Open AccessMicrobial spectrum and rational antibacterial therapy in treatment of infected forms of necrotic pancreatitis
Author(s) -
V. G. Yaresko,
S. O. Potalov,
I. V. Filimonov,
Y. O. Mikheev,
A. I. Marousi
Publication year - 2019
Publication title -
sučasnì medičnì tehnologìï
Language(s) - English
Resource type - Journals
ISSN - 2072-9367
DOI - 10.34287/mmt.2(41).2019.2
Subject(s) - meropenem , medicine , pseudomonas aeruginosa , antibiotics , acinetobacter , klebsiella pneumoniae , sepsis , microbiology and biotechnology , intensive care unit , acute pancreatitis , pancreatitis , intensive care medicine , biology , antibiotic resistance , escherichia coli , bacteria , biochemistry , genetics , gene
The most significant areas of scientific andpractical research in urgent pancreatology ofthe last decade are the study of the course ofnecrotic pancreatitis with the evaluation of theeffectiveness of antibiotic therapy at differentstages of the disease according to microbiologicalstudies, nosocomial infection and the developmentof sepsis.Purposw of the study. To study the effectivenessof antibacterial therapy in complex treatmentof infected forms of necrotizing pancreatitis,depending on the species composition of theinfection, the severity of the pathology and thedevelopment of sepsis.Materials and methods. The study included48 patients with infected forms of necroticpancreatitis over the past two years undergoingtreatment at the Department of Anesthesiologyand Intensive Care of Zaporizhzhia 3rd CityClinical Hospital in 2017–2018.Results. Research of the species composition ofmicroorganisms showed that there is predominantgram-negative flora in pancreatogenic infectionsuch as: Pseudomonas aeruginosa – 26,3%,Acinetobacter spp. – 21,1%, the Enterobacteriaceaefamily: Klebsiella pneumoniae – 10,5%and Escherichia coli – 15,8%. The detectedspectrum of microorganisms gives an idea ofthe main pathogens characteristic of infectedforms of necrotizing pancreatitis. Antibioticsensibility analysis showed that high activityagainst pathogens was observed in meropenem,taygecycline and tobramycin. In 21% of patients,resistant strains of Ps. Aeruginosa were detected,but in 3 patients there was a positive dynamics inthe use of detoxication therapy with inclusion ofextracorporal methods (discrete plasmapheresis)in combination with two-component antibiotictherapy (meropenem + linezolid).Conclusion. The analysis of treatment ofpatients with infected necrotizing pancreatitisand its complication sonthebasis of continuousmonitoring of bacterial flora with the provisionof adequate antibiotic therapy, prevention ofnosocominal infectionand a modern strategy forthe use of surgical interventions, especiallynoninvasive,contributes to the reduction of sepsisand, as a result, reduction in mortality andsevere postoperative complications.Keywords: necrotizing pancreatitis, combinedantibiotic therapy, nosocomial infection, mortality.