Comprehensive Immunotherapy as a Method of Treatment of Surgical Nosocomial Infections

Abstract


Relevance In recent years, the risk of nosocomial infections, especially surgical, increases. Nosocomial infections develop in patients obtaining medical care as well as medical personnel providing it. Mortality rate from these infections in different hospitals ranges from 3.5 to 60%. The purpose of the study was to develop the algorithm of prescription and evaluate the effectiveness of the differentiated immunotherapy of patients with nosocomial infections. Material and methods We observed 450 patients with different types of nosocomial infections (purulent wounds of the soft tissue, deep pyoderma, acute and flare-up of chronic salpingo-oophoritis, acute and flare-up of chronic pyelonephritis). All patients were subjected to conventional treatment for each nosological entity and additionally treated with immunomodulators and antioxidants in regulated doses (donor gamma globulin, Derinat, Limontar, Izoprenozin, Imunofan, Immunomaks, ozonated saline solution, Myelopid, Kipferon, Ridostin, Viferon and their various combinations). In addition to traditional clinical and laboratory parameters, immunological parameters were evaluated using the flow cytometer before and after the differentiated treatment in all patients. Reliability of the data was ensured by the randomization of patients in groups, representation of their number, choice of adequate statistical criteria, assessment of the formulas of disorders and targets of immunocorrection. Results and their discussion Inclusion of the immunotropic drugs in the differentiated basic treatment of pyoinflammatory diseases eliminated the immunological disorders as well as increased treatment efficiency, reduced hospitalization and risk of chronization and recurrence of infectious pathological processes in patients. Conclusion 1. Traditional therapy of the patients with 10 types of nosocomial infections in only three cases (septic wounds of the soft tissue, complications of atopic dermatitis, combination of deep pyoderma with skin allergosis) makes the satisfactory correction of immunological disorders. 2. Additional prescription of the differentiated immunotropic drugs to

eliminated the immunological disorders as well as increased treatment efficiency, reduced hospitalization and risk of chronization
and recurrence of infectious pathological processes in patients.
Conclusion 1. Traditional therapy of the patients with 10 types of nosocomial infections in only three cases (septic wounds of
the soft tissue, complications of atopic dermatitis, combination of deep pyoderma with skin allergosis) makes the satisfactory
correction of immunological disorders. 2. Additional prescription of the differentiated immunotropic drugs to the patients with
nosocomial infections successfully corrects the disorder of laboratory status. 3. Based on the analysis of the summary of the
formulas of the set targets of immunocorrection, laboratory indications for the choice of its options are determined.

the patients with nosocomial infections successfully corrects the disorder of laboratory status. 3. Based on the analysis of the summary of the formulas of the set targets of immunocorrection, laboratory indications for the choice of its options are determined.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
 MD, Professor, head. the Microbiology Department of the Voronezh state medical Academy. NEC, honored worker of science of the Russian Federation.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
candidate of Microbiology Department of the Voronezh state medical Academy named NEA.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
 assistant of the Department of Microbiology of the Voronezh state medical Academy named NEA.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
post-graduate student of Microbiology Department of the Voronezh state medical Academy named NEA.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
 full-time PhD student of Microbiology Department of the Voronezh state medical Academy named NEA.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
 candidate of Microbiology Department of the Voronezh state medical Academy named NEA.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com

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