DOI: https://doi.org/10.22263/2312-4156.2020.4.40
Fedzianin S.D.
Monitoring of the pathogens etiological structure in patients with purulent wounds
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2020;19(4):40-45.
Abstract.
Objectives. To study changes in the etiological structure of pathogens in patients with purulent wounds.
Material and methods. On the basis of the bacteriological laboratory, in 2006-2007 and in 2019-2020, 92 and 99 patients with purulent wounds of various locations, respectively, were examined by bacteriological methods. Patients underwent inpatient treatment at the department of purulent surgery at the Vitebsk Regional Clinical Hospital.
Microflora was identified on an automated biochemical analyzer ATB Expression «bioMerieux» using test-systems: ID 32 STAPH – for staphylococci, ID 32 E – for enterobacteria, ID 32 GN – for gram-negative bacilli, rapid ID 32 A – for anaerobes and the «ID-ENTER», «ID-ANA» test-systems, developed by us for identification of enterobacteria and anaerobes, respectively.
Results. As a result of the conducted investigations it has been found, that the role of the genus Staphylococcus decreased by 13.96% (p<0.05), and that of S.pyogenes decreased by 6.19% (p<0.05). The proportion of K.pneumoniae increased by 12.25% (p <0.05), and that of A.baumannii increased by 15.58% (p<0.05).
New associations began to appear in the microbial landscape: S.aureus + A.baumannii – 14.71% (p<0.05), a representative of the family Enterobacteriaceae + A.baumannii – 11.76% (p<0.05).
Conclusions. Over 13 years, significant changes have occurred in the etiological structure of exogenous microorganisms in patients with purulent wounds. Against the background of a decreasing role of gram-positive flora, a significant increase in the proportion of gram-negative problem pathogens, such as K.pneumoniae and A.baumannii, is observed. The obtained results must be taken into account, when providing antibiotic therapy in patients with purulent wounds.
Key words: purulent wound, staphylococci, enterobacteria, pseudomonas, klebsiella, acinetobacter, anaerobes.
References
1. Gelfand BR, red. Sepsis: classification, clinical and diagnostic concept and treatment. 4-e izd, dop i pererab. Moscow, RF: MIA; 2017. 408 р. (In Russ.)
2. Gelfand BR, Kozlov RS, Kubyshkin VA, Khachatrian NN. Surgical skin and soft tissue infections: ros nats rek. 2-e pererab i dop izd. Moscow, RF: Izd-vo MAI; 2015. 109 р. (In Russ.)
3. Efimenko NA, Novozhilov AA, Knorring GIu. Systemic enzyme therapy in purulent surgery. Ambulator Khirurgiia Statsionarozameshchaiushchie Tekhnologii. 2005;(3):51-5. (In Russ.)
4. Iakovlev SV, Sidorenko SV, Rafalskii VV, Spichak TV, red. Strategy and tactics for the rational use of antimicrobial agents in outpatient practice: Eurasian clinical guidelines. Moscow, RF: Pre100 Print; 2016. 144 р. (In Russ.)
5. Saini S, Gupta N, Lokveer A, Griwan MS. Surgical infections: a microbiological study. Braz J Infect Dis. 2004 Apr;8(2):118-25. doi: http://dx.doi.org/10.1590/s1413-86702004000200001
6. Pokrovskii VI. Man and microorganisms. Health and disease. Vestn RAMN. 2000;(11):3-6. (In Russ.)
7. Xiao QZ, Su DH, Jiang JH, Zhong NS. Distribution and drug-resistance of 3 500 gram-negative bacteria in Guangzhou. Di Yi Jun Yi Da Xue Xue Bao. 2005 Feb;25(2):132-8.
8. Sow AI, Boye A, Sall RK, Ndour CT, Soumare M, Seydi M, et al. Resistance of bacteria and antibiotic prescription in Fann University Teaching Hospital, Dakar. Dakar Med. 2003;48(3):189-93.
9. Hariharan S, Nanduri SB, Moseley HSL, Areti KY, Jonnalagadda R. Spectrum of microbes and antimicrobial resistance in a surgical intensive care unit, Barbados. Am J Infect Control. 2003 Aug;31(5):280-7. doi: http://dx.doi.org/10.1067/mic.2003.67
10. Struchkov VI, Gostishchev VK, Struchkov IuV. Surgical infection. 2-e izd, pererab i dop. Moscow, RF: Meditsina; 1991. 560 р. (In Russ.)
11. Iliukevich GV. Modern possibilities and prospects of antibacterial therapy of infections caused by gram-positive flora. Retsept. 2001;(4):61-5. (In Russ.)
12. Rapp RP. Overview of resistant gram-positive pathogens in the surgical patient. Surg Infect (Larchmt). 2000;1(1):39-47. doi: http://dx.doi.org/10.1089/109629600321281
13. Mohanty S, Kapil A, Dhawan B, Das BK. Bacteriological and antimicrobial susceptibility profile of soft tissue infections from Northern India. Indian J Med Sci. 2004 Jan;58(1):10-5.
Information about authors:
Fedzianin S.D. – Candidate of Medical Sciences, associate professor of the Chair of Hospital Surgery with the courses of Urology & Pediatric Surgery, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0003-4771-4724
Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Hospital Surgery with the courses of Urology & Pediatric Surgery. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Siarhei D. Fedzianin.
