Problema vybora preparatov dlya antimikrobnoy terapii infektsii protezirovannykh sustavov


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Abstract

The article discusses the problem of the choice of antimicrobial drugs that are optimal for the treatment of orthopedic periprosthetic infection (PPI). Based on the results of a retrospective analysis of the etiological structure of causative agents of PPI (2429 strains) and data of five-year (2010-2014) monitoring of antimicrobial resistance, microbial spectrum of the main etiological factors and ranges of levels of pathogens resistance to commonly used antimicrobial agents are established. It was found that a large proportion of the leading pathogens of PPI has multiple resistance factors: 56.6 and 23.9% of the Staphylococcus epidermidis and Staphylococcus have resistance to methicillin; 25% of the Enterobacteriaceae strains produce β- extended-spectrum β-lactamases; up to 29% of Pseudomonas aeruginosa strains are resistant to carbapenems. Proper analysis of the scientific data and medical literature determines the need for the use of combined antimicrobial therapy in the treatment of PPI and the importance of creating a register of patients with periprosthetic infection to determine the most effective treatment of such severe complications after replacement arthroplasty.

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