ANALYTIC PROGNOSTICAION OF SENSITIVITY TO FLUOROQUINOLONES IN PSEUDOMONAS AERUGINOSA, ISOLATED FROM BURN PATIENTS

Nazarchuk A. A., Paliy D. V., Osadchuk N. I., Kovalenko I. V., Burkot V. M.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

In the research, the new data of Рseudomonas aeruginosa clinical strains’ sensitivity to fluoroquinolones are presented. The aim of the research was to carry out analytic prognosis of sensitivity to fluoroquinolones in clinical strains of Рseudomonas aeruginosa, isolated from patients with burns. Materials and methods. Our research was carried out in the period of 2011-2015 years. There were enrolled 295 patients with hard burn trauma (the 3rd – 4th stage of severity) in who purulent-inflammatory complications happened. All patients with burns were treated in Vinnitsa Regional Clinical Hospital named after N. I. Pirogov according to standard management guidelines. In their treatment, they had antimicrobial administrations (antibiotics, antiseptics). From patients there were isolated 127 clinical strains of Р. aeruginosa (2011 р. – n 27; 2012 р. – n 26; 2013 р. – n 26; 2014 р. – n 23; 2015 р. – n 25). There was studied the sensitivity of Р. aeruginosa clinical strains to such fluoroquinolones as norfloxacin, ofloxacinum, levofloxacin, gatifloxacin. We used by means of standard disc-diffusion method on dense medium and quantitive serial dilution one. The analytical dependence of dynamic prognostic changing criteria of Р. aeruginosa clinical strains’ sensitivity to fluoroquinolones was found by means of mathematical prognostication. Prognostic mathematical models were conducted. Authenticity of every model and substantiation of the prognosis of antibiotic sensitivity of Р. aeruginosa were estimated due to determination criteria (r2). “STATISTICA 7”; “Matlab 7.11” programs were used. Results. Discussion. In the result of the statistical analysis of the data, obtained in research, we found decreasing sensitivity of Р. aeruginosa to norfloxacin, ofloxacinum, levofloxacin, gatifloxacin. The analysis of smoothed data series (2011-2015 years) of Р. aeruginosa sensitivity have shown decreasing exponential tendency of the effectiveness of gatifloxacin agains opportunistic pathogens of Р. aeruginosa in patients with burns lower then 30%. The sensitivity to ofloxacinum in Р. aeruginosa strains was found to be reduced the 36 % after last five years. As for norfloxacin and levofloxacin – they had similar tendency but their effectiveness became 17 % lower than five years ago. Mathematical extrapolation of previous normality testified decreasing sensitivity of Р. aeruginosa in future even to ofloxacinum lower than 10 % and gatifloxacin lower than 30%. Conclusion. Obtained formulas of analytical prognosis of sensitivity of Р. aeruginosa, colonizing burn surfaces in patients, proved the decreasing effectiveness of fluoroquinolones in prophylaxis and treatment of infectious complications, caused by this opportunistic pathogen.That is why microbiologicl research at the beginning of management administration of antimicrobials in these patients is of great importance.

sensitivity, antimicrobials, fluoroquinolones, Рseudomonas aeruginosa, infectious complications

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«Bulletin of problems biology and medicine» Issue 1 part 2 (127), 2016 year, 105-109 pages, index UDK 577.182:579.841.1