© Новости хирургии К.М. КУБРАКОВ ДИАГНОСТИКА И ЛЕЧЕНИЕ

реклама
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«
»
–
(
).
146
-
,
(
),
.
(
,
65
).
.
,
Expression.
(53,3%)
Acinetobacter baumannii.
33,3%
-
.
:
,
,
,
,
-
.
The article is devoted to the problem of diagnostics and treatment of the most widely spread
intracranial pyo-inflammatory complications – to meningoencephalitis ( E). The death rate at the given
pathology reaches 20-30 %. The analysis of 146 cases of the patients with postoperative E, who were
operated on with severe cranial-cerebral traumas, diseases of the brain and vascular pathology is presented
in the article. It is shown, that priority value in diagnostics and treatment of the patients with ME belongs
to studying of the structure of the cerebrospinal fluid (CSF). Bacteriological studying of CSF in 65
patients was performed. Identification and estimation of microorganisms sensitivity was carried out by
means of the tests - systems on the biochemical analyzer ATB Expression. The growing role of gram
negative polyresistant microflora (53,3 %) in the etiological structure of the postoperative E was proved;
33,3 % of cases of them were caused by Acinetobacter baumannii. On the basis of the data concerning
the structure and sensitivity to antibiotics, circuitries of the rational antibiotic therapy of E in the
neurosurgical patients are developed.
Keywords: meningoencephalitis, diagnostics, polyresistant flora, antibiotic therapy,
prophylaxis.
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(28,8%),
Streptococcaceae
–8
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(11,1%),
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(8,8%),
- 15
(33,3%) ( . 3).
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aureus – 4
(30,7%)
(
): S.
saprophyticus – 4
(30,7%), S.
pidermidis – 5
(38,4%).
Enterococcus Spp. – 4
(50%),
Streptococcus – 2
(25%) 2
(25%) Aerococcus viridans.
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– 1 (20%) 2
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(40%), P.vulgaris
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Streptococcaceae
17,77%
Enterobacteriaceae
11,11%
Pseudomonadaceae
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Staphylococcus
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33,33%
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(33,3%)
Acinetobacter baumannii
<0,01).
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1).
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21,63%.
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53,3 %
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33,3%
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// III
.–
., 2002. – . 4.
/ . .
, 1995. – 79 .
, . .
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;
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//
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. 46-49.
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.] //
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11.
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1993. – 351 .
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13.
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[
.] // III
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., 2002. – . 444.
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