The architectonics of microbe ecology in the purulent surgery department of municipal clinical hospital

2012 
S. aureus, S. pyogenes, P. aerugenosa, E. coli, P mirabilis, A. baumannii, S. epidermidis, K. pneumoniae, E. faecalis, E. cloacae are the priority pathogens of various forms of pyoinflammatory diseases. They form the architectonics of microbe ecology of the purulent surgery department of multi-type hospital of regional level with S.aureus subsp.aureus playing dominating role. In case of unchanged specter of priority pathogens of pyoinflammatory and pyoseptic diseases the number of gram-positive coccuses decreases at the expense of decrease of number of streptococcuses and staphylococcuses. At the same time, the number of enterobacteria and gram-negative non-fermentative bacteria increases. The resistance ofgram-positive coccuses increases regarding erythromycin, clyndamicin and cyprofloxacin. The resistance of gram-negative bacilli increases regarding ciprofloxacin, cephalosporins of III-IV generations, amikacin. The resistance is the highest among clinical isolates MRSA, K. pneumoniae, A. baumannii. The vancomycin is active regarding all gram-positive pathogens. The carbapenems are active regarding all enterobacteriae. The carbapenems, cefoperazone/tazobactam, cefepime are most active regarding non-fermentative glucose oxidizing bacteria. The netimicin is active regarding A.baumannii. The polymyxine is active regarding P. aerugenosa. The circulation of S. aureus hospital strain of particular genotype is established confirming the propagation of epidemic S. aureus strains in Moscow multi-type medical institutions. The strains are genetically affined to epidemic strains in European and other countries according the international data base (http://SpaServer.ridom.de). The genetic typing of S. aureus ssp. aureus out-hospital hemocultures detected their considerable genetic variety. The epidemic relationship between isolates from different patients is not established. The algorithms of rationale antibacterial chemotherapy of pyoinflammatory and pyoseptic diseases are developed to be implemented in the purulent surgery department of municipal clinical hospital of Moscow.
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