КОАГУЛАЗО-ОТРИЦАТЕЛЬНЫЕ СТАФИЛОКОККИ КАК ЭТИОЛОГИЧЕСКИЙ ФАКТОР ГНОЙНО-СЕПТИЧЕСКИХ ИНФЕКЦИЙ В СТОМАТОЛОГИЧЕСКОМ СТАЦИОНАРЕ

Abstract

In the etiological structure of purulent-septic infections, there is a tendency to increase the role of conditionally pathogenic bacteria, previously considered insignificant in human pathology. These include coagulase-negative staphylococci. An important condition for increasing the clinical significance of any microorganism is its ability to circulate in the nosocomial environment, forming hospital strains with increased resistance and virulence. Identification of circulating microbial strains requires the use of costly and labor-intensive molecular genetic methods. The purpose of the study is to show the role of coagulase-negative staphylococci as an etiological factor in purulent-septic infections in a dental hospital, as well as to assess their prevalence in the nosocomial environment. The article reflects the clinical structure of purulent-septic infections in a dental hospital for 3 years of work, the results of bacteriological studies of wound transudate and sanitary-microbiological studies of objects in the hospital environment. To identify circulating strains of coagulase-negative staphylococci, an original phenotypic epidemiological marker was used – the complex of indicators of the strains sensitivity to antiseptics, disinfectants and aniline dyes. The study showed that staphylococci were the reason of 30.8% of cases of purulent-septic infections of the maxillofacial region. Coagulase-negative species were more common than Staphylococcus aureus (S. aureus): 52.5% versus 47.5%. The leading species are S. epidermidis, S. saprophyticus and S. haemolyticus. In 47.1% of cases, their strains were methicillin-resistant. Incomplete sensitivity of cultures of coagulase-negative staphylococci to a chlorine-containing disinfectant was noted. A prolonged (up to 3 weeks) presence of strains of coagulase-negative staphylococci with identical characteristics was revealed in the nosocomial environment of a dental hospital. Thus, coagulase-negative staphylococci are among the leading pathogens of purulent-septic infections of the maxillofacial region. A number of isolates have features of hospital strains: multiple antimicrobial resistance and circulation in the nosocomial environment.