Year 2013 Vol. 21 No 6

NEUROSURGERY

K.M. KUBRAKOV, V.M. SEMENOV, I.A. KOVALEVA, S.K. ZIANKOVA, V.V. SKVORTSOVA

ANTIBIOTIC RESISTANCE OF THE MAIN CAUSATIVE PATHOGENS OF BACTERIAL MENINGITIS IN NEUROSURGICAL PATIENTS

EE Vitebsk State Medical University,
The Republic of Belarus

Objectives. To study the etiological structure of the bacterial meningoencephalitis in neurosurgical patients in the late postoperative period, determine the resistance of the main causative agents to antibacterial drugs.
Methods. Bacteriological analysis of liquor was performed in 98 patients in the late postoperative period due to the development of bacterial meningoencephalitis clinical signs. The average age of patients was 48 (40-56) years, males dominated 84,69% (n = 83). The identification and assessment of the sensitivity of microorganisms towards antimicrobial agents was carried out with the help of the test-system on the microbiological analyzer ATB Expression and by the method of standard paper discs (Becton Dickinson (USA).
Results. In 29 persons (29,59%) 53 pathogens were identified. Gram-negative microorganisms were identified in 81,17% of cases (n=43), gram-positive microorganisms (n=10) were obtained in 18,87%. Gram-positive strains included S. aureus 9,43% (n=5), S. haemolyticus (n=2), S. pneumoniae (n=2), and one isolate E. faecalis. The group was represented by gram-negative bacteria K. pneumonia 9,43% (n=5) and non-fermenting gram-negative rods 38 isolates (71,70%), which included 35 isolates of A. baumannii (66,04%) and 3 isolate of P. aeruginosa (5,66%). A. baumannii strain is highly resistant to commonly used antibiotics in hospital (cephalosporins III-IV-generation, aminoglycosides). The high resistance of S. aureus to broad-spectrum antibiotics particular to oxacillin, cefazolin, ceftriaxone has been determined.
Conclusions. In the late postoperative period the dominant causative agent of pyogenic meningoencephalitis in neurosurgical patients is A. baumannii. High resistance and polyresistance of the main causative agents of bacterial meningoencephalitis towards antibiotics requires the conduction of permanent bacteriological monitoring and timely correction of antibacterial therapy protocols.

Keywords: meningoencephalitis, neurosurgical operations, postoperative period, causative pathogens, antibiotic resistance
p. 78 83 of the original issue
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Address for correspondence:
210023, Respublika Belarus', g. Vitebsk, pr. Frunze, d. 27, UO Vitebskii gosudarstvennyi meditsinskii universitet, kafedra nevrologii i neirokhirurgii,
e-mail: k-kubrakov@yandex.ru,
Kubrakov Konstantin Mikhailovich
Information about the authors:
Kubrakov K.M. PhD, an associate professor of the chair of neurology and neurosurgery of EE Vitebsk State Medical University.
Semenov V.M. MD, professor, a dean of the medical faculty of EE Vitebsk State Medical University.
Kovaleva I.A. A 5-year medical student of EE Vitebsk State Medical University.
Ziankova S.K. PhD, an associate professor of the chair of infectious diseases of EE Vitebsk State Medical University.
Skvortsova V.V. PhD, an associate professor of the chair of infectious diseases of EE Vitebsk State Medical University.
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