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
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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”.
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