Scientific journal
European Journal of Natural History
ISSN 2073-4972

ANTIBIOGRAM ANALYSIS IN PATIENTS WITH II-III DEGREE BURNS

Zhuravlyova L.A., Lazareva Ye.N., Samotruyeva M.A.
Antibiotic therapy takes a leading place in complex treatment of patients with II-III degree burns complicated with pyoinflammatory processes of soft tissues. Nowadays growth of causative agents´ multiresistant strains to germicides in the given patient group is registered. That is why the disease differs from others with long-term and persistent treatment course, appreciation of treatment.

Purpose: To investigate the etiological structure of the causative agents and the spectrum of their sensibility to germicides at burn disease.

Materials and methods: In the paper the bacteriological research analysis of the material from the burnt surfaces of 199 patients and autogenerated causative agents´ sensibility to 29 germicides with the disco-diffuse method using.

Results: The contamination of the material under examination made 96,5%. The dominant activators of the burnt infection were S.аureus (50,8%) and Ps.aeruginosa (20%). From opportunistic enterobacteria Proteus (6,7%), E.coli (5,6%), Enterobacter (5,1%), Klebsiella spp. (2,6%) were plated most commonly. In 50,2% of cases combined infection forms consisting of two and more kinds, being formed on account of tolerant associations, were marked: S.аureus and Ps.aeruginosa (51,0%), S.аureus and enterobacteria of different kinds (31,0%). The antibiogram studies demonstrated nonsensibility of S.аureus to penicillins (0,9%). The most effective preparations against the given activator were: ofloxacin (45,7%), ciprofloxacin (32,4%), carbapenems (45,7%), rifampicin (44,8%), fusidic acid (32,4%), gentamicin (22,9%). From the cephalosporin group S. аureus was sensible to ceftriaxone in 28,6% of cases and to cefazolin in 24,8% of cases, and to the representatives of the third generation - to cefoperazone (9,2%) and ceftazidine (10,5%). Antipseudomonal activity was manifested in carbapenems (53,8%) and monofluorchinolones (ofloxacin - 43,6% and ciprofloxacin - 41,0%). From the aminoglycoside group the activator was more sensible to amikacin (20,5%), than to gentamicin (15,4%). Only ceftazidim from the cephalosporin series was active in regard to Ps.aeruginosa in 25,6% of cases. The bacteriostatic effect to S. аureus and Ps.aeruginosa occurred on the part of semisynthetic tetracyclines in doxycycline (13,3% and 25,6% accordingly). The increase of enterobacteria was suppressed in the majority of cases by: ceftriaxone (41%), ceftazidime (35,9%), imipenem (46,2%), gentamicin (43,6%), ciprofloxacim (41,0%), piperacillin (28,2%), chloramphenicol (20,5 %). 

Conclusion:  Antibacterial therapy of burn disease infectious complications is determined by the spectrum of probable activators. Monofluorchinolones and carbapenems turned out to be the most effective antimicrobial agents as the result of the research.

The article is admitted to the International Scientific Conference "Innovation technologies in medicine"; Spain (Costa Brava) of the July 8-15, 2007г.; came to the editorial office on 13.06.07