Investigation of the sensitivity of pathogens of purulent-inflammatory processes of the mediastinum to modern antiseptics

Abstract

Annotation. A well-chosen tactic for the prevention and treatment of infectious complications in patients with purulent-inflammatory processes of the mediastinum is important in reducing the colonization of the biotope by pathogens, contributes to the reduction of inflammation and accelerates recovery. The aim of our work was to conduct a comparative study of the antimicrobial efficacy of antiseptic drugs (decasan, myramistinum, chlorhexidine, povidone iodine and polyhexamethylene guanidine) on 278 clinical strains of microorganisms (S. aureus, E. coli, K. pneumoniae, Enterobacter spp.), which cause purulent-inflammatory complications of the mediastinum in patients. For the comparative characterization of the antimicrobial action, the method of double dilutions was used; calculated antiseptic activity index (AAI); a quantitative suspension test was performed to evaluate the decontamination effect of antiseptics. Standard methods of descriptive statistics and special and office programs “STATISTICA 6.0”, “Microsoft Excel 2010” were used. Staphylococci showed the highest level of sensitivity to most of the antiseptics under study. The mean MBSC values of S. aureus clinical strains for decasan, myramistinum, chlorhexidine was respectively 1.75±1.27 µg/ml, 3.25±2.27 µg/ml, and 5.53±3.74 µg/ml. The AAI of myramistinum and chlorhexidine before the Pseudomonas was 4.5, which is the threshold for clinical activity. The clinical activity of a solution of povidone iodine against infections caused by P. aeruginosa is doubtful, based on the activity level of 2.6. The studied antiseptics provided a full decontamination effect against most strains at 5 min exposure, the decontamination effect lasted for 15 min, followed by 30 min. There were found single microorganisms, the number of which gradually increased and after 1 hour reached 1.9×104 and 1.5×102 CFU/ml, respectively. The high sensitivity of gram-positive and gram-negative pathogens to decasan and polyhexamethylene guanidine hydrochloride substantiates their high antimicrobial effectiveness and opens wide prospects for their use in the prevention and treatment of infectious complications in modern conditions.