Leontieva A. V., Voronkova O. S., Vinnikov A. I.

MICROBIOLOGY

Scentific article

In recent years, an increase of incidence of lesions caused by the pathogenic microflora was fixed. This can be explained by many factors, the most important among which are changes in immune status of macroorganism as a result of various exogenous and endogenous factors that most often occurs among hospital patients. Opportunistic microorganisms are able not only to survive in adverse environmental conditions, but also multiply there. Moreover, majority of opportunistic pathogens has been and continues to take different pathogenicity factors. They have a large number of factors of adhesion, allowing them to compete with saprophytes – representatives of host microflora, a large number of enzymes that destruct host cells (hyaluronidase, haemolysin) etc. A special feature of these microorganisms are also their comparatively high resistance to antimicrobials, including antibiotics. The circulation of various opportunistic microorganisms in hospitals caused a certain percentage of postoperative lesions of wound surfaces, that requires finding the solutions of problem. For the development of prophylaxis and treatment actions the monitoring studies should be carried out. The aim of research was to determine the frequency of isolation of antibioticresistant strains of opportunistic enterobacteria and pseudomonas causing the lesions of wound surfaces. For realization of research were used bacterioscopic and bacteriological methods, disk-diffusion method. In study of the spectrum of pathogens caused the lesions of wound surfaces was found Gram-negative bacteria of genus Proteus, Enterobacter, Klebsiella, Pseudomonas, and Gram-positive bacteria – Staphylococcus, Streptococcus and Enterococcus. The most frequent lesions of wound surfaces there were in the department of purulent surgery and were virtually no in a burn department. It was established that the predominant pathogens of lesions of wound surfaces were gram-negative bacteria in the department of endo-video surgery (enterobacteria up 70%) and in purulent surgery (pseudomonas – more than 50%). High resistance to antibiotics was determined to β-lactams: more than 60% of isolates were resistant. Among isolates of Proteus, Klebsiella, Citrobacter, E coli and Pseudomonas were not revealed any sensitive isolates, from isolates of Enterobacter 42,9% were resistant. The highest level of resistant recorded for ampicillin. More than a half of all the studied isolates were resistant to cefepime. The most effective was meropenem (87.5% of isolates were sensitive). Resistance took place only among pseudomonas isolates (12.5% resistant). Activity of gentamicin was not high: resistance to it confirmed among isolates of E. coli (66,7%), Enterobacter and Proteus (for both 57.1%). Resistant to ofloxacin were from 14.3 to 42.9% of isolates, to ciprofloxacin – from 0 to 25%. To gatifloxacin and norfloxacin resistant isolates were found only among pseudomonas – 25%. In general, it should be noted that most studied strains characterized by sensitivity to majority of applied drugs. Among the isolated strains of Gram-negative bacteria there were no multidrugresistant that was a good prognostic marker. Absolute sterility in a surgical hospital can not achieve. However, knowing the range of circulating strains and their sensitivity to antibiotics can reduce the risk of development of the postoperative lesions of patients or to achieve maximum effect of their treatment. So further monitoring studies may be useful for developing of schemes that prevent the spread of microorganisms and optimized the rational antibiotic therapy of lesions caused by antibioticresistant bacteria.

enterobacteria, pseudomonas, antibioticresistance, wound surface

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