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

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.