Features of microbiological diagnosis and choice of selective antibiotic therapy in patients with acute cholecystitis

A. G. Salmanov, V. I. Mamchich, V. V. Potochilova, E. L. Rudneva, M. A. Chaika

Abstract


The objective: to improve the results of destructive forms of acute cholecystitis (AC) surgery by the development of antibiotic therapy algorithm and taking into account the severity of the disease according to Tokyo guidelines (2013). Materials and methods: 266 patients having been operated on for AC made up a treatment group and 203 patients - the control one. In 234 treatment group patients microflora’s bacteriological study was carried out and its selective sensitivity to antibiotics was determined. Results and discussion. The AC treatment group patients (n=266) were arranged according to Tokyo guidelines (2013) into 3 grades. Mild course (grade I) consisted of 29 patients (11%), microbiological studies were not conducted. Antibiotic prophylaxis with beta-lactam antibiotics was used. At moderately severe AC (grade II, n = 200, 75%) escalation antibiotic therapy was carried out. At severe disease (grade III, n = 37, 14%) de-escalation antibiotic therapy was performed. Bacteriological studies were conducted in 237 patients with destructive forms of AC, at that 531 microflora isolates were cultured. Intestinal group microorganisms were the most frequently cultured. Beta-lactam antibiotics’ sensitivity was prevailing and constituted 83.3%. The number of suppurations in the treatment group decreased from 9.8% to 4.3%, and mortality rate decreased from 1.48% to 0.75% (p<0.05) as contracted with control group where empirical antibiotic therapy was used. Conclusions. 1. Intestinal group microflora prevailed in destructive forms of AC. 2. In mild course of cholecystitis antibiotic prophylaxis is consider to be method of choice, in moderately severe disease – escalating therapy, and in severe cases – de-escalating antibiotic therapy should be used, as that beta-lactam antibiotics had the highest selective sensitivity (83.3%). 3. AC is local intra-abdominal infection, where evidence-based antibiotic therapy has reduced postoperative complications to 4.3%, and mortality rate - to 0.75%.

Keywords


acute cholecystitis; prophylactic; escalation; de-escalation selective antibiotic therapy; microbiological diagnostics

Full Text:

PDF

References


Glumcher F.S. New methods of treatment of sepsis // Health of Ukraine.- 2018 (May). - P. 28-30.

Zubkov N.M. Collecting, transporting biological material and interpreting the results of microbiological research // Clinical Microbiology and Antimicrobial Chemotherapy. - 2004 - №2. - P.143-150.

Kulya AF, Sabo Yu., Koval G. M. Comparative analysis of methods for determining the antibiotic susceptibility of opportunistic bacteria - pathogens of opportunistic infections of a person // Microbiological journal. - 2011. -T. 23. - No. 5. - P. 47 - 53.

Lupaltsev V. I., Lesova V. N. Emergency surgery of the organs of the abdominal cavity and retroperitoneal space. - Kharkov: Contrast, 2017. - 235 p.

Mishalov V. G., Bondarev P. V., Ivantsyuk V. M., Kondratenko S. A. The results of treatment of complicated acute cholecystitis in the elderly and the elderly // Surgery of Ukraine. - 2015. - №4. - P. 49 - 53.

Mishakov V. G., Burka A. A., Markulan L. Yu., Vaush S. M., Shtypuk N. I. Use of semi-synthetic penicillins in abdominal surgery with prophylactic and therapeutic purpose // Surgery of Ukraine. - 2009. - № 4. – P. 20 - 27.

Mishalov V.G., Kondratenok S.O., Markulan L.Yu. Severity for Tokyo guidelines (2013) and pathological forms of acute calculous cholecystitis in patients with coronary heart disease // Surgery of Ukraine. - 2017 - No. 4 (64). - P. 22 - 26.

Fomin P.D. Perioperative prevention of infectious complications: to the question of the choice of antibiotics // General surgery. Aspects of prevention. Health of Ukraine. - 2011 (July) .- P. 16 - 17.

Tsyupa I. Do we all know about the colon? // Health of Ukraine. - 2018 (May). - P. 43 – 48

Emilio Etala. Atlas of abdominal surgery: Transl. from English; Vol. I. - Moscow.: Medical literature. - 2008. - 459 p.

Gotzky K., Landwehr P., Jahne J. Epidemiology and clinical presentation of acute cholecystitis // Surgeon. - 2013. - № 3. - P.179 -184.

Vincent J. L. Microbial resistance: lesson from the EPIC study European prevalence of Intaction // Intensive Care Medicine. - 2000. - № 26. - Р. 53 - 58.

Waine P. A. Clinical and Laboratory Standart Institute. Performance Standard for Antimicrobial susceptibility testing CLSI: document M100-S 24 // Clinical and Laboratory Standart Institute, 2014.




DOI: http://dx.doi.org/10.5281/zenodo.3350836

Refbacks

  • There are currently no refbacks.




Copyright (c) 2019 © The Author (s) 2019

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

https://pbn.nauka.gov.pl/sedno-webapp/search?search&searchCategory=WORK&filter.inJournal=36616

POL-index 2011 - 2014

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-32a319c5-a850-4f44-ba70-1418a6087655

BASE 2011 - 2014

https://www.base-search.net/Search/Results?lookfor=Journal+of+Health+Sciences+%28Radom%29&type=all&oaboost=1&ling=1&name=&thes=&refid=dcrespl&newsearch=1

http://elibrary.ru/contents.asp?titleid=37467

http://journal.rsw.edu.pl/index.php/JHS/issue/archive

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

https://www.ncbi.nlm.nih.gov/nlmcatalog/101679844

Find a library that holds this journal: http://worldcat.org/issn/23918306

Journal Language(s): English 

PBN Poland

https://pbn.nauka.gov.pl/sedno-webapp/journals/49068

POL-index

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-c39c8169-88d2-45db-9e7f-d948ce9981c4

BASE

https://www.base-search.net/Search/Results?join=AND&bool0[]=AND&lookfor0[]=2391-8306&type0[]=all&page=11&l=pl&oaboost=1&refid=dcpagepl

Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2  www.ukw.edu.pl Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy http://ojs.ukw.edu.pl/index.php/johs  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at https://dbh.nsd.uib.no/publiseringskanaler/erihplus/periodical/info?id=485984

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.

http://journals.indexcopernicus.com/Journal+of+Education+Health+and+Sport,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase Index.com.

Website: www.infobaseindex.com

Universal Impact Factor 1.78 for year 2012. (http://www.uifactor.org/AppliedJournals.aspx)

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (https://pbn.nauka.gov.pl/journals/36616)

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ) http://elibrary.ru/contents.asp?titleid=37467

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski

(http://www1.bg.us.edu.pl/bazy/czasopisma/czasop_full.asp?id=3595)