Abstract
Background. Surgical intra-abdominal and wound infection is a significant problem in abdominal surgery, and is associated with increased mortality, prolonged hospitalization and significant economic costs for patient treatment. The main pathogens, such as E. coli, K. pneumoniae and P. aeruginosa, demonstrate high levels of resistance, which limits the effectiveness of antimicrobial therapy. Aim: analysis of the structure of the microbial composition of pathological material and postoperative wounds in connection with the pathology for which surgical intervention was performed in the abdominal cavity, as well as determination of the sensitivity profile of isolated microorganisms to antimicrobial drugs. Materials and methods. The study included 287 patients who were operated on for abdominal pathology: intra-abdominal abscess – 77, acute pancreatitis – 62, peritonitis – 40, cholelithiasis – 24, acute appendicitis – 22, acute cholecystitis – 9, other pathologies – 53. Samples for analysis of susceptibility to basic antibiotics by the disc diffusion method were taken from the locus morbi (abdominal cavity contents, pathological contents, postoperative wound). The statistical proceХРІng of the study results was performed using the EZR v.1.68 software (graphical user interface for R statistical software version 4.3.1, R Foundation for Statistical Computing, Vienna, Austria). Results. The distribution of pathogens varies depending on the pathology: E. coli and K. pneumoniae predominate in all pathologies and occur with almost equal frequency (only in acute appendicitis and cholecystitis E. coli significantly prevails). P. aeruginosa is often isolated in intra-abdominal abscesses, acute pancreatitis, peritonitis and gastrointestinal diseases. In acute pancreatitis, other microorganisms are often isolated, most often A. baumannii. The highest rate of positive antibiotic susceptibility tests for E. coli and K. pneumoniae was observed in carbapenems (11.1%-23.7%), amikacin (15.2%-17%) and gentamicin (7.3%-11.1%), for P. aeruginosa in amikacin (22.2%), piperacillin+tazobactam and cefoperazone (18.5% each), for S. aureus to the same extent in erythromycin, linezolid and oxacillin (9.5% each). Conclusion. The distribution of pathogens varies depending on the surgical pathology of the abdominal cavity, but with a constant predominance of E. coli and K. pneumoniae in most of the cases and a small proportion of P. aeruginosa, S. aureus and other microbes. The most common bacteria were typically susceptible to carbapenems, amikacin and gentamicin