Badikov V D, Krylov K M, Minnullin I P
Antibiot Khimioter. 1997;42(9):33-5.
The paper presents data on clinico-microbiological investigation of gunshot and firemine wounds in 27 injured during the Afghan war at the stage of their qualified surgical treatment 2-5 days after the injury. The quantitative and qualitative compositions of Clostridium that caused the infection and their susceptibility to 20 antimicrobials were determined. It was shown that the main pathogen of the anaerobic infection at the prehospital stage was Clostridium perfringens as a monoculture or association with aerobic and obligate anaerobic microbes. For rational antimicrobial therapy of gas gangrene it was advisable to preliminarily have antibioticograms of the isolates from the wounds. In the empirical therapy it was preferable to use penicillins (benzylpenicillin, ampicillin and others), rifampicin, metronidazole or ceftriaxone. The results are useful for substantiation of schemes for rational antimicrobial prophylaxis of wound infectious complications in injured in war time.
本文介绍了阿富汗战争期间27名伤员枪伤和地雷伤在受伤后2至5天进行合格外科治疗阶段的临床微生物学调查数据。确定了引起感染的梭菌的定量和定性组成及其对20种抗菌药物的敏感性。结果表明,院前阶段厌氧菌感染的主要病原体是产气荚膜梭菌,可为单一培养或与需氧菌和专性厌氧菌联合存在。为合理进行气性坏疽的抗菌治疗,建议预先对伤口分离菌株进行药敏试验。在经验性治疗中,优选使用青霉素(苄青霉素、氨苄青霉素等)、利福平、甲硝唑或头孢曲松。这些结果有助于证实战时受伤人员伤口感染并发症合理抗菌预防方案。