Novosti
Khirurgii

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Year 2014 Vol. 22 No 5

GENERAL AND SPECIAL SURGERY

A.M. KUPCHENKO

THE AEROBIC MICROFLORA IN THE ETIOLOGICAL STRUCTURE OF GENERALIZED PURULENT PERITONITIS

EE “Vitebsk State Medical University”,
The Republic of Belarus

Objectives. To study the etiological structure and sensitivity of aerobic microorganisms of peritoneal exudate to antibacterial preparations in patients with generalized purulent peritonitis in regards to the current condition.
Methods. At Vitebsk Emergency Hospital the peritoneal exudate in 92 patients with generalized purulent peritonitis has been studied by the developed test systems «ID - ENT», «AB - ENTER», «AB - GRAM (-)», «AB - STAF», «AB - PSEUD». Pathogenetic significance of enterobacteria and Gram Negative Aerobic microorganisms as well as their specious composition and sensitivity to antibacterial preparations has been defined.
Results. In the majority (73%) cases the conducted microbiological examination has manifested the generalized purulent peritonitis caused by mixed aerobic and anaerobic flora (only by anaerobes – in 14%, only aerobes – in 13%). The representatives of the genus Enterobacteriaceae have dominated among the isolated 80 strains of aerobic and facultative - anaerobic microorganisms. The aerobic microflora of peritoneal exudate components was represented by E. ñoli – 53,75%, Enterococcus spp.– 10%, Streptococcus spp. – 8,75%, Klebsiella spp. – 10%, Proteus spp. – 5%, Staphylococcus spp. – 6,25%, Pseudomonas aeruginosa – 6,25%. In studying the sensitivity of main aerobic pathogens of generalized purulent peritonitis to antimicrobial agents the existence in the vast majority of strains of multiple drug resistance has been established. Carbapenems (meropenem – 94,4% of the sensitive microorganisms, imipenem – 88,7%), the third-generation aminoglycosides (amikacin – 87,3%), fluoroquinolones (moxifloxacin – 87,3%, ciprofloxacin – 84,5%, norfloxacin – 83,1%), the fourth generation cephalosporins (cefepime – 80,3%) exhibit maximal antibacterial effect on the aerobic component.
Conclusion. The obtained data concerning the etiological structure of aerobic microflora of peritoneal exudate in patients with generalized purulent peritonitis will assist in creating of new effective antibiotic therapy schemes available to reduce mortality rate and improve pharmacoeconomic treatment results of given morbility.

Keywords: generalized purulent peritonitis, antibacterial therapy, aerobic microflora, test-systems
p. 568-574 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,
tel. 375 33 675-48-62, e-mail: anna.annushka75@mail.ru,
Kupchenko Anna Mihaylovna.
Information about the authors:
Kupchenko A.N. A senior lecturer of the operative surgery and topographic anatomy chair of EE “Vitebsk State Medical University”.
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