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Khirurgii

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Year 2014 Vol. 22 No 2

GENERAL AND SPECIAL SURGERY

V.A. SAMARTSEV1, Y.A. ENCHEVA1, 2, M.V. KUZNETSOVA1, 3, T.I. KARPUNINA1

THE PECULIARITIES OF BURN WOUND CONTAMINATION

SBEE HPE “Perm State Medical Academy named after academician E.A. Vagner” 1,
SAME PR “City Clinical Hospital №21”, Perm2,
Institute of Ecology and Genetics of Microorganisms of Ural Branch or RAS3,2

Objectives. To reveal the peculiarities of burn wound contamination taking into account antibiotic sensitivity and genotypic characteristics of dominant pathogens.
Methods. The medical records from the burn unit of Perm multi-type hospital have been analyzed for the period 2011-2012 yrs. Microbiological monitoring included the detection of genetic determinants of antibiotic resistance and strain typing with rep-PCR and RAPD-PCR.
Results. It was shown that 270 bacterial cultures that were referred to 19 taxons were isolated from 190 patients within the period analyzed. Total proportion of Staphylococcus aureus and Pseudomonas aeruginosa comprised 40% of the bacteria isolated. Frequency of S. aureus and P. aeruginosa in mono- or mixed cultures did not significantly differ, whereas A. baumannii was more often detected in associations. Prevailing majority of associations including S. aureus was found with Enterococcus spp., while P. aeruginosa associations were observed with A. baumannii. Following the repeated inoculations from the wound S. aureus and P. aeruginosa strains were detected in 37,5% and 52,2%, respectively. The proportion of S. aureus strains being oxacillin-resistant comprised 32,6%, specific weight of ceftazidime-resistant P. aeruginosa strains – 33,3% and imipenem – 21,7%. Molecular typing confirmed the suggestion based on phenotypic characteristics of cultures about circulation of the closely related isolates in burn unit. Genome of non-fermenting bacterial strains of P. aeruginosa and A. baumannii contain neither intI-, nor blaVIM- sequences.
Conclusions. Characteristic features of infectious complications of burn wounds could be considered as follows: predominance of S. aureus and P. aeruginosa among etiopathogens; growing role of multi-resistant A. baumannii strains; delayed pathogen elimination from wounds and development of mixed and super infections.

Keywords: microbiota, burn wound, antibiotic resistance, genotyping
p. 199 – 206 of the original issue
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Address for correspondence:
614107, Rossiiskaia Federatsiia, g. Perm', ul. Kim, d. 2, GBOU VPO «Permskaia gosudarstvennaia meditsinskaia akademiia im. ak. E.A. Vagnera», kafedra obshchei khirurgii №1,
e-mail: samarcev-v@mail.ru,
Samartsev Vladimir Arkad'evich
Information about the authors:
Samartsev V.A. MD, professor, a head of the general surgery chair №1 of SBEE HPE “Perm State Medical Academy named after E.A.Vagner”.
Encheva Y.A. An extramural post-graduate student of the general surgery chair №1 of SBEE HPE “Perm State Medical Academy named after E.A.Vagner”, surgeon of the burn unit of SAME PR “City Clinical Hospital №21”.
Kuznettsova M.V. PhD, a senior researcher of the molecular microbiology and biotechnology laboratory of Institute of ecology and genetics of microorganisms of Ural branch of RAS, an associate professor of the microbiology and virology chair of SBEE HPE “Perm State Medical Academy named after E.A.Vagner”.
Karpunina T.I. MD, professor of the microbiology and virology chair of SBEE HPE “Perm State Medical Academy named after E.A.Vagner”.
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