Frolova A.V., Kosinets A.N., Okulich V.K.
Wound infection. State of the problem
The etiological structure of purulent-inflammatory wound healing process of different localization has been studied. It has been found that for all the species diversity of the wound microflora the dominant role in the occurrence and development of purulent-inflammatory diseases and complications in surgery and otorhinolaryngology is played by gram-positive microorganisms, represented mainly by staphylococci. Despite the prevalence of Str. pyogenes in inoculations from the pharynx in peritonsillitis, the relatively high incidence of S. aureus can be regarded as an etiological risk factor of the process chronicity. In purulent-inflammatory processes in the middle ear the expediency of microbiological examination of a wound discharge from the tympanic cavity has been demonstrated. All selected strains of the causative agents possess multidrug resistance to antibiotics. It has been found that the species composition of the causative agents and their biological properties (pathogenic and persistence potential), antimicrobial resistance determine the variety of clinical forms of the surgical infection. The protracted nature of purulent-inflammatory process of any localization is due to the high level of antilysozyme activity of the pathogen contributing to its long-term persistence in the body. Correlation between the expression level of antilysozyme activity of staphylococci and their antibiotic resistance (r=0,85, p<0,01) has been found out. At the same time in all types of this pathology higher antilysozyme activity in gram-negative bacteria compared to that in gram-positive ones has been observed that correlates with the symptoms of the diseases caused by them. It has been suggested to perform the microbiological monitoring of the air in the surgical departments to exclude the possibility of the exogenous infecting of the wound surface.
Key words: wound infection, etiology, biological properties, resistance.
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