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Kubrakov K.M.*, Abodovsky S.A.*, Podolinsky Y.S.**, Ermashkevich S.N.*, Chulkov A.A.*
The antibiotic resistance of pleural empyema pathogens
*Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
**Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus

Vestnik VGMU. 2016;15(6):54-62.

Objectives. To study the etiological structure of pleural empyema  causative agents  and their resistance to antibiotics.
Material and methods. The bacteriological analysis of pleural effusion was made in 241 patients of the thoracic department of Public Health Establishment «Vitebsk Regional Clinical Hospital». There were 181 (75%) men and 60 (25%) women. The age median made up 54 (45-63) years. The identification and assessment of  microorganisms sensitivity to antibiotics were carried out by means of test systems (ID 32 E, ID 32 S) on the microbiological analyzer ATB Expression. The statistical analysis was made with the calculation of the sign frequency, 95% confidence interval, median and interquartile range Me (LQ-UQ).
Results. Out of 241 bacteriological inoculations in 123 (51,04%) microorganisms were isolated. Out of 146 strains in 27 cases  gram-positive flora  was identified – 18,49% (95% CI: 12,12-24,86), in 118 cases (80,82%) (95% CI: 74,36-87,28) – gram - negative microorganisms and in one case fungi (C. albicans – 0,69%) were isolated. S. aureus – 9,59% (95% CI: 4,75-14,42), S. epidermidis – 6,85% (95% CI: 2,70-10,99), and E. faecalis – 2,05% were identified. Out of gram-negative pathogens K. pneumonia (1,37%), E. coli (0,685%), Pr. mirabilis (0,685%), A. baumannii (1,37%) and P. aeruginosa (76,70% ) (95% CI: 69,77-83,5) were identified.
Conclusions. The major causative agents of pleural empyema are gram-negative microorganisms – 80,82%, inoculation of pathogens makes up 51,04%. The dominant pathogen is P. aeruginosa (76,70%) (95% CI: 69,77-83,5). Considering its high resistance the most effective antibacterial drugs for the treatment of pleural empyema caused by P. aeruginosa are colistin, meropenem, levofloxacin, amikacin and their combinations. In case of gram-positive flora revealing preference should be given to the drugs of choice – vancomycin or linezolid.
Key words: pleural empyema, blue pus bacillus, antibiotic resistance.


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Information about authors:
Kubrakov K.M. – Candidate of Medical Sciences, associate professor of the Chair of Neurology & Neurosurgery, Vitebsk State Order of Peoples’ Friendship Medical University;
Abodovsky S.A. – the sixth - year medical student, Vitebsk State Order of Peoples’ Friendship Medical University;
Chulkov A.A. – the sixth - year medical student, Vitebsk State Order of Peoples’ Friendship Medical University;
Podolinsky Y.S. – physician of the thoracic department, Vitebsk Regional Clinical Hospital;
Ermashkevich S.N. – Candidate of Medical Sciences, associate professor of the Chair of Hospital Surgery with the course of Urology & Pediatric Surgery, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Neurology & Neurosurgery. E-mail: к-кЭтот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Kubrakov Konstantin M.

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