TAXONOMIC STRUCTURE OF PANCREATIC INFECTIOUS AGENTS IN PATIENT WITH ACUTE NECROTIC PANCREATITIS

Abstract

The article describes the change in the level of antimicrobial resistance of infectious agents of acute infected necrotizing pancreatitis in patients in the dynamics of the disease and the treatment, classified the data according to the sensitivity of microorganisms. The main purpose of the prospective cohort study is to determine the taxonomic structure of pathogens of pancreatic infection in patients with acute necrotizing pancreatitis in the dynamics The relevance of the study of this pathology is the importance of the phenomenon of increasing the level of antibiotic resistance during long-term antibiotic therapy, which is shown to patients with pancreatic infection. The methodology of the study consisted of three-stage bacteriological monitoring and subsequent qualitative and quantitative evaluation of microbial agents and antibiotic resistance characteristics according to the stratified classification of the European Center for Disease Control ( Magiorakos et al., 2012): the taxonomic structure of pancreatic pathogens in 123 microbial isolates identified during the study was evaluated using antibioticogram results. The duration of the study was the entire duration of the diagnosed infectious process and averaged 33.4 days. The object of the study was selected microbial isolates, which were isolated in the above terms from the biological material of patients: aspirate parapancreatic fluid clusters in the initial stage, removed pancreatic sequesters in the second stage, and isolation from the drainage of the bursa omentalis and retroperitoneum in the third stage. The study empirically confirms and theoretically proves that the qualitative component of microbial pathogens of acute infected necrotic pancreatitis is characterized by time dependence: the level of classified resistance is higher in the third stage of the study compared with the obtained characteristics of the microorganisms in the first stage and, accordingly, in the second stage of the study; a consistent bacteriological characteristic indicates a transition from mono- to mixed infection (р< 0,001) with the inclusion of all members of the 'ESKAPE'-group in the second stage and the predominance of the gram-negative flora at each stage. The fungal component of the microorganisms is represented by the sole pathogen since the second stage of the study in the group with bacteria only. The results of the study may be useful in predicting the success of antibiotic therapy at different stages of the disease and the expected bacteriological characteristics in successive bacteriological crops of biological material of patients during the acute infected necrotizing pancreatitis.