The aim of our work was to study the species profiles of microorganisms that complicate the course of trophic ulcers of the lower extremities, determination of the sensitivity spectrum of isolated strains to antibacterial drugs and the search for effective metabolites of streptomycetes relative to clinical isolates of microorganisms. During the research were examined 65 patients with chronic trophic ulcers and clinical material was collected by using sterile cotton swabs. A total of 113 strains of microorganisms were isolated. P. aeruginosa was the most common pathogen in 45 patients, amounted to 69.23%±5.72%, in monoculture – 12 cases (18.46%±4.81%). The second place of the terms for frequency were isolation among of contaminants of trophic wounds is S.aureus, isolated in 33 patients, which is 50,77%±6,2%, and in monoculture isolated – only 4 strains (6,15%±2,98%). The third place is occupied by S. epidermidis, isolated from 10 patients (15,38%±4,47%), in monoculture it was detected in one case (1,54%±1,53%). Klebsiella pneumoniae, which is 4,62%±2,6%, and Proteus vulgaris (1,54%±1,53%) were detected in 3 cases in the monoculture. Other microorganisms are isolated only in associations. The most common association of S.aureus and P.aeruginosa – 22 cases, which is 33,85%±5,87%. Much less often S.epidermidis and P.aeruginosa – in 6 cases 9,23%±3,59%. Isolated associations have been found among microorganisms such as Streptococcus spp. and P.aeruginosa (3,08%); Acinetobacter spp. and S.aureus (3,08%); Klebsiella spp. and S. epidermidis (1,54%); E.coli and Proteus spp. (1,54%); P.aeruginosa and Acinetobacter spp. (1,54%); Acinetobacter spp. and S.epidermidis (1,54%); Citrobacter spp. and S. aureus (3,08%); Peptostreptococcus spp. and P.aeruginosa (3,08%); S.epidermidis and Proteus spp. (1,54%); Klebsiella spp. and S. aureus (1,54%); Peptostreptococcus spp. and S. aureus (1,54%); Enterobacter spp., Candida albicans and S.aureus (1,54%); Enterococcus spp., Klebsiella pneumoniae and S. epidermidis (1,54%). Colistin was the most active modern antibacterial drug against P. aeruginosa – 86.67% of sensitive isolates, gentamicin was 73.33%, piperacillin and tazobactam 71.11%, ciprofloxacin 66.67%. Drugs such as tobramycin, meropenem and imipenem (35.56%–26.67%) were the least active. The low efficiency of antibacterial agents frequently used in surgical hospitals in relation to clinical isolates of P. aeruginosa induce the search for new drugs. In order to search for active metabolites of streptomycetes, a dual culture method was used with using of 7-day culture of actinomycetes. According to this technique, screening of 369 actinomycetes isolates isolated from the juniper sphere of high Juniperus excelsa Bieb was performed. Among the streptomycetes isolates tested, seven of them were detected with activity against the reference strain P. aeruginosa ATCC 9027. The active metabolites of these streptomycetes were tested for activity against P. aeruginosa clinical isolates. One strain of actinomycetes Je 1–79 was found to exhibit high inhibitory activity against all clinical isolates of pseudomonads. Active metabolites of Je 1–79 are promising to create a tool for topical use in patients with P. aeruginosa infected trophic ulcers.

Added: 25.05.2020

Keywords: antibacterial agents, metabolites of streptomycetes, high-resistance clinical isolates, nosocomial infection

Full text: PDF (Ukr)

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