Etiologic structure of infectious complications in traumatologic and orthopaedic patients has been studied at CITO named after N.N. Priorov during the period from 2005 to 2007. Using modern agents and techniques 6799 samples from 3023 patients were studied. Resistance of pathogenic microorganisms to the wide spectrum of antibiotics including the drugs of last gene-ration was studied. Basing on the study results the protocols for the application of modern antibiotics including protected aminopeptides, cephalosporins of third-forth generation including the protected ones, glycopeptides, oxazolidinones, aminoglycosides, fluoroquinolones, carbape-nemones have been elaborated and introduced into clinical practice.
During some years at clinical departments and laboratories of CITO electrochemically activated solutions are used for disinfection and sterilization. These solutions are synthesized in apparatus STEL10N1201 (katalytic neutral anolyte). Results obtained are promising for the prevention of intrahospital infections. Practically no other disinfectants are used at the hospital.
The basic preconditions and rational schemes of intraoperative chemoprophylaxis of purulent complications are considered. The leading role of Staphylococcus in the infection pathology of loco-motor system (in 77% of patients, aged after 18, with osteomyelitis and infection of soft tissue) is taken into account. The comparative analysis of the results of the 1st (cefazolin) and 2nd (zinacef) generation cephalosporins application is performed at reconstructive operations in the comparable groups of patients. With due regard for the significant rate of Staphylococcus resistence to cefazolin in vitro (up to 25- 42% of isolates in patients with different diseases) and considerably lower resistence to zinacef (under 10%) the authors consider the later to be more preferable for the prevention of suppurative complications in traumatology and orthopaedics.
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