New possibilities in antibacterial treatment of intra-abdominal infections caused by multiresistant microflora

Дибиров, М. Д.; Khachatryan, Nana N.; Isaev, A. I.; Karsotyan, G. S.; Alimova, E. E.; Kostyuk, E. A.

doi:10.17116/hirurgia201912174

Khir. Z. im. N.I. Pirogova

2019

DOI: 10.17116/hirurgia201912174

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New possibilities in antibacterial treatment of intra-abdominal infections caused by multiresistant microflora

М. Д. Дибиров

Nana N. Khachatryan

A. I. Isaev

et al.

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Cited by 3 publications

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“…Сегодня исследования показывают, что полиорганная недостаточность, вызванная тяжелым острым панкреатитом, тесно связана с синдромом системной воспалительной реакции [27,28]. Повреждение миокарда, таким образом, обусловливается дисбалансом гомеостаза по причине избыточной продукции трипсина, цитокинов и воспалительных медиаторов (оксида азота, амфотерина и активных форм кислорода).…”

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Modern Ideas on the Role of Hemodynamic Disorders in the Pathogenesis of Acute Pancreatitis

Midlenko,

Chavga

et al. 2023

Ulyanovsk Medico-biological Journal

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Acute pancreatitis remains one of the most common abdominal diseases, causing a large number of both local and systemic complications. Acute pancreatitis has a high death rate. The pathogenesis of acute pancreatitis is complex and needs careful examination. Many authors suppose, that hemodynamic disorders lead to the development of complications, often fatal. Thus, such disorders need be studied separately. The review is based on the analysis of articles included in such databases as elibrary.ru, cyberleninka.ru, and e-versions of specialized open access journals. All the articles outline modern views on the role of hemodynamic disorders in the pathogenesis of acute pancreatitis. The causes and mechanisms of development of hemodynamic disorders are considered in terms of central and regional hemodynamics, and microcirculation. The authors describe their mutual influence and role in the development of both local and systemic complications of acute pancreatitis. Contractility disorders can be observed in the pathogenesis of central hemodynamics. They can be caused by a highly active myocardial depressant factor. These disorders are supported and aggravated by other organs and systems with the development of multiple organ failure. Violations of regional hemodynamics are associated mainly with an increase in intra-abdominal pressure. A direct dependence of intestinal wall perfusion on intra-abdominal pressure is established. Intestinal barrier dysfunction contributes to the infection of necrosis foci. Microcirculation disorders are the most important element in the pathogenesis of acute pancreatitis, often defining its outcome. Microcirculation disorders include angiospasm, venous stasis, microthrombi formation, and interstitial edema. A decrease in local perfusion due to impaired gland microcirculation can cause tissue ischemia and pancreonecrosis.

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unclassified

Modern Ideas on the Role of Hemodynamic Disorders in the Pathogenesis of Acute Pancreatitis

Midlenko,

Chavga

et al. 2023

Ulyanovsk Medico-biological Journal

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Test for the antimicrobial peptide lactoferricin in appendicitis and peritonitis

Yasnopolsky,

Kokhanov,

Zurnadzhyants

et al. 2024

jour

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The purpose of the study: was to compare the concentrations of bacterial infection indicators lactoferrin (LF) and lactoferricin (LFC) in the blood serum and peritoneal exudate of patients with destructive forms of acute appendicitis after laparoscopic and laparotomic appendectomy. The concentrations of LF protein and LFC peptide were studied in blood and peritoneal exudate samples of 45 patients with destructive forms of acute appendicitis of varying severity after laparoscopic or laparotomic appendectomy. When studying the levels of LF and LFC in patients with acute destructive appendicitis, it was found that their levels differ from the donors' figures by 3 times for both LF and LFC. It was found that the concentrations of LF and LFC in patients with acute destructive appendicitis and appendicular peritonitis are 3 times higher than the donors' figures for both LF and LFC. As for the peritoneal exudate of patients with destructive forms of acute appendicitis, they were compared with the results of the same patients in the blood serum. In this case, a statistically significant excess of peritoneal concentrations over serum levels in patients with acute destructive appendicitis and appendicular peritonitis is characteristic only for LF (by 3–4 times), but not for LFC. Comparison of the levels of the two studied biochemical indicators in the blood serum and peritoneal exudate in patients with destructive forms of acute appendicitis after laparoscopic and laparotomic appendectomy options did not reveal a reliable relationship between LF and LFC and the type of appendectomy. Thus, tests for LF and LFC in patients with destructive forms of acute appendicitis are primarily closely related to the severity of patients with acute destructive appendicitis and appendicular peritonitis. The antibacterial properties of LF and LFC have been actively studied in recent years in emergency medicine for abdominal surgical infection. The fact is that a serious problem in antibacterial therapy of abdominal infection is the rapid development of resistance to known antibiotics, which requires the use of increasingly new classes of antibiotics and antiseptics and the development of new classes of antibacterial agents, including lactoferrin and its derivative lactoferricin. We have found that, despite the common nature of these substances, the mechanisms of action of the LF protein and LFC peptide on bacteria differ significantly, which is confirmed in our study using the example of studying both tests in destructive forms of acute appendicitis. LF in surgical abdominal infection primarily reflects various bactericidal and bacteriostatic effects of iron in the blood, intestines and abdominal cavity. The short peptide LFC is not associated with iron metabolism, which does not prevent this peptide, due to its unique amino acid composition, from exhibiting in the experiment even higher antimicrobial activity than LF.

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Surgical Site Infections: Risk Factors for Multiple Antibiotic Resistance in Abdominal Surgery

Parshin,

Topchiev,

Astakhin

et al. 2024

Neotložnaâ med. pomoŝʹ

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INTRODUCTION. Multidrug-resistant (MDR) organisms are increasingly becoming a major surgical site infection (SSI); however, the clinical outcomes and risk factors associated with resistant pathogens in general surgery remain poorly understood.THE AIM of the present research is to study the risk factors and consequences of infections in patients with SSI caused by antibiotic resistant pathogens with MDR.MATERIAL AND METHODS. A single-center, retrospective case-control study was carried out. The results of the examination and treatment of 50 patients with SSI + MDR, who made up the main group, and two control groups — non-MDR SSI and no SSI, 50 patients each, were analyzed. A total of 38 risk factors were used: pre- and surgical criteria, clinical, biochemical, instrumental data, postoperative complications and treatment features. The microbial landscape was studied in SSI+MDR. Single- and multivariate analysis was carried out, binary and multinomial logistic regression was performed. P-values <0.05 were considered significant at 95% CI.RESULTS. Significant risk factors were as follows: previous hospitalization, previous antibiotic therapy, terms of preoperative stay of the patient in the department, emergency surgery, class of surgery, decrease in the ratio of ALP/ ALPI, MEI and EMFC (p<0.01); elevated ASA score, obesity, low levels of plasma proteins and albumin, (p<0.05). Among the pathogens, there were more gram-negative enterobacteria (61%) than gram-positive ones (30.5%). Escherichia coli (36.3%) was the most commonly found bacterium, followed by Enterococcus faecium (9.09%), Morganella morganii (7.58%), Staphylococcus aureus (6%), and Pseudomonas aeruginosa (6%). In SSSI, Staphylococcus spp. prevailed. (>80%); in DSSI — Echerichia, Acinetobacter (>70%); and in OSSSI — Enterobacter spp., Acinetobacter and Citrobacter (>90%). SSI+MDR were characterized by serious surgical complications (Clavien Dindo Classification grade 3–5), wound dehiscences and OSSSI, reoperations (p<0.05).CONCLUSION. 1. The primary risk factors for multiple antibiotic resistance were as follows: previous hospitalization, previous antibiotic therapy, the duration of the patient’s preoperative stay in the department, emergency surgery, surgery class, reduced ALP/ALPI ratio, MEI and EMFC. In addition to the above, the following were also of great importance: increased ASA score, obesity, low plasma proteins, albumin.2. When identifying risk factors for multiple antibiotic resistance in surgical patients, the development of severe postoperative complications, sepsis and multiple organ failure can be predicted.3. Perioperative medical and preventive measures require a multidisciplinary approach involving the microbiologist, pharmacologist, immunologist, nutrition specialist, and other expert consultants.

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New possibilities in antibacterial treatment of intra-abdominal infections caused by multiresistant microflora

Cited by 3 publications

References 27 publications

Modern Ideas on the Role of Hemodynamic Disorders in the Pathogenesis of Acute Pancreatitis

Modern Ideas on the Role of Hemodynamic Disorders in the Pathogenesis of Acute Pancreatitis

Test for the antimicrobial peptide lactoferricin in appendicitis and peritonitis

Surgical Site Infections: Risk Factors for Multiple Antibiotic Resistance in Abdominal Surgery

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