Due to the spreading highly resistant strains among clinically significant P. aeruginosa clones, it becomes necessary to prescribe antibiotics not only taking into account the knowledge of sensitivity spectrum of a particular isolate but the data of microorganism biofilm activity as well. To study the dependence of biofilm-forming ability on the sensitivity to antibacterial preparations of P. aeruginosa clinical strains, isolated from patients with chronic osteomyelitis. 36 patients above 18 with chronic osteomyelitis of long tubular bones who were treated in the center of purulent osteology took part in the experiment. Object of the study - material isolated from wounds, fistulas, as well as from inflammatory foci. The sensitivity of isolated microorganisms to 10 antibiotics was analyzed: Piperacillin/Tazobactam, Imipenem, Meropenem, Aztreonam, Amikacin, Ciprofloxacin, Ceftriaxone, Ceftazidime, Cefotaxime, Cefepime. High- and medium-adhesive strains accounted for 86,1 % among P. aeruginosa clinical isolates, obtained from the wounds of patients with chronic osteomyelitis of long tubular bones. Highly adhesive strains are resistant to a wide range of antibacterial preparations used clinically. Penicillins were the most effective preparations when analyzing antibioticograms obtained for highly adhesive strains, for medium adhesive strains - penicillins, aminoglycosides and carbapenems, for low adhesive ones - aminoglycosides, penicillins, carbapenems, monobactams, quinolones. P. aeruginosa multi-resistance is a serious problem in the treatment of patients with chronic osteomyelitis. Spreading antibiotic-resistant strains of P. aeruginosa is associated with the presence of bacteria in the biofilm. Since adhesion is the first step in the biofilm formation, it is important to identify strains having high adhesive ability timely.

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Федеральное государственное бюджетное учреждение «Российский научный центр «Восстановительная травматология и ортопедия» им. академика Г.А. Илизарова» Министерства здравоохранения Российской Федерации, г. Курган, Россия Laboratory criteria for pathological process monitoring in patients with chronic osteomyelitis of the lower leg at the stages of restorative treatment

Chronic osteomyelitis in long tubular bones is generally aggravated by metabolic imbalance in patients’ organisms affecting mineral metabolism. It is critically important that the extent of this imbalance should be determined prior to surgical intervention to choose optimal methodology, proper monitoring of recovery and adequate prognostication of final results. With this in mind a comparative assessment has been carried out to shed light on the intensity of mineral metabolism in the blood serum of patients suffering from osteomyelitis in their shoulders and crura. Dynamics of how indices of electrolytes and activity of acidic and alkaline phosphatases vary have been studied in blood serum samples in 24 patients, 18 patients suffering from osteomyelitis in crus bones and 6 - in shoulders. In addition, correlations between total calcium, inorganic phosphate and phosphatase index have been computed. The mineral metabolism indices which were exhibited by the patients having shoulder osteomyelitis and by the patients with crus osteomyelitis are statistically meaningful differences prior to surgery and 2-3 days after surgery. 21 days after surgical intervention the activity of osseous remodeling enzymes, content of total calcium and phosphates as well as the correlations with the phosphatase index show no significant differences. These specific features of mineral metabolism turn out to level out in the process of treating chronic osteomyelitis in upper and lower limbs with transosseous compression-distraction osteosynthes. It has been the first study aimed at discovering comparative characteristics of mineral metabolism in patients with shoulder osteomyelitis and the ones with crus osteomyelitis at different times following surgical intervention. The study looks into correlations between the electrolytes and the mineralization index and shows specific traits exhibited by patients who suffering from osteomyelitis in shoulder and crus went through reparative regeneration at different periods of treatment.