Microbial environment of surgical patients


Cite item

Full Text

Abstract

Purulent inflammatory diseases are one of the most common problems in modern surgery. Various methods are used for the diagnosis and analysis of purulent processes in surgery, including clinical examination, visual assessment of the lesion, laboratory and microbiological studies. In the course of the current study, pathogens of purulent-inflammatory diseases were identified, and their sensitivity to antibacterial drugs was determined. Goal. To study the microflora of pathological excretion in persons suffering from purulent-inflammatory processes, taking into account the sensitivity of pathogens to antimicrobial drugs. Materials and method. In the course of this study, the identification of causative agents of purulent-inflammatory diseases was carried out by separating material from wounds, as well as determining their sensitivity to antibacterial drugs using the disco-diffusion method. The research was conducted during 2019-2022 on the basis of the surgical department of GBUZ GKB No. 7 in the city of Tver. Results. Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli occupy leading positions in the surgical department under study. Conclusion. The use of antibiotics should be carefully monitored to minimize the risk of developing resistance to them. Limiting the use of antibiotics, prescribing the correct dosages and duration of treatment, as well as using combinations of various antibacterial drugs to increase their effectiveness leads to a decrease in the likelihood of developing resistance.

Full Text

Introduction. Purulent-inflammatory processes are one of the most common problems of the surgical profile, and their proper treatment and prevention plays a key role in maintaining the health of patients [1].Purulent inflammation is characterized by the presence of purulent exudate, which is formed as a result of bacterial infection. Pus occurs due to the immune system's response to infection. Initially, there is a local inflammatory reaction to injury or infection, which leads to activation of the immune system and the influx of neutrophils, macrophages and lymphocytes into the damaged area [2]. However, an insufficient immune response or disorders in the remodeling processes can lead to chronic purulent inflammation and scar formation [3].Various methods are used to diagnose purulent inflammation within the surgical profile, including clinical examination, visual assessment of the lesion, laboratory and microbiological studies. The treatment of purulent inflammation includes drug therapy aimed at eliminating infection and direct surgical intervention [4].The effective use of antimicrobial drugs for the prevention and treatment of infections in the postoperative period plays a leading role in surgical doctors. Antibiotic resistance is becoming more common, which is a problem in the surgical department. The bacteria that cause infections become resistant to antibiotics and stop responding to them. Excessive and improper use of antibiotics can contribute to the development of this process [5, 6].There are several causes of antibiotic resistance in the surgical department. One of them is the unjustified prescription of antibiotics on an outpatient basis, when they are used unnecessarily, and with an incorrectly selected dosage. Resistance can also occur due to improper adherence to the antibiotic regimen by patients and staff who are responsible for taking antibiotics. The problem of antibiotic resistance requires a comprehensive approach. In the surgical department, the rational use of antibiotics and compliance with the recommendations for their use is especially important in the prevention of infections in the postoperative period [7].Antibiotic resistance has a number of consequences for public health. If bacteria become resistant to antibiotic treatment, then infections that were previously controllable begin to actively develop. Patients suffering from antibiotic-resistant infections require longer and more expensive treatment, which increases the health burden and economic burden on society. The risk of complications and mortality increases, as well as the effectiveness of modern medicine in general decreases [8].In addition, the detection and determination of antibiotic sensitivity of pathogenic microorganisms is an essential step for the effective treatment of infections. The use of antibiotics, taking into account their spectrum of action, can help reduce antibiotic resistance. In general, the fight against antibiotic resistance in the surgical department requires the joint efforts of doctors, medical staff, patients, as well as social and government agencies. The creation of strategies and programs aimed at the rational use of antibiotics, improvement of hygiene and infection control standards, as well as the development of new antibiotics and therapeutic approaches can help overcome this problem [9, 10].

The aim of the work is to study the microflora of pathological excretion in persons suffering from purulent-inflammatory processes, taking into account the sensitivity of pathogens to antimicrobial drugs.

Materials and methods of research. In the course of this study, the identification of causative agents of purulent-inflammatory diseases was carried out by separating material from wounds, as well as determining their sensitivity to antibacterial drugs using the disco-diffusion method. The research was conducted during 2019-2022 on the basis of the surgical department of GBUZ GKB No. 7 in the city of Tver.

The results of the study. The most common pathogens of purulent inflammatory diseases in the study department were: Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli.Staphylococcus aureus is one of the most common pathogens of purulent inflammatory diseases. This microorganism has a low sensitivity to the drug Ciprofloxacin, however, there is a high resistance to the following drugs: Amikacin and Amoxicillin together with Clavulanic acid. The reason for this resistance may be related to the widespread use of these drugs for the treatment of most community-acquired infections.Klebsiella pneumoniae is a common pathogen of nosocomial infections from the enterobacteriaceae group and ranks second in prevalence in this study. Strains of this microorganism exhibit a high degree of resistance to inhibitor-protected penicillin (amoxicillin and clavulanic acid), cephalosporin of the 4th generation (cefepime) and cephalosporins of the 3rd generation (cefotaxime and ceftriaxone). When comparing the effectiveness of 3rd generation cephalosporins (ceftriaxone and cefotaxime) with a combination of 3rd generation cephalosporin with a β-lactamase inhibitor (cefoperazone/sulbactam), a significant increase in resistance to unprotected 3rd generation cephalosporins was found.E. Coli is the third most common in the surgical profile. In most cases, it is useful and performs important functions for the body, helping in digestion and keeping conditionally pathogenic microorganisms under control. However, some strains of e. Coli can become pathogenic and cause various infectious diseases, including nosocomial infections.In this study, it was revealed that E. coli showed the highest resistance to Gentamicin. According to the results of the resistance analysis, the antibiotic of the aminoglycoside group is Amikacin in second place. The antibiotic Amoxicillin with Clavulanic acid is in third place. From the present study, it was also revealed that E.coli had the greatest sensitivity to Ampicillin.

Conclusion: a lot of time has passed since the appearance of the first antibiotic. Microorganisms have developed resistance to many drugs of the studied group. Therefore, the results obtained should be taken into account when developing new antibiotics and strategies for the use of existing drugs. The use of antibiotics should be carefully monitored to minimize the risk of developing resistance to them. Limiting the use of antibiotics, prescribing the correct dosages and duration of treatment, as well as using combinations of various antibacterial drugs to increase their effectiveness leads to a decrease in the likelihood of developing resistance.

×

About the authors

Anastasia Antonovna Utkina

Tver State Medical University

Email: ammorozovv@gmail.com
ORCID iD: 0009-0006-8695-3444
Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

Ekaterina Andreevna Fisyuk

Tver State Medical University

Email: ammorozovv@gmail.com
ORCID iD: 0009-0000-0582-7398
SPIN-code: 2392-8968
Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

Matvey Alexsandrovich Uzhov

Tver State Medical University

Email: ammorozovv@gmail.com
ORCID iD: 0009-0006-3550-821X
Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

Artem Мihailovich Morozov

Tver State Medical University

Author for correspondence.
Email: ammorozovv@gmail.com
ORCID iD: 0000-0003-4213-5379
SPIN-code: 6815-9332

Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of General Surgery

Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

References

  1. Оценка экономических потерь вследствие развития инфекции области хирургического вмешательства / А. М. Морозов, С. В. Жуков, М. А. Беляк, А. Б. Стаменкович // Менеджер здравоохранения. – 2022. – № 1. – С. 54-60. – doi: 10.21045/1811-0185-2022-1-54-60
  2. Dossou, M.A.М. Drainage of purulent wounds of soft tissues (review article) / M.A.M. Dossou // Tambov Medical Journal. – 2022. – Vol. 4, No. 4. – P. 47-52. – doi: 10.20310/2782-5019-2022-4-4-47-52
  3. Shivashankar, S.B.K. Antibiogram of Enterococcus spp. associated with post-operative wound infections / S.B.K. Shivashankar, N.R. Bhat, B. Dhanashree // Infectious Diseases: News, Views, Education. – 2023. – Vol. 12, No. 1(44). – P. 84-89. – doi: 10.33029/2305-3496-2023-12-1-84-89
  4. Морозов, А. М. Поливалентные препараты бактериофагов в лечении хирургических инфекций / А. М. Морозов, А. Д. Морозова, Е. М. Мохов // Студенческая наука - 2017: Материалы Всероссийского научного форума студентов и молодых ученых с международным участием, Санкт-Петербург, 13–14 апреля 2017 года. – Санкт-Петербург: Санкт-Петербургский государственный педиатрический медицинский университет" Министерства здравоохранения Российской Федерации, 2017. – С. 196.
  5. Атакишизаде, С.А. Этиология хирургических раневых инфекций в многопрофильных клиниках / С.А. Атакишизаде // Евразийский Журнал Клинических Наук. – 2019. – Т. 2, № 2. – С. 16-21. – doi: 10.28942/ejcs.v2i2.75
  6. Природный сорбент цеолит в комплексе с антибактериальными препаратами при раневых инфекциях животных / А.С. Гасанов, З.М. Зухрабова, Н.В. Шамсутдинова [и др.] // Ученые записки Казанской государственной академии ветеринарной медицины им. Н.Э. Баумана. – 2022. – Т. 252, № 4. – С. 72-75. – doi: 10.31588/2413_4201_1883_4_252_72
  7. Антимикробная активность нановолокон хитозана и его модификаций по отношению к возбудителям раневой инфекции / В.В. Машель, Г.Г. Кондратенко, А.И. Протасевич, П.С. Неверов // Военная медицина. – 2022. – № 3(64). – С. 40-45. – doi: 10.51922/2074-5044.2022.3.40
  8. Современные антисептические средства в обработке операционного поля / А. М. Морозов, А. Н. Сергеев, В. А. Кадыков [и др.] // Вестник современной клинической медицины. – 2020. – Т. 13, № 3. – С. 51-58. – doi: 10.20969/VSKM.2020.13(3).51-58
  9. Спектр возбудителей осложненных абдоминальных инфекций у пациентов хирургического профиля / Н.В. Евдокимова, Т.В. Черненькая, О.В. Никитина, А.Г. Лебедев // Неотложная медицинская помощь. Журнал им. Н.В. Склифосовского. – 2023. – Т. 12, № 1. – С. 51-56. – doi: 10.23934/2223-9022-2023-12-1-51-56
  10. Морозов, А. М. Оценка эффективности применения бактериофагов в условиях общехирургического отделения / А. М. Морозов // Горизонты медицинской науки : VIII Конференция молодых ученых РМАНПО с международным участием, Москва, 19–20 апреля 2017 года. Том II. – Москва: Российская медицинская академия последипломного образования Министерства здравоохранения Российской Федерации, 2017. – С. 45-46.

Supplementary files

There are no supplementary files to display.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies