Year 2012 Vol. 20 No 6

GENERAL AND SPECIAL SURGERY

K.M. KUBRAKOV 1, I.A. KOVALEVA 1, A.V. PAVLENKO 2, E.A.KONOPELKO 2

ETIOLOGICAL STRUCTURE AND RESISTANCE OF THE MAJOR INFECTIOUS AGENT OF THE WOUND INFECTION IN PATIENTS WITH BURN DISEASE

EE VITEBSK STATE MEDICAL UNIVERSITY 1,
ME VITEBSK REGIONAL CLINICAL HOSPITAL 2,
THE REPUBLIC OF BELARUS

Objectives. To study the etiological structure of the wound infection in patients with burn disease, to carry out analysis of sensitivity of the isolated microflora to antibacterial drugs.
Methods. We analyzed the results of 868 bacterial platings of the wound discharge from the burn surface of the patients who were treated at the burn department of ME Vitebsk regional clinical hospital in 2010. The species composition of microflora isolated in patients with burn disease was studied; the leading pathogens of suppurative-inflammatory processes were determined. Resistance to antibiotics of 718 strains included into the group of the main pathogens was established. The identification and evaluation of sensitivity of microorganisms to antimicrobial drugs was carried out with the help of test-systems on the microbiological analyzer ATB Expression.
Results. Gram-positive microorganisms identified in 63,19% of the bacteriological research dominate in the structure of the wound infection in patients with burn disease. Gram-negative microorganisms are isolated in the composition of associations in 72,34% of cases. The main agent causing suppurative-inflammatory processes in the case of burns is the S. aureus (57,57% of cases). The dominant representative among gram-negative microflora is P. aeruginosa. (19,71%). A high level of resistance of S. aureus to the antibacterial drugs has been established in relation to oxacillin, gentamycin, ciprofloxacin; and of P. aeroginosa to ciprofloxacin, gentamycin, ofloxacin.
Conclusions. A leading role of gram-positive microorganisms in the etiology of the wound infection in patients with burn disease has been certified. Clinically most significant strains have been proved to possess a high degree of resistance in relation to the frequently applied antibiotics used at the burn department. Isolated microorganisms are resistant to oxacillinum, gentamycinum, ciprofloxacinum and this should be taken into consideration when the empirical antimicrobial therapy is administered.

p. 53 59 of the original issue
References
  1. Tolstov AV. Diagnostika, klassifikatsiia, profilaktika i lechenie generalizovannoi infektsii u tiazhelo obozhzhennykh [Diagnosis, classification, prevention and treatment of generalized infection in severely burned patients ]. Aspirant Vestn Povolzh'ia. 2008;(3-4):12427.
  2. Vorob'eva ON, Denisenko LI, Doshchitsina AS, Chelpanova LI, Dulepo SA. Dinamika antibiotikorezistentnosti vozbuditelei gnoino-septicheskikh protsessov u ozhogovykh bol'nykh [Dynamics of antimicrobial resistance of septic processes in burn patients ]. Biul Vostoch-Sibir Nauch Tsentra SO RAMN. 2005;(1):1924.
  3. Alekseev AA, Krutikov MG, Iakovlev VP. Ozhogovaia infektsiia. Etiologiia, patogenez, diagnostika, profilaktika i lechenie [Burn infection. The etiology, pathogenesis, diagnosis, prevention and treatment]. Moscow, RF: Vuz kn; 2010. 416 p.
  4. Wibbenmeyer L, Danks R, Faucher L, Amelon M, Latenser B, Kealey GP, Herwaldt LA. Prospective analysis of nosocomial infection rates, antibiotic use, and patterns of resistance in a burn. J Burn Care Res. 2006 Mar-Apr;27(2):15260.
  5. Krutikov MG, Bobrovnikov AE. Antibiotikoprofilaktika posleoperatsionnykh infektsionnykh oslozhnenii u bol'nykh s termicheskimi porazheniiami [Antibiotic prophylaxis of postoperative infectious complications in patients with thermal injury ]. Antibiotiki i Khimioterapiia. 2002;47(1):2125.
  6. Pruitt BA Jr, McManus AT, Kim SH, Goodwin CW. Burn Wound Infections: Current Status. World J Surg. 1998 Feb;22(2):13545.
  7. Sharma BR. Infection in patients with severe burns: causes and prevention thereof. Infect Dis Clin North Am. 2007 Sep;21(3):745-59, ix.
  8. D'Avignon LC, Saffle JR, Chung KK, Cancio LC. Prevention and management of infections associated with burns in the combat casualty. J Trauma. 2008 Mar;64(3 Suppl):S27786.
  9. Spiridonova TG. Patogeneticheskie aspekty lecheniia ozhogovykh ran [Pathogenetic aspects of the treatment of burn wounds]. Rus Med zhurn. 2002;10(8-9):39599.
  10. Krutikov MG. Kontrol' infektsii v ozhogovom statsionare [Infection control in the burn hospital]. Kombustiologiia. 2003;(14). Available from: http://www.burn.ru/all/number/show/?id=3531.
  11. Greenhalgh DG, Saffle JR, Holmes JH 4th, Gamelli RL, Palmieri TL, Horton JW, Tompkins RG, Traber DL, Mozingo DW, Deitch EA, Goodwin CW, Herndon DN, Gallagher JJ, Sanford AP, Jeng JC, Ahrenholz DH, Neely AN, O'Mara MS, Wolf SE, Purdue GF, Garner WL, Yowler CJ, Latenser BA. American Burn Association consensus conference to define sepsis and infection in burns. J Burn Care Res. 2007 Nov-Dec;28(6):77690.
  12. Ugburo AO, Atoyebi OA, Oyeneyin JO, Sowemimo GO. An evaluation of the role of systemic antibiotic prophylaxis in the control of burn wound infection at the Lagos university teaching hospital. Burns. 2004 Feb;30(1):438.
  13. Simor AE, Lee M, Vearncombe M, Jones-Paul L, Barry C, Gomez M, Fish JS, Cartotto RC, Palmer R, Louie M. An outbreak due to multiresistant Acinetobacter baumannii in a burn unit: risk factors for acquisition and management. Infect Control Hosp Epidemiol. 2002 May;23(5):2617.
  14. Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev. 2006 Apr;19(2):40334.
  15. Beloborodova NV, Bogdanov MB, Chernen'kaia TV. Algoritmy antibiotikoterapii [Algorithms of antibiotic therapy]: ruk dlia vrachei. Moscow, RF; 1999. 144 p.
Address for correspondence:
210023, Respublika Belarus, g. Vitebsk, pr. Frunze, d. 27, UO Vitebskiy gosudarstvennyiy meditsinskiy universitet, kafedra nevrologii i neyrokhirurgii,
e-mail: k-kubrakov@yandex.ru,
Kubrakov Konstantin Mihaylovich
Information about the authors:
Kubrakov K.M. Candidate of medical sciences, associate professor of the neurology and neurosurgery chair of EE Vitebsk State Medical University
Kovaleva I.A. A 5-year student of the medical faculty of EE Vitebsk State Medical University
Pavlenko A.V. Head of the burn unit of ME Vitebsk regional clinical hospital
Konopelko E.A. Physician-bacteriologist of ME Vitebsk regional clinical hospital, Republican Scientific and Practical Center Infection in surgery.
Contacts | ©Vitebsk State Medical University, 2007-2023