VARIETY OF DIAGNOSED MICROORGANISMS IN PATIENTS WITH ERYSIPELAS
Purpose. The purpose is to find out the frequency of surgical forms of erysipelas among the general population of the disease.
Materials and methods. Traditionally, there is a widespread point of view about streptococcal etiology of erysipelas. However, recently, staphylococcus or microbial associations are increasingly sown from the focus of inflammation in patients.
The relevance of studying the course of erysipelas is determined by the tendency to relapse, a significant increase in complications of the disease in recent years and the final phenomena.
The existing clinical situation is largely explained by changes in the spectrum of pathogens of purulent surgical infection of soft tissues. Its leading pathogens are mainly staphylococci and streptococci, as well as gram - negative aerobic bacteria.
The nature of the clinical course of the disease, including the nature of the local inflammatory focus, depends on the totality of the pathogenic properties of microbes that form the microbial landscape.
It was found that most often the local focus was localized on the lower extremities.
114 case histories of patients who were hospitalized in the center of purulent-septic surgery in the Non-profit municipal enterprise “City Hospital № 3” in Zaporizhzhia for the period 2019-2020 were analyzed retrospectively and prospectively. All patients were diagnosed with erysipelas on admission, according to the forms: erythematous - 24 (21.0%), bullous - 28 (24.6%), phlegmonous form - 48 (42.1%), necrotic - 14 (12.3%). %). Disease relapses were noted in 21 patients. In terms of gender: men - 47 (41.2%), women - 67 (58.8%). The patients' age was 62.1 ± 2.6 years. Automated devices "Vitek-2" or "BaCT ALERT" (France) were used to determine the sensitivity of microorganisms in a purulent focus to antibacterial drugs. Statistical analysis was performed using the “Statgraphics Plus for Windows 7.0” software package.
Research results and their analysis. It was found that most often the local focus was localized on the lower extremities. A total of 26 types of bacteria were identified from the wound contents of patients with destructive forms of erysipelas. No bacterial growth was found in 3 (4.8%) patients, and mixed flora was isolated in 27 (45.8%) patients. Gram-positive flora accounted for 61.0%, gram-negative flora - 35.6%, anaerobes - were not found, fungi - 3.4%.
Conclusions. The number of destructive forms of erysipelas among the general population of the disease is more than 50%. The study of purulent-necrotic foci in patients with destructive forms of erysipelas makes it possible to determine the qualitative and quantitative composition of microflora, sensitivity to antibiotics, and make adjustments to the conduction of antibiotic therapy.
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