Novosti
|
This journal is indexed in Scopus |
|---|
Year 2012 Vol. 20 No 5
GENERAL AND SPECIAL SURGERY
V.A. KOSINETS
IDENTIFICATION AND DETERMINATION OF SENSITIVITY TO ANTIBACTERIAL PREPARATIONS OF THE MAIN CAUSATIVE AGENTS OF WIDESPREAD PURULENT PERITONITIS
ГОУ ВПО «Первый Московский государственный медицинский университет им. И.М.Сеченова»,
Российская Федерация
УО «Витебский государственный медицинский университет»,
Республика Беларусь
Objectives. To create test-systems for identification of gram-negative and non-clostridial anaerobic microorganisms and for deter-mination of their sensitivity to antibacterial preparations, to work out effective schemes of the antibacterial therapy at treatment of patients with widespread purulent peritonitis.
Methods. By means of the developed test systems investigations of peritoneal exudate of 85 patients with widespread purulent peritonitis have been carried out. The character of gram-negative aerobic and non-clostridial anaerobic microflora has been studied, its sensitivity to antibacterial preparations has been defined, and also effective schemes of rational antibacterial therapy have been sug-gested
Results. The dominating role in peritonitis development belongs to E.coli (54,9 %) and B. fragilis (63,4 %). Rational application of antimicrobial preparations in pre – and postoperative periods in many respects predetermine success of treatment of widespread purulent peritonitis. On the basis of data on the etiologic structure and sensitivity of microorganisms to antimicrobial preparations we have established the following effective schemes of rational empirical antibacterial therapy of widespread purulent peritonitis: cephalosporins of III generation + metronidazole; cephalosporins of III generation + aminoglycosides + metronidazole; cephalosporins of IV generation + metronidazole; carbapenems (imipenem, meropenem); fluoroquinolones + metronidazole.
Conclusions. «ID-ENT» and «AB-GRAM (-)» test systems have been developed for identification of gram-negative microorganisms and determination of their sensitivity to antibacterial preparations, for obligate anaerobic microorganisms – «ID-ANA» and «AB-AN», respectively. The developed test systems are characterized by a great variety of antibiotics, relative low cost, simplicity in manufacturing and use, speed of determination of sensitivity and can find a wide application for determination of sensitivity of strains of causative agents of a surgical infection in bacteriological laboratories of a various profile.
1.Gostishchev VK, Sazhin VP, Avdovenko AL. Peritonit [Peritonitis]. Moscow, RF: GEOTAR-Media, 2002. 238 p.
2. Eriukhin IA, Gel'fanda BR, Shliapnikov SA, red. Khirurgicheskie infektsii: ruk dlia vrachei [Surgical infections: a guide for physicians]. Saint-Petersburg, RF: Piter; 2004. 325 p.
3. Savel'ev BC, Gel'fanda BR, Filimonova MI, red. Peritonit: prakt ruk [Peritonitis: a practical guide]. Moscow, RF: Litterra, 2006. 208 p.
4.Shurkalin BK. Gnoinyi peritonit [Purulent peritonitis]. Moscow, RF: Dva Mira Print; 2000. 224 p.
5. Gain IuM, Leonovich SI, Alekseev SA. Sindrom enteral'noi nedostatochnosti pri peritonite: teoreticheskie i prakticheskie aspekty, diagnostika i lechenie [Enteral insufficiency syndrome in peritonitis: theoretical and practical aspects of diagnosis and treatment]. Molodechno, RB; 2001. 265 p.
6. Briskin BS, Khachatrian HH, Ionov SA, Khmelevskii SV Antibiotikoprofilaktika v abdominal'noi khirurgii [Antibiotic prophylaxis in abdominal surgery]. Consilium Medicum Pril Khirurgiia. 2003;(1):9–13.
7. Eremin SR, Zueva LP. Aktual'nye problemy epidemiologii intraabdominal'nykh infektsii [Actual problems of epidemiology of intra-abdominal infections]. Infektsii v Khirurgii. 2003;1(2):58–62.
8. Savel'ev VS, Gel'fanda BR, red. Abdominal'naia khirurgicheskaia infektsiia: klinika, diagnostika, antimikrobnaia terapiia: prakt ruk [Abdominal surgical infection: clinical features, diagnosis, antimicrobial therapy: a practical guide]. Moscow, RF: Literra; 2006. 168 p.
9. Khachatrian NN. Antibakterial'naia terapiia peritonita [Antimicrobial therapy of peritonitis]. Consilium Medicum Pril Khirurgiia. 2002;(1):19–25.
119991, Rossiyskaya Federatsiya, g. Moskva, ul. Yauzskaya, d. 11, GOU VPO «Pervyiy Moskovskiy gosudarstvennyiy meditsinskiy universitet im. I.M. Sechenova», kafedra obschey khirurgii,
e-mail: vkosinets@yandex.ru,
Kosinets Vladimir Aleksandrovich
Kosinets V.A. Candidate of Medical Sciences, Applicant for Doctor’s Degree of the General Surgery Chair of SEE HPE “I.M. Sechenov First Moscow State Medical University”
Article in the .pdf format
