Features of the use of antibiotics in the treatment of gunshot fractures of long bones

SummaryBackground. Infections associated with medical care pose a serious threat tohumanity. Irrational use of antibiotics leads to the development of resistance ofmicroorganisms to them.The aim of the work was to establish the species composition of microorganismsthat contaminate the gunshot wound and to establish the sensitivity of the isolatedmicroorganisms to antibiotics.Materials and methods. A microbiological study of gunshot wounds of thewounded at a specialized stage of medical care and determination of the sensitivity ofthe isolated microorganisms to antibiotics.Results. The dominance of acinetobacteria (53% of the wounded) andpseudomonads (20% of cases) was established. Analysis of the sensitivity of the isolatedmicroorganisms to antibiotics showed significant resistance of these microorganisms tothe most antibacterial drugs. Among all isolated strains, 11.9% were polyresistant(MDR) according to EUCAST criteria, and 76.5% were microbes with extendedresistance (CDR). Acinetobacter ssp., were resistant to most of the tested antibiotics. Atthe same time, all isolates of Acinetobacter ssp. were sensitive to polymyxin B andcolistin. 75% of Pseudomonas aeruginosa strains were resistant.Conclusion. Contamination of gunshot wounds at the stage of specialized medicalcare by multidrug-resistant gram-negative bacteria indicates nosocomial transmissionin the previous stages of evacuation and requires a clear list of antibacterial drugs thatcan be used to prevent and treat infectious complications.