Annotation. The problem of treatment of burn wounds is closely related to the specificity of the spectrum of microorganisms that impair wound healing in this category of patients. A generally alarming trend in recent years is the significant increase in the etiological structure of wound infection, both in frequency and in severity and in the difficult choice of treatment tactics in the isolation of poly antimicrobial resistant strains of Pseudomonas aeruginosa, Acinetobacter baumannii. The aim of our study was to create a model of biofilm formed by bacteria on the wound surface and to investigate, in a comparative study, the sensitivity of planktonic and film forms of non-enzymatic gram-negative bacteria to a composition based on decamethoxin with prolonged antiseptic action. To determine the effect of the antiseptic composition on planktonic and film forms of bacteria there was used the method of two consecutive dilutions. The results of a comparative study of the activity of the antiseptic composition with decamethoxin planktonic and biofilm forms of strains of NFGB indicated that in the bacterial film bacteria were more resistant to drugs than in planktonic form. Film forms of A. baumannii and B. cepacia have a sensitivity to decamethoxin at a concentration of 13.6±1.95 µg/ml and 15.6±0 µg/ml, respectively. P. aeruginosa film forms have a higher degree of resistance to the test composition with decamethoxin (MBc 137.5±30.6 μg/ml). Disinfection of the planktonic form of NFGB is 10 times faster than the film form, the destruction of which is achieved with prolonged exposure of 120–150 minutes.

The aim: To perform microbiological investigation and analytic mathematic prediction of clinical isolates of S. aureus to aminoglycosides in patients with severe burns. Materials and methods: We analyzed resistance of 199 S. aureus strains to aminoglycosides (gentamicin, tobramycin and amikacin) and doxycycline from 435 patients treated in the regional hospital due to burns for the period from 2011-2017. Results: We created predictive curves for the prediction of susceptibility of S. aureus strains to aminoglycosides and doxycycline based on the changes in S. aureus resistance during the years of observation and expressed in mathematic equations. Susceptibility of S. aureus to gentamicin was 42.86 % at the end of observation and will decline in future. Despite tobramycin was efficient against 72.86 % of strains in 2017, mathematic modeling indicates rapid decline in its efficacy in future. Efficacy of amikacin was dropping during the last years, but according to the equation it efficacy will increase over 60 % in 2018. S. aureus susceptibility to doxycycline was 65.38 % in 2017 and mathematic modeling indicates its gradual decline in the nearest future. Conclusions: Predicitive values of S. aureus susceptibility indicates not sufficient efficacy of these drugs in patients with infectious complications of burns. Tendency of the slight decline of S. aureus susceptibility to doxycycline still indicates sufficient levels of its efficacy in the nearest future. This justify its use as a second-line therapy with the causative agent in patients with burns.

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Antibiotic-resistant strains of Acinetobacter baumannii has become yet recognized one of the most leading causative pathogens of infectious complications in patients with severe burns. This greatly complicates the treatment of such patients and requires in-depth study with a prognostic determination of the dynamics of antimicrobial efficacy of antibacterial agents. The aim — to study the susceptibility to antibiotics in clinical isolates of A. baumannii, pathogens of infectious complications in patients with hard burns. From patients (n=435) with burns of the 2ndb – 3rd degree, isolates of A.baumannii were received in early period after burn trauma before antibiotic therapy. Patients who participated in the study received standard surgical, complex general and local treatment in the required volume according to the protocols for the treatment of this disease. In total, 222 clinical strains of A.baumannii were isolated and identified during 2011–2016. The susceptibility of clinical strains A.baumannii to the following beta-lactam antibiotics: ampicillin-sulbactam, amoxicillin-clavulanate, piperacillin-tazobactam, cefoperazone-sulbactam, imipenem, meropenem, was determined by standard microbiological methods (qualitative disco-diffusion and quantitative double dilution methods). Using statistical methods, mathematical and analytical prognosis of the real sensitivity of A. baumannii strains to these antibiotics with the use of licensed computer programs “STATISTICA 7” was carried out; “Matlab 7.11”. The results of the study demonstrated a low susceptibility of clinical strains of A.baumannii to the studied beta-lactam antibiotics. The change in the antibiotic susceptibility profile of A.baumannii in 2011–2016 was established. Thus, the vast majority of strains were of low susceptibility to cefoperazone-sulbactam (55,6%), imipenem (57,1%) and meropenem (52,8%). In the dynamics, the prognostic decrease of the sensitivity in clinical isolates of Acinetobacteria to the antibiotics has been proved. The susceptibility of A.baumannii to amoxicillin-clavulanate was consistently low (less than 13,3%), and significantly decreased to cefoperazone–sulbactam (25,0%). The resistance of this pathogen to imipenem (up to 75,0%), meropenem (up to 84,3%) has been established to increase. At the same time, the gradual restoration of the susceptibility of A.baumannii to ampicillin–sulbactam (from 3,4% to 70,2%) was determined. The A.baumannii, pathogens of infectious complications in patients with burns, were characterized by a decrease in sensitivity to inhibitor-protected penicillins, carbapenems except ampicillin–sulbactam, that proved their low effectiveness against this pathogen.

Annotation. In the research, the new data of S. aureus clinical strains’ sensitivity to fluoroquinolones is presented. The aim of the research was to carry out analytic prognosis of sensitivity to fluoroquinolones in clinical strains of S. aureus, isolated from patients with burns. Our research was carried out in 2011–2018. From patients there were isolated 204 clinical strains of S. aureus. There was studied the sensitivity of S. aureus clinical strains to such fluoroquinolones as ofloxacinum, levofloxacin, gatifloxacin. The sensitivity was carried out by means of standard qualitative disc-diffusion method on dense medium and quantitative serial dilution one. The analytical dependence of dynamic prognostic changing criteria of S. aureus clinical strains’ sensitivity to fluoroquinolones was found by means of mathematical prognostication. Prognostic mathematical models were conducted. Authenticity of every model and substantiation of the prognosis of antibiotic sensitivity of S. aureus were estimated due to determination criteria (r2). “STATISTICA 10.0”; “Matlab 7.11” programs were used. In the result of the statistical analysis of the data, obtained in research, we found decreasing sensitivity of S. aureus to ofloxacinum and levofloxacin. The sensitivity to ofloxacinum in S. aureus strains was found to be reduced the 94,12% in 2012 years to 56,2% in 2020 years.). The resulting mathematical model showed a prognostic decrease in the sensitivity of hospital strains of S. aureus to levofloxacin. A mathematical prognostic model indicated a likely improvement in staphylococcus sensitivity to gatifloxacin in 2020 (94.1%). Obtained formulas of analytical prognosis of sensitivity of S. aureus, colonizing burn surfaces in patients, proved the decreasing effectiveness of fluoroquinolones in prophylaxis and treatment of infectious complications, caused by this opportunistic pathogen. That is why microbiological research at the beginning of management administration of antimicrobials in these patients is of great importance.