Characteristics of Microbiocenosis of Wounds in Patients with Skin and Soft Tissue Infections on the Background of Type II Diabetes Mellitus

Abstract


Relevance. Assessment of microbiocenosis of wounds in patients with infections of the skin and soft tissues is an integral part of the complex of diagnostic measures carried out for patients of this nosological group, which allows predicting the severity of the course of the purulent inflammatory process and monitoring the effectiveness of the selected method of systemic and local treatment.

Objective: To assess the microbiocenosis of wounds in patients with infections of the skin and soft tissues against the background of type II diabetes mellitus and the effectiveness of using a local, directed flow of the ozone-oxygen gas mixture.

Materials and methods. A qualitative and quantitative assessment was made, an analysis of the antibiotic resistance of the microbial composition of wound biopsies in 90 patients in three clinical groups. The first group consisted of patients with background type II diabetes mellitus who underwent local wound sanation with an ozone-oxygen gas mixture as the local treatment, the second and third groups consisted of patients receiving basal therapy as a topical treatment. However, in the second group, type II diabetes mellitus was registered in patients, while in the third group there were patients without it.

Results and discussion. Based on the results of the microbiocenosis assessment, it was found that in patients with background type II diabetes mellitus, in addition to representatives of staphylo-, strepto-, enterococci and enterobacteria, nonfermentative Gram-negative bacteria were significantly more often from the biopsy specimens of the wounds, which were represented by acinotobacteria. Significantly higher in the first two groups methicillin-resistant strains of staphylococci were verified. Along with the difference in the qualitative composition of the pathogens in the study groups at the time of admission, pathogens of the purulent-inflammatory process in patients with background diabetes mellitus type II showed a high primary antibiotic resistance to the main classes of antimicrobial agents.

Also, in the patients of the first group, a significantly lower incidence of secondary surgical interventions resulted from the persistence and superinfection of wounds from the data of the dynamic microbiological evaluation of the causative agents.

Key words: skin and soft tissue infections, type II diabetes, purulent wounds, ozone, local treatment of wounds.


Anna Mikhailovna Plakhotnikova

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Author for correspondence.
Email: anuta19-90@mail.ru
ORCID iD: 0000-0002-6294-5945
SPIN-code: 6316-8030

Russian Federation, 1 P. Zeleznyaka street, Krasnoyarsk, 660022

graduate student of the Department of General Surgery named after prof. M.I. Gulman 

Yuri Semenovich Vinnik

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: yuvinnik@yandex.ru
ORCID iD: 0000-0002-8135-0445
SPIN-code: 5070-8140

Russian Federation, 1 P. Zeleznyaka street, Krasnoyarsk, 660022

Doctor of Medicine, Prof., Head of the Department of General Surgery named after prof. M.I. Gulman

Olga Valerievna Teplyakova

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: teplyakova-olga@yandex.ru
ORCID iD: 0000-0003-0005-3316
SPIN-code: 4975-0569

Russian Federation, 1 P. Zeleznyaka street, Krasnoyarsk, 660022

Doctor of Medicine (PhD), Associate Professor of the Department of General Surgery named after prof. M.I. Gulman

Olga Vladimirovna Perianova

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: perianova@mail.ru
ORCID iD: 0000-0001-7150-9670
SPIN-code: 2470-8992

Russian Federation, 1 P. Zeleznyaka street, Krasnoyarsk, 660022

PhD in Micrbiology, Associate Professor, Head of the Department of Microbiology named after Associated. prof B.M. Zelmanovich

Nadezhda Konstantinovna Potkina

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: potkinanadezhda@mail.ru
ORCID iD: 0000-0003-4007-6395
SPIN-code: 3850-7411

Russian Federation, 1 P. Zeleznyaka street, Krasnoyarsk, 660022

Researcher Russia-Japan Scientific Center of Microbiology, Metagenomics and Infectious Diseases at Krasnoyarsk State Medical University named after prof. V.F. Voino-Yasenetsky

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Copyright (c) 2017 Plakhotnikova A.M., Vinnik Y.S., Teplyakova O.V., Perianova O.V., Potkina N.K.

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