FEATURES OF MICROBIAL LANDSCAPE IN GUNSHOT WOUNDS OF THE SMALL PELVIS COMPLICATED BY PERITONITIS

Maslyakov Vladimir Vladimirovich, Polidanov Maxim Andreevich, Pronina Elena Alexandrovna, Parshin Alexey Vladimirovich, Polkova Irina Aleksandrovna, Barsukov Vitaly Gennadievich

Objective of the study. To study the microbial landscape in patients with gunshot wounds of the small pelvis complicated by peritonitis. Material and methods. The study is a multicenter, retrospective one. The study involved 86 women with shrapnel gunshot wounds of the abdominal cavity resulting in damage to the internal genitalia. All casualties were from the civilian population, ranging in age from 18 to 45 years, with a mean age of 34 ± 5 years. Taking into account the time of delivery, all the wounded were divided into 2 subgroups: the 1st (group A) included 45 (52.3%) people whose delivery time did not exceed 1.5 h; the 2nd (group B) included 41 (47.7%) women whose delivery time from the moment of wounding exceeded the specified time. Results. On the basis of the obtained data we can conclude that peritonitis in gunshot wounds of the small pelvis in women is characterized by a rather severe course, which depends on the time elapsed from the moment of wounding to the beginning of surgical treatment. The microbial landscape also depended on the time of wounding, however, the results obtained showed that Escherichia coli predominated in both groups. In addition, Enterobacter spp., Staphylococcus, Streptococcus, and Enterococcus spp. were obtained. Proteus and Klebsiella were obtained in group B. This microbial landscape is supported by studies that have been previously conducted and reported in the literature [6, 7]. It was shown that in group A, monocultures were predominant and were obtained in 26.1% of cultures, and associations (componentization) were noted in only 7.7% of observations (p < 0.05), whereas in group B, monoculture growth was noted in 19.2% of observations and associations (componentization) in 50% of cases. The analysis of microorganism sensitivity showed that in the majority of observations it can be recognized as rational. When comparing laboratory and clinical results, as well as analyzing the postoperative period, it was found that complications developed in 13.9% of cases. At that, in group A in 2.3% of observations, and in group B - in 11.6% (r = 0.87, p < 0.05). Conclusion. The microbial landscape in peritonitis due to gunshot wounds of the pelvis depends on the time elapsed from the moment of wounding to the beginning of surgical treatment fulfillment

Keywords:Gunshot wounds, small pelvis, peritonitis, microflora, microbial sensitivity, mortality, complications