Novosti
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Year 2014 Vol. 22 No 4
GENERAL AND SPECIAL SURGERY
A.M. KUPCHENKO, V.A. KOSINETS
IDENTIFICATION AND DETERMINATION OF ANTIBACTERIAL SENSITIVITY OF ANAEROBIC MICROFLORA IN TREATMENT OF GENERALIZED PURULENT PERITONITIS
EE “Vitebsk State Medical University”
The Republic of Belarus
Objectives. To study the structure and sensitivity of anaerobic microflora of peritoneal exudate to antibacterial preparations in patients with generalized purulent peritonitis.
Methods. By means of the test systems “ID-ANA“ and “AB-AN“, designed in Vitebsk State Medical University, the bacteriological study of peritoneal exudate in patients (n=92) with generalized purulent peritonitis have been performed and identification of pathogens and determination of their sensitivity to antibacterial preparations were carried.
Results. Bacteriological study of peritoneal exudate confirmed the polymicrobial character of microflora with a wide spectrum of anaerobic pathogens, often multiply resistant to antibacterial preparations. In 73% of cases the peritoneal inflammation was caused by the mixed aerobic-anaerobic microflora, in 14% – only anaerobes, in 13% – only aerobes. Among the selected 93 strains of anaerobic microorganisms of the genus Bacteroides spp. – 63,4%, Eubacterium spp. – 7,53%, Fusobacterium spp. – 6,45%, Peptococcus spp. – 5,63%, Peptostreptococcus spp. – 5,38%, Bifidobacterium spp. – 4,32%, Peptococcus spp. – 4,3%, Clostridium spp. – 3,23%, of undifferentiated gram (-) rods – 3,22%, of undifferentiated gram (+) and gram (-) coccuses – 3,22%. Anaerobic non-clostridial flora of peritoneal exudate is the most sensitive to meropenem (96,8%), imipenem (94,6%) and metronidazole (88,2%). Extremely low activity against drug-resistant anaerobes: penicillin (8,6% sensitive strains), amoxicillin (24,7%), ticarcillin (31,2%) and chloramphenicol (28%) has been registered.
Conclusions. Identification of anaerobic microflora and determination of sensitivity to antibacterial preparations applying the test- systems “ID-ANA” and “AB-AN” allow reducing time required to study the sensitivity for 4 strains of microorganisms to antibacterial preparations up to 17 minutes, records of the results – up to 5 minutes, providing the prescription and conduction of a targeted effective antibacterial therapy in generalized purulent peritonitis.
- Savel'ev VS, Gel'fand BR, red. Antibakterial'naia terapiia abdominal'noi khirurgicheskoi infektsii [Antibiotic therapy of abdominal surgical infection]. Moscow, RF: T-Vizit, 2003. 240 p.
- Chernov VN, Mareev DV. Kompleksnoe lechenie bol'nykh abdominal'nym sepsisom [Complex treatment of patients with abdominal sepsis]. Khirurgiia. 2010;(8):44–47.
- Gauzit R, Pean Y, Barth X, Mistretta F, Lalaude O; Top Study Team.Epidemiology, management, and prognosis of secondary non-postoperative peritonitis: a French prospective observational multicenter study. Surg Infect (Larchmt). 2009 Apr;10(2):119–27.
- Mazuski JE, Solomkin JS.Intra-abdominal infections. Surg Clin North Am. 2009 Apr;89(2):421–37.
- Gao H1, Evans TW, Finney SJ.Bench-to-bedside review: sepsis, severe sepsis and septic shock - does the nature of the infecting organism matter? Crit Care. 2008;12(3):213.
- Kosinets AN, red. Antibakterial'naia terapiia v gnoinoi khirurgii [Antibiotic therapy in purulent surgery]: ruk. Vitebsk, RB: VGMU; 2002. 600 p.
- Sazhin VP, Bodrova NG, Klimov DE. Antibiotikoterapiia pri gnoinykh khirurgicheskikh zabolevaniiakh organov briushnoi polosti i miagkikh tkanei [Antibiotic treatment of purulent surgical diseases of the abdominal cavity and soft tissue]. Khirurgiia. 2010;(6):4-9.
- Llewelyn MJ, Cohen J.Tracking the microbes in sepsis: advancements in treatment bring challenges for microbial epidemiology. Clin Infect Dis. 2007 May 15;44(10):1343–48.
- Rybachkov VV, Kostiuchenko KV, Maevskii SV. Peritonit [Peritonitis]. Iaroslavl', RF: IarMediaGrup, 2010. 304 p.
- Sidorenko SV, Shurkalin BK, Popov TV, Karabak VI. Mikrobiologicheskaia struktura peritonita [Microbiological structure of peritonitis]. Infektsii v Khirurgii. 2007;(1):15–17.
- Svetukhin AM, Zemlianoi AB, Istratov VG, Blatun LA, Terekhova RP. Klinicheskoe znachenie rannei diagnostiki anaerobnoi neklostridial'noi infektsii [The clinical significance of early diagnosis of non-clostridial anaerobic infection]. Khirurgiia. 2005;(8): 41–44.
- Kosinets VA. Identifikatsiia i opredelenie chuvstvitel'nosti k antimikrobnym preparatam osnovnykh vozbuditelei rasprostranennogo gnoinogo peritonita [Identification and antimicrobial susceptibility of major pathogens of generalized purulent peritonitis]. Novosti Khirurgii. 2012;20(5):62–69.
- Hasper D, Schefold JC, Baumgart DC.Management of severe abdominal infections. Recent Pat Antiinfect Drug Discov. 2009 Jan;4(1):57-65.
- Montravers P, Gauzit R, Muller C, Marmuse JP, Fichelle A, Desmonts JM.Emergence of antibiotic-resistant bacteria in cases of peritonitis after intraabdominal surgery affects the efficacy of empirical antimicrobial therapy. Clin Infect Dis. 1996 Sep;23(3):486–94.
- Strachunskii LS, Belousov IuB, Kozlov SN, red. Prakticheskoe rukovodstvo po antiinfektsionnoi khimioterapii [Practical guidance on anti-infective chemotherapy]. Smolensk: RF: MAKMAKh, 2007. 464 p.
210023, Respublika Belarus, g. Vitebsk, pr. Frunze, d. 27, UO «Vitebskiy gosudarstvennyiy meditsinskiy universitet», kafedra operativnoy khirurgii i topograficheskoy anatomii,
e-mail: anna.annushka75@mail.ru,
Kupchenko Anna Mihaylovna
Kupchenko A.M. A senior lecturer of the operative surgery and topographic anatomy of EE “Vitebsk State Medical University”.
Kosinets V.A. MD, professor of the hospital surgery chair of EE “Vitebsk State Medical University”.
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