PATHOGENETIC VALUE OF CERTAIN PATHOGENS AND THEIR ASSOCIATIONS IN PURULENT-NECROTIC PROCESSES UNDER DIABETIC FOOT SYNDROME

Polyovyy V. P., Khorshani Bilel, Sydorchuk I. І., Knut R. P., Plehutsa I. M., Sydorchuk R. I., Rak O. G.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Diabetic foot syndrome is one of the most common surgical diseases. Existing studies of microflora under the diabetic foot syndrome provide no complete understanding of which pathogens are the dominating, those that determine the severity of the pathological process. The aim of the study is to determine the taxonomic composition, population levels and pathogenetic significance of the microflora in the diabetic foot syndrome. Pathological material was taken from 107 patients with DFS, 2-3 stage according the PEDIS classification, with mild and moderate severity of infection according to IDSA. Material was taken intraoperationally or during primary procedures at admission. To determine the pathogenetic value of microbiota, a number of integral indices were calculated including Margalef’s, Whittaker’s, Simpson and Berger-Parker’s coefficients. One hundred and twenty strains of 18 different taxonomic groups were isolated and identified. The main pathogens of suppurative-necrotic processes in diabetic foot syndrome are gram-positive, facultative anaerobic and aerobic cocci (73.33%), among which the central role belongs to coagulase-positive S. aureus, which forms purulent necrotic process in 31.78% of patients in monoculture and in 8.41% of patients in associations with S. saprophyticus, P. vulgaris and P. magnus. The significance of conditionally pathogenic bacteria in the formation of purulent-necrotic processes with diabetic foot syndrome is highest for S. aureus. It is 2.93 times lower in S. epidermidis, S. intermedius by 4.1 times, S. haemolyticus and S. pyogenes by 6.83 times, P. vulgaris by 10.25 times. A further clinical study of the effect of microbiota on the course of purulent-necrotic processes on the diabetic foot syndrome is planned. Long-term results of such observations will allow development of a set of measures for the treatment and prevention of this diabetes’ complication.

diabetic foot syndrome, purulent necrotic processes, pathogens, pathogenesis, diagnostics

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«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 153-156 pages, index UDK 617.586 : 616.379–008.64]–036.1–037-07-089

10.29254/2077-4214-2019-1-1-148-153-156