THE ETIOLOGICAL STRUCTURE OF MICROFLORA OF WOUNDS OF THE ANAL CANAL AND PERINEUM AND THEIR SENSITIVITY TO ANTIBACTERIAL DRUGS

Abstract

We have performed a retrospective analysis of the results of the bacteriological study of the discharge from wounds of the perianal area and anal canal in patients of the Proctology and Colorectal Surgery Ward of the health institution «Gomel Regional Specialized Clinical Hospital» of different nosology over 2014-2015. Significant etiological strains of microorganisms were isolated in 157 samples. The inoculation was 68 %. Representatives of Enterobacteriaceae family prevailed in the general structure of causative agents - 78.4 %, including E. coli - 52.3 %, K. pneumoniae - 15.3 %, E. agglomerans - 10.8 %. Among gram-positive bacteria (15.3 %) Streptococcus spp ., including E. faecalis (7 %), Streptococcus agalactiae (3.8 %) predominated, and S. aureus (4.5 %) was also detected. Enterobacteriaceae isolates were characterized by high resistance to ampicillin - 91.7 %, amoxicillin/clavulanate - 61.1 %, ceftazidime - 42.6 %, cefotaxime - 18.5 %. Ciprofloxacin (93.5 %) and gentamicin (94.4 %) had high-level sensitivity. Since it is impossible to avoid the entry of microorganisms intoa woundcompletely, it is advisable to prevent such a concentration of micro-organisms in tissues which leads to passing of microbial contamination intoa clinically significant wound infection. As gram-positive and gram-negative microorganisms are detected in wounds after surgery on the perineum, it is necessary to prescribe a wide spectrum of antibiotic drugs in order to prevent inflammatory complications. The existing diversity of schemes of antibiotic prevention indicatesthat the problem is not solved yet and indirectly testifies the topicality of research aimed at developing new methods of prevention of postoperative complications in patients having undergone operationson the distal rectum, anal canal, and perineum.