FEATURES OF ANTIBACTERIAL THERAPY SURGICAL INFECTIONS
About the author:
Storozhenko O. V.
Heading:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Scentific article
Annotation:
One of the most complex and far from the fnal soluton to the problem in surgery remains treatment of infectous diseases and their complicatons. Despite the wide introducton into the clinical practce of a huge arsenal of antbacterial drugs, the number of patents with purulent surgical infecton remains at a high level and is about 35-40% of the number of patents with a general surgical profle. Do not decrease and mortality with purulent infecton, which according to the data of various authors from 19 to 70%. This is primarily due to changes in pathogens in the directon of the growth of multresistant hospital strains, an increase in the number of heavy contngent patents in the hospital, due to progress in the treatment of previously fatal diseases. Therefore, at the present stage, the directon of optmizaton of treatment is important, which is primarily determined by the refnement andre-evaluaton of the place of antbacterial agents of a wide spectrum of acton against the antbiotc-resistant hospital microflora. The purpose of the study: the identfcaton of microbial landscape features of surgical infectons, the sensitvity of identfed microorganisms to major antmicrobial drugs and the applicaton of the principles of ratonal antbiotc therapy. We conducted a retrospectve analysis of the results of diagnosis and treatment of patents with acute surgical infecton of sof tssues. The nature of microbial contaminaton of sof tssue infecton was presented in the form of: aerobic and optonal gram-positve cocci – Staphylococcus aureus – 28.79%, Staphylococcus epidermidis – 24.31%, Enterococcus faecalis – 15.0%, Enterococcus faecium – 10.86 %, extractve anaerobic grams of negatve stcks – Escherichia coli – 7.59%, Klebsiella pneumoniae – 10.34%, aerobic nonfermentng gram-negatve stcks – Pseudomonas aeruginosa – 1.55% and Cocobacillus – Acinetobacter – 1.55%. In general, gram-positve flora was found in both monoculture and associatons in 76% of patents. The number of MRSA strains was 33.6%. Abdominal surgical infectons, as a rule, have a polymicrobial etology with the partcipaton of a wide range of gram-positve and gram-negatve aerobic and anaerobic bacteria. In most cases, the most sensitve antbiotcs and, respectvely, the most effectve antbacterial agents were: carbapenems, cephalosporins 3-4 in batch, β-lactam antbiotcs, 3-generaton aminoglycosides, 2-3 generatons of 8-hydroxyquinolines. Conclusions: the main pathogens of surgical infectons of sof tssues are gram-positve microflora, both in monoculture and in associatons. Abdominal surgical infectons usually have a polymicrobial etology. MRSA strains make up one third of all identfed microorganisms and represent a real threat to both the health and the lives of patents. In conditons of increasing resistance of microorganisms to antbiotc therapy, its ratonal use should be based solely on data of bacterioscopy and an-tbiotcograms. Advantage When choosing antbacterial drugs should be preferred β-lactam antbiotcs, cephalosporins 3-4 generatons and aminoglycosides 3 generatons, as monotherapy – carbapenems.
Tags:
purulent surgical infecton, microflora, antbiotcs
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 198-201 pages, index UDK 617.586: 616.379