RESULTS OF MICROBIOLOGICAL MONITORING OF INFECTIOUS AGENTS AT THE SURGICAL SITE IN PATIENTS WITH COLONIC CANCER COMPLICATED WITH COLONIC OBSTRUCTION

Beschastnov Vladimir Viktorovich, Candidate of medical sciences, associate professor, surgical department resident, Municipal clinical hospital № 12 (8 Pavla Molchanova street, Nizhny Novgorod, Russia), lancet2003@list.ru
Ryabkov Maksim Georgievich, Candidate of medical sciences, associate professor, surgical department resident, Municipal clinical hospital № 12 (8 Pavla Molchanova street, Nizhny Novgorod, Russia), lancet2003@list.ru
Malakhova Nina Ivanovna, Head of bacteriological laboratory, Municipal clinical hospital № 12 (8 Pavla Molchanova street, Nizhny Novgorod, Russia), lancet2003@list.ru
Moskovskaya Alla Evgen'evna, Bacteriologist, bacteriological laboratory, Municipal clinical hospital № 12 (8 Pavla Molchanova street, Nizhny Novgorod, Russia), lancet2003@list.ru
Kleyment'ev Evgeniy Viktorovich, Surgical department resident, Municipal clinical hospital № 12 (8 Pavla Molchanova street, Nizhny Novgorod, Russia), lancet2003@list.ru

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Background. The aim of the study was to evaluate the antimicrobial resistance and justification of the rational choice of drugs for the empirical and causal antibiotic therapy in patients with colorectal cancer complicated with intestinal obstruction, based on the analysis of the results of the study of etiological structure of infections of surgical intervention.
Materials and methods. The authors analyzed the dynamics of the microbial landscape of purulent wounds and the results of treatment in 62 patients with surgical site infection, who underwent surgery for acute colonic ob-struction of tumor genesis. Results. It is revealed that the main etiological factor of infection of surgical intervention was the autochthonous flora, most of which were gramnegative bacteria - especially members of the family Enterobacteriaceae, retaining high sensitivity to III generation cephalosporins and protected penicillins. In the analysis of the repeated results of microbiological tests obtained during the treatment, it was found that by the 5th day of wound healing process in 68 % of cases there was a change in the flora of the initiating Antimicrobial hospital strains. The greatest activity in the treatment of nosocomial infection in surgical wounds of patients with colorectal cancer is shown by 2–3 generation fluoroquinolones and carbapenems.
Conclusions. It is advisable to start antibacterial treatment of suppurative inflammation in the area of surgical wounds in patients using the III generation cephalosporins or protected penicillins in combination with metronidazole, while avoiding the use of the drug that was used for perioperative antibiotic prophylaxis. It is advisable to change antibiotics after 7–10 days of treatment.

antibiotic therapy, surgical intervention, intestinal obstruction, cancer, evaluate the antimicrobial resistance.

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