Improving effectiveness of microbiological diagnostics in patients with surgical infection of soft tissues.

Abstract

Recently, there has been a steady tendency towards  increase in the resistance of microorganisms to antibacterial drugs, which is due to the lack of development of new antibiotics, their uncontrolled administration, total use in animal husbandry, etc. leads to fatal outcomes, unsatisfactory results of treatment, rise in cost of treatment, formation of hospital pan-resistant strains. The increasing ability of microorganisms to cooperate in biofilms, production and improvement of resistance mechanisms in symbiosis are intractable issues in the treatment of patients with surgical infection of soft tissues. In patients with surgical infection of soft tissues, surgical treatment of a purulent focus and antibiotic therapy are fundamental doctrinal, determining the success of treatment.The choice of an antibacterial drug in most cases is based on the results of an antibioticogram. A study of wounds by smear technique and biopsy samples of wound tissues in 81 patients was performed. The quantitative and qualitative composition of wound microflora of patients was evaluated during the study of biopsy samples and standard culture from the wound surface. When examining the biopsy samples, 86 strains were isolated, and 110 – in the material from the wound surface. There was no growth on the wound surface in 11 cases (13.5%), against 20 (almost 25%) in biopsy samples. One species of flora was isolated from 37 wound surfaces (about 46%), biopsy samples of wounds with monoculture – in 61 samples (75%). Associations (two or more) are present in 33 (41%) wound samples, and only in 21 biopsy samples (26%). Thus, the conducted studies confirm the fact that wound surface is more contaminated by foreign microflora than biopsy samples. The data obtained allow us to recommend the method of wound biptates instead of a smear, as more specific and sensitive in patients with surgical infection of soft tissues.