Year 2012 Vol. 20 No 5




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Objectives. To create test-systems for identification of gram-negative and non-clostridial anaerobic microorganisms and for deter-mination of their sensitivity to antibacterial preparations, to work out effective schemes of the antibacterial therapy at treatment of patients with widespread purulent peritonitis.
Methods. By means of the developed test systems investigations of peritoneal exudate of 85 patients with widespread purulent peritonitis have been carried out. The character of gram-negative aerobic and non-clostridial anaerobic microflora has been studied, its sensitivity to antibacterial preparations has been defined, and also effective schemes of rational antibacterial therapy have been sug-gested
Results. The dominating role in peritonitis development belongs to E.coli (54,9 %) and B. fragilis (63,4 %). Rational application of antimicrobial preparations in pre and postoperative periods in many respects predetermine success of treatment of widespread purulent peritonitis. On the basis of data on the etiologic structure and sensitivity of microorganisms to antimicrobial preparations we have established the following effective schemes of rational empirical antibacterial therapy of widespread purulent peritonitis: cephalosporins of III generation + metronidazole; cephalosporins of III generation + aminoglycosides + metronidazole; cephalosporins of IV generation + metronidazole; carbapenems (imipenem, meropenem); fluoroquinolones + metronidazole.
Conclusions. ID-ENT and AB-GRAM (-) test systems have been developed for identification of gram-negative microorganisms and determination of their sensitivity to antibacterial preparations, for obligate anaerobic microorganisms ID-ANA and AB-AN, respectively. The developed test systems are characterized by a great variety of antibiotics, relative low cost, simplicity in manufacturing and use, speed of determination of sensitivity and can find a wide application for determination of sensitivity of strains of causative agents of a surgical infection in bacteriological laboratories of a various profile.

Keywords: widespread purulent peritonitis, test-systems, aerobs, anaerobs, antibacterial therapys
p. 62 - 69 of the original issue

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Address for correspondence:
119991, Rossiyskaya Federatsiya, g. Moskva, ul. Yauzskaya, d. 11, GOU VPO Pervyiy Moskovskiy gosudarstvennyiy meditsinskiy universitet im. I.M. Sechenova, kafedra obschey khirurgii,
Kosinets Vladimir Aleksandrovich
Information about the authors:
Kosinets V.A. Candidate of Medical Sciences, Applicant for Doctors Degree of the General Surgery Chair of SEE HPE I.M. Sechenov First Moscow State Medical University
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