THE RESULTS OF A MICROBIOLOGICAL STUDY OF PATIENTS WITH EXTENSIVE BURNS IN THE DYNAMICS OF THE COURSE OF BURN DISEASE AND AN ALGORITHM FOR THEIR INTERPRETATION

The results of a dynamic microbiological study of the samples of 195 patients with extensive burns are presented. Depending on the order of hospitalization of patients, differences were found in the struc- ture of the microbiota, the level of resistance to antibiotics and the manifestation of pathogenic properties (biofilm formation, secretion of protective proteases and aggression factors, adhesive activity, the pres- ence of virulence genes). There was an increase in the frequency of matches of the species composition, especially for isolates of P. aeruginosa, K. pneumoniae, A. baumannii, in 2 or more types of samples, depending on the length of stay in the intensive care unit. The results obtained determine a differentiated approach to microbiological examination and empirical initial antibiotic therapy in patients with exten- sive burns with the need to take into account the order of hospitalization. An algorithm for interpreting the results of sowing discharge from extensive burns is presented, taking into account the timing of the study, the number of bacteria, the level of resistance, markers of pathogenic potential, the coinci- dence of the species composition in biomaterials.

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