Mamchich V I, Ulitovskiĭ I V, Savich E I, Znamenskiĭ V A, Beliaeva O A
Khirurgiia (Mosk). 1998(1):26-9.
362 patients with acute appendicitis (AA) were examined. For microbiological diagnosis of aerobic and anaerobic nonclostridial microflora we used complex accelerated methods (including evaluation of gram-negative microorganisms in comparison with tinctorial-fermentative method of differential staining according to oxygen sensitivity of catalasopositive together with aerobic and cathalasonegative anaerobic microorganisms) as well as complete bacteriologic examination with determination of sensitivity of the above microorganism to antimicrobial remedies. High rate of aerobic-anaerobic microbial associations and substantial identity of microflora from appendicis and exudate from abdominal cavity was revealed, which evidenced the leading role of endogenous microorganisms in etiology and pathogenesis of AA and peritonitis i. e. autoinfection. In patients with destructive forms of AA, complicated by peritonitis it is recommended to use the accelerated method of examination of pathologic material as well as the complete scheme of examination with the identification of the isolated microorganisms and the correction of antibiotic treatment.
对362例急性阑尾炎（AA）患者进行了检查。对于需氧和厌氧非梭菌微菌群的微生物学诊断，我们采用了综合加速方法（包括评估革兰氏阴性微生物，并与根据过氧化氢酶阳性需氧微生物及过氧化氢酶阴性厌氧微生物的氧敏感性进行的鉴别染色的染色发酵法相比较）以及确定上述微生物对抗菌药物敏感性的完整细菌学检查。结果显示需氧 - 厌氧微生物联合的比例很高，且阑尾和腹腔渗出液中的菌群具有实质性一致性，这证明了内源性微生物在AA和腹膜炎的病因学和发病机制中起主导作用，即自身感染。对于患有破坏性AA并伴有腹膜炎的患者，建议采用病理材料的加速检查方法以及完整的检查方案，包括鉴定分离出的微生物并调整抗生素治疗。
