptor activator of nuclear factor kappa-B ligand and decreased levels of bone morphogenetic protein-2 in blood serum; patients of second comparison group did not demonstrate any changes in the studied indexes. Conclusion. The activation of soluble receptor activator of nuclear factor kappa-B ligand and decreased activity of bone morphogenetic protein-2 have leading role in the pathogenesis of implant-associated inflammation.

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The role of microbial associations in the development of implant-associated infection after primary total knee replacement

Year: 2018, volume 14 Issue: №3 Pages: 492-497
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Bondarenko A.S., Mamonova I.A., Shpinyak S.P., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

Aim: to study the role of microbial associations in the etiology of implant-associated infection, the peculiarities of associates antibiotic resistance, to propose informative methods for the microbiological diagnostics of mixed infections. Material and Methods. The biological samples from 488 patients with infectious complications after total knee replacement were studied. Microorganisms were isolated and identified using a BD BBL™ Crystal™ AutoReader analyzer and Crystal™ Enteric/ Nonfermenter ID Kit, Crystal™Gram-Positive ID Kit panels. Results. Polyetiological infectious complications comprise up to 21.4-24.8% out of the total number of implant-associated infection cases; microbial associations have broad microbial spectrum and various component structure. Specific gravity of clinically significant microorganisms — methicillin-resistant Staphylococcus aureus, polyresistant enterobacteria and nonfermentative Gram- negative bacteria is statistically higher (p<0.05) among the associates (38.2, 25.2, 64.3 and 72.8% respectively) than in monocultures (18.2, 11.8, 47.5 and 58.3% respectively). Microbiological methods should be modified in order to verify polyetiological implant-associated infection. Conclusion. The organization of microbiological monitoring of polyetiologi-cal implant-associated infections with detailed study of microbial associations structure, the monitoring of associates antibiotic resistance is necessary to optimize the diagnostics and causal treatment of this pathology.

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The etiological role of opportunistic microflora in the pathogenesis of implant-associated inflammation in patients after primary total knee replacement

Year: 2018, volume 14 Issue: №1 Pages: 30-34
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Bondarenko A.S., Ulyanov V.Yu., Chibrikova Yu.A., Adilov R.G., Kupina E.S.
Organization: Saratov State Medical University
Summary:

The aim: to study etiological role of opportunistic microflora in the pathogenesis of implant-associated inflammation in patients after primary knee joint replacement and antibiotic sensitivity of main agent groups. Material and Methods. The retrospective analysis of microbiological samples of 383 patients with implant-associated inflammation occurred after primary total knee replacement. Results. Gram-positive cocci (63.5%) are the leading agents of implant-associ- ated inflammation, and there is an increase in the etiological role of coagulase-positive Staphylococci. Main agents of Gram-negative group were Enterobacteraceae and non-enzyme bacteria. We revealed high resistance of Staphylo-coccus spp. to antibiotics of various groups. Oxazolidinones and glycylcyclines were the most active among all antibiotic groups. Gram-negative bacteria were highly resistant to cephalosporine and macrolides with carbapenems and fluoroquinolones being most active. Conclusion. Gram-negative Enterobacteraceae, non-enzyme bacteria and Gram-positive cocci are most significant etiological factors in the pathogenesis of implant-associated inflammation in patients after primary total knee replacement.

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Role of humoral immunity markers and bone tissue metabolism in paraimplant inflammation pathogenesis after primary knee arthroplasty

Year: 2017, volume 13 Issue: №3 Pages: 756-761
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ulyanov V.Ju., Bondarenko A.S., Galashina E.A., Chibrikova Ju.A,. Avilov R.G., Kupina E.S.
Organization: Saratov State Medical University
Summary:

The aim: is to study the peculiarities of paraimplant inflammation pathogenesis after primary knee arthroplasty on the basis of dynamic changes of humoral immunity markers and bone tissue metabolism. Material and Methods. Research object includes 140 cases: 50 patients with paraimplant inflammation make up the main group; 30 patients with early aseptic instability make up the first experimental group; 30 patients undergoing primary arthroplasty make up the second experimental group; 30 conditionally healthy blood serum donors make up the control group. We determined the content of humoral immunity markers (circulating immune complexes binding C3d and containing IgG, triggering receptor expressed on myeloid cells) and bone tissue metabolism (tumor necrosis factor a, interleukin 1 (3, bone isoen-zyme of alkaline phosphatase) by the method of hardphase immune-enzyme analysis in all the groups. Results. We noticed elevated activity of circulating immune complexes binding C3d and containing IgG, triggering receptor expressed on myeloid cells, proinflammatory cytokines and alkaline phosphatase in blood serum of patients with paraimplant inflammation; proinflammatory cytokines and alkaline phosphatase — in patients with early aseptic instability; there were no changes in the studied indicators- in patients undergoing primary arthroplasty. Conclusion. Increased expression of triggering receptor expressed on myeloid cells causing release of proinflammatory cytokines and also elevated activity of circulating immune complexes binding C3d and containing IgG and bone isoenzyme of alkaline phosphatase play a significant role in paraimplant inflammation pathogenesis after primary knee arthroplasty.

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