Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)1990-472XФедеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации2710.18499/1990-472X-2018-0-71-130-135Original ArticleBACTERIOLOGICAL EXAMINATION OF TROPHIC LEG ULCERSAralovaM V-BordachovaV S-ManchenkoA A-Voronezh State Regional Clinical HospitalVoronezh State Medical University150320187113013503022020Copyright © 2018, Научно-медицинский вестник Центрального Черноземья2018The trophic changes in the skin breaks the barrier function, resulting in a significant infection leads to rapid development of necrotic complications. Re-microbial environmental damage trophic ulcer of the skin increases the size of the ulcer and is an indication for the use of antibiotics. Objective: to study the species composition and evaluate antibiotic sensitivity of microorganisms isolated from wound discharge venous ulcers of the lower extremities in the last 5 years for the selection of empirical antibiotic treatment of septic complications of venous ulcers. Materials and methods. Investigated 100 cases of venous ulcers of the lower extremities in the department of purulent and outpatient surgery FPD IN "Voronezh regional clinical hospital №1» from 2011 to 2015. Patients underwent bacteriological examination of wound: the definition of species of microorganisms using a differential diagnostic and chromogenic media; susceptibility to antibiotics was conducted disk diffusion method. The data of microbiological studies, the dynamics of the spectrum of microorganisms and the effectiveness of antibiotic therapy in these patients during the observation period. Conclusions. In the structure of microbial trophic ulcers in the past 5 years, the proportion of Pseudomonas aeruginosa, Proteus, Klebsiella. In the 1st phase of wound healing results of bacteriological examination of venous ulcers plays a fundamental importance in the selection antibiotic. Antibiotic therapy of purulent complications of venous ulcers is preferably carried out in a hospital in the complex intensive therapy of the underlying disease, with parenteral administration.venous leg ulcersmicroorganisms resistantantibacterial therapyтрофические язвы нижних конечностеймикроорганизмырезистентностьантибактериальная терапия[Алексеева Н.Т., Глухов А.А., Остроушко А.П. Роль клеток фибробластического дифферона в процессе заживления ран. Вестник экспериментальной и клинической хирургии. 2012. Т. V. №3. С. 601-608.][Амбулаторная ангиология. Под ред. А.И. Кириенко, В.М. Кошкина, В.Ю. Богачева. М: Литтера 2007; 328.][Белоусов Ю.Б., Страчунский Л.С., Козлов С.Н. Практическое руководство по антиинфекционной терапии. Смоленск. - 2007. - 464с.][Глухов А.А., Зуйкова А.А., Петрова Т.Н. и др. Клинико-патогенетическое обоснование применения антимикотических средств в комплексном лечении пациентов с синдромом диабетический стопы // Вестник экспериментальной и клинической хирургии. - 2012. - Т. V. - №4. - С. 639-643.][Липницкий Е.М. Лечение трофических язв нижних конечностей. - М.: Медицина, 2001, 160 с.][Стратегия и тактика применения антимикробных средств в амбулаторной практике: Российские практические рекомендации / Под ред. С.Я. Яковлева, С.В. Сидоренко, В.В.Рафальского, Т.В.Спичак. М.: Издательство Престо, 2014. -121 с.][Chakraborti C., Le C., Yanofsky A. Sensitivity of superficial cultures in lower extremity wounds. J Hosp Med, 2010. - 5. - P.415-420.][Otto M. Coagulase-negative staphylococci as reservoirs of genes facilitating MRSA infection: Staphylococcal commensal species such as Staphylococcus epidermidis are being recognized as important sources of genes promoting MRSA colonization and virulence // BioEssays: news and reviews in molecular, cellular and developmental biology. 2013. № 35. Р. 4-11.][Shah P.M. Parenteral carbapenems. Clin Microbiol Infect. - 2008. - 14 (Suppl 1). - P.174-180.]