nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2023-12-1-51-56nmp-1569Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESСпектр возбудителей осложненных абдоминальных инфекций у пациентов хирургического профиляThe Spectrum of Causative Agents of Complicated Abdominal Infections in Surgical Patientshttps://orcid.org/0000-0001-7473-8727ЕвдокимоваН. В.YevdokimovaN. V.

Евдокимова Наталья Витальевна, кандидат биологических наук, старший научный сотрудник лаборатории клинической микробиологии

129090, Москва, Б. Сухаревская пл., д. 3

Natalya V. Yevdokimova, Candidate of Biological Sciences, Senior Researcher, Laboratory of Clinical Microbiology

3, Bolshaya Sukharevskaya Sq., Moscow, 129090

env1111@yandex.ruhttps://orcid.org/0000-0002-6167-7117ЧерненькаяТ. В.ChernenkayaT. V.

Черненькая Татьяна Витальевна, кандидат медицинских наук, заведующая лабораторией клинической микробиологии

129090, Москва, Б. Сухаревская пл., д. 3

Tatyana V. Chernenkaya, Candidate of Medical Sciences, Head, Laboratory of Clinical Microbiology

3, Bolshaya Sukharevskaya Sq., Moscow, 129090

https://orcid.org/0000-0002-3516-5492НикитинаО. В.NikitinaO. V.

Никитина Ольга Владимировна, кандидат медицинских наук, старший научный сотрудник отделения неотложной хирургии, эндоскопии и интенсивной терапии

129090, Москва, Б. Сухаревская пл., д. 3

Olga V. Nikitina, Candidate of Medical Sciences, Senior Researcher, Department of Emergency Surgery, Endoscopy and Intensive Care

3, Bolshaya Sukharevskaya Sq., Moscow, 129090

nikitinaov@sklif.mos.ruhttps://orcid.org/0000-0003-4008-6462ЛебедевА. Г.LebedevA. G.

Лебедев Александр Георгиевич, доктор медицинских наук, главный научный сотрудник отделения неотложной хирургии 

129090, Москва, Б. Сухаревская пл., д. 3

Alexander G. Lebedev, Doctor of Medical Sciences, Chief Researcher, Department of Emergency Surgery

3, Bolshaya Sukharevskaya Sq., Moscow, 129090

lebedevag@sklif.mos.ruЛаборатория клинической микробиологии ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияLaboratory of Clinical Microbiology N.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation2023150420231215156Copyright © Евдокимова Н.В., Черненькая Т.В., Никитина О.В., Лебедев А.Г., 20232023Евдокимова Н.В., Черненькая Т.В., Никитина О.В., Лебедев А.Г.Yevdokimova N.V., Chernenkaya T.V., Nikitina O.V., Lebedev A.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/1569

АКТУАЛЬНОСТЬ Лечение больных с осложненными абдоминальными инфекциями до сих пор остается сложной задачей, о чем свидетельствуют высокие показатели летальности.  

ЦЕЛЬ ИССЛЕДОВАНИЯ Анализ результатов микробиологического обследования больных с распространенным перитонитом, находившихся на лечении в хирургическом отделении стационара неотложной медицинской помощи.  

МАТЕРИАЛ И МЕТОДЫ В настоящей работе проведено изучение основных возбудителей распространенного перитонита у 69 пациентов (cредний возраст пациентов — 64±17 лет). Причиной перитонита в абсолютном большинстве наблюдений (94%) явилась перфорация одного из отделов желудочно-кишечного тракта. Выполнено исследование различных видов клинического материала: кровь — 143 пробы, моча — 125 проб, бронхоальвеолярный лаваж — 119 проб и 130 проб раневого отделяемого. Было выделено 260 штаммов микроорганизмов.  

РЕЗУЛЬТАТЫ Обнаружено преобладание представителей семейства Enterobacteriaceae (K. pneumoniae и E. сoli), неферментирующих бактерий (Acinetobacter), а также возрастающая роль Enterococcus spp. и Staphylococcus spp. (S. aureus и коагулазоотрицательных стафилококков). Среди выявленных возбудителей доминировали полирезистентные штаммы.  

ЗАКЛЮЧЕНИЕ Полученные данные о структуре возбудителей осложненной абдоминальной инфекцией подтверждают общемировые тенденции. Для разработки новых методов лечения осложненной абдоминальной инфекцией одним из возможных решений может являться использование подходов микробной экологии человека. 

RELEVANCE Treatment of patients with complicated abdominal infections (AI) is still a difficult task, as evidenced by high mortality rates.  

THE AIM OF THE STUDY is to analyze the results of microbiological investigations of patients with advanced diffuse peritonitis who were treated in the surgical department of the emergency hospital.  

MATERIAL AND METHODS In this study, the main pathogens of advanced peritonitis were identified in 69 patients (the average age of patients was 64±17 years). The cause of peritonitis in the absolute majority of cases (94%) was a perforation of the gastrointestinal tract. A study of various types of clinical material was carried out: blood — 143 samples, urine — 125 samples, bronchoalveolar lavage — 119 samples and 130 samples of wound discharge. 260 strains of microorganisms were isolated.  

RESULTS The predominance of the Enterobacteriacea species (K. pneumoniae and E. coli), non-fermenting bacteria (Acinetobacter spp.) as well as the increasing role of Enterococcus spp. and Staphylococcus spp. (S. aureus and CNS) were found. Multidrug-resistant strains dominated among the identified pathogens.  

CONCLUSION The obtained data on the structure of pathogens of complicated abdominal infection confirm global trends. In order to develop new treatment methods for complicated AI, one of the possible solutions may be the use of human microbial ecology approaches. 

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The authors declare that there are no conflicts of interest present.