Year 2014 Vol. 22 No 4




EE Vitebsk State Medical University
The Republic of Belarus

Objectives. To study the structure and sensitivity of anaerobic microflora of peritoneal exudate to antibacterial preparations in patients with generalized purulent peritonitis.
Methods. By means of the test systems ID-ANA and AB-AN, designed in Vitebsk State Medical University, the bacteriological study of peritoneal exudate in patients (n=92) with generalized purulent peritonitis have been performed and identification of pathogens and determination of their sensitivity to antibacterial preparations were carried.
Results. Bacteriological study of peritoneal exudate confirmed the polymicrobial character of microflora with a wide spectrum of anaerobic pathogens, often multiply resistant to antibacterial preparations. In 73% of cases the peritoneal inflammation was caused by the mixed aerobic-anaerobic microflora, in 14% only anaerobes, in 13% only aerobes. Among the selected 93 strains of anaerobic microorganisms of the genus Bacteroides spp. 63,4%, Eubacterium spp. 7,53%, Fusobacterium spp. 6,45%, Peptococcus spp. 5,63%, Peptostreptococcus spp. 5,38%, Bifidobacterium spp. 4,32%, Peptococcus spp. 4,3%, Clostridium spp. 3,23%, of undifferentiated gram (-) rods 3,22%, of undifferentiated gram (+) and gram (-) coccuses 3,22%. Anaerobic non-clostridial flora of peritoneal exudate is the most sensitive to meropenem (96,8%), imipenem (94,6%) and metronidazole (88,2%). Extremely low activity against drug-resistant anaerobes: penicillin (8,6% sensitive strains), amoxicillin (24,7%), ticarcillin (31,2%) and chloramphenicol (28%) has been registered.
Conclusions. Identification of anaerobic microflora and determination of sensitivity to antibacterial preparations applying the test- systems ID-ANA and AB-AN allow reducing time required to study the sensitivity for 4 strains of microorganisms to antibacterial preparations up to 17 minutes, records of the results up to 5 minutes, providing the prescription and conduction of a targeted effective antibacterial therapy in generalized purulent peritonitis.

Keywords: generalized purulent peritonitis, antibacterial therapy, anaerobic microflora, test-system
p. 457 462 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 operativnoy khirurgii i topograficheskoy anatomii,
Kupchenko Anna Mihaylovna
Information about the authors:
Kupchenko A.M. A senior lecturer of the operative surgery and topographic anatomy of EE Vitebsk State Medical University.
Kosinets V.A. MD, professor of the hospital surgery chair of EE Vitebsk State Medical University.
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