Rosova L V, Godovykh N V
Klin Lab Diagn. 2016 Oct;61(10):727-30.
The article presents analysis of results of microbiological study of pathologic samples from fistula and surgical wounds of 155 patients with chronic osteomyelitis of long bones in the period of exacerbation of disease during 2014-2015. In totality, 126 samples from fistula and 95 samples from wounds were analyzed. Correspondingly, 164 and 102 strains of bacteria were separated. The microbial contamination of fistula and wounds was established. The species composition of microflora was analyzed. It is established that in the analyzed groups the main agent still continues to be staphylococcus and priority pathogen Staphylococcus aureus differing slightly in rate of occurrence and coefficient of resistance. MRSA was separated up to 5.6% more often from surgical wounds than from fistula. The highest detection rate of strains S. aureus and MRSA falls on 2009-2010. In 2015, the lowest detection rate of S. aureus was marked with relatively high rate of detection of MRSA. The disk diffusion D-test was applied to determine resistance of inducible type to Clindamycin of 17 strains of S. aureus resistant to Erythromycin and sensitive to Clindamycin. The inducible resistance to Clindamycin for strains from surgery pounds made up to 62.5% that is three times higher than in case of strains separated from fistula. The important role in development of chronic of osteomyelitis of long bones is played by Gram-negative microorganisms (E. coli, Enterobacter, P. aeruginosa, etc.). The rate of detection of these microorganisms in surgery wounds makes up to 22.5% and 17.1% in fistula.
本文呈现了对155例长骨慢性骨髓炎患者在2014 - 2015年疾病加重期瘘管和手术伤口病理样本的微生物学研究结果分析。总共分析了126份来自瘘管的样本和95份来自伤口的样本。相应地，分离出了164株和102株细菌。确定了瘘管和伤口的微生物污染情况，并分析了微生物群落的种类组成。结果表明，在所分析的组中，主要病原体仍然是葡萄球菌，优先病原体金黄色葡萄球菌在发生率和耐药系数上略有不同。耐甲氧西林金黄色葡萄球菌（MRSA）在手术伤口中的分离率比瘘管高5.6%。金黄色葡萄球菌和MRSA菌株的最高检出率出现在2009 - 2010年。2015年，金黄色葡萄球菌的检出率最低，而MRSA的检出率相对较高。应用纸片扩散D试验来确定17株对红霉素耐药但对克林霉素敏感的金黄色葡萄球菌对克林霉素的诱导型耐药性。手术伤口分离菌株对克林霉素的诱导耐药率高达62.5%，是瘘管分离菌株的三倍。革兰氏阴性微生物（大肠杆菌、肠杆菌、铜绿假单胞菌等）在长骨慢性骨髓炎的发展中起重要作用。这些微生物在手术伤口中的检出率为22.5%，在瘘管中的检出率为17.1%。
