DOI: https://doi.org/10.22263/2312-4156.2023.6.35
M.A. Litviakou1, K.M. Kubrakou2, V.I. Averin3, V.M. Semenov2
Analysis of the etiological structure and resistance of causative agents of the inflammatory process of the abdominal cavity in acute destructive appendicitis in children
1Vitebsk Regional Clinical Pediatric Hospital, Vitebsk, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
3Belarusian State Medical University, Minsk, Republic of Belarus
Vestnik VGMU. 2023;22(6):35-46.
Abstract.
Objectives. To analyze the etiological structure and resistance to antibiotics of the main causative agents of the inflammatory process of the abdominal cavity in acute destructive appendicitis (ADA) in children.
Material and methods. We observed 394 children who were being treated for ADA. Group I included 306 patients (77.67% of all children) who had uncomplicated by generalization ADA. Group II included 88 children (22.33% of all patients) in whom ADA was complicated by peritonitis.
For diagnostic purposes, peritoneal exudate (PE) was taken from the operating table during emergency surgery and sent to the laboratory for bacteriological analysis. The studies were performed in accordance with standard approved laboratory research methods. Additionally, PE was examined using the MULTIBAK PCR test system (Sivital LLC, Republic of Belarus) to identify the DNA of the pathogen.
Results. Patients of the study groups were characterized by the presence of an inflammatory process with systemic disturbances of homeostasis, while in patients of group II they were more pronounced. Bacteriological examination of peritoneal exudate in group I was positive only in 53.74% (95% CI 47.87–59.60) of cases, in group II in 86.36% (95% CI 60.12–81.21). The main causative agents of ADA in Gram staining are gram-negative bacteria, namely the representative of the Enterobacteriaceae family – E. coli (group I – 64.24% (95% CI 56.51–71.97), group II – 70.67% (95 % CI 60.12– 81.21)), and only 29.4% and 19.7% of their strains were sensitive to all antibiotics.
Conclusions. The presence of a large number of strains of ADA pathogens with high resistance to antibiotics dictates the need to determine the beta-lactamase activity of PE for the effective use of beta-lactam antibiotics.
Keywords: acute destructive appendicitis, peritonitis, pediatric surgery, bacteriology, microorganism, antibiotic.
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Information about authors:
M.A. Litviakou – head of the surgical department, Vitebsk Regional Clinical Pediatric Hospital, https://orcid.org/0000-0002-8209-5060,
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Mikhail A. Litviakou;
K.M. Kubrakou – Doctor of Medical Sciences, associate professor, professor of the Chair of Neurology & Neurosurgery, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0001-6723-0589
V.I. Averin – Doctor of Medical Sciences, professor, head of the Chair of Pediatric Surgery, Belarusian State Medical University;
V.M. Semenov – Doctor of Medical Sciences, professor, head of the Chair of Infectious Diseases with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-7029-9226
