Anaerobic infection is a severe toxic wound infection caused by anaerobic microorganisms, with a predominant lesion of the connective and muscle tissue [1] .
Anaerobic etiological agent is divided into three types [1] :
- Classical clostridial
- Non-clostridial
- Putrefactive
Anaerobic infection is often found in gunshot , contaminated, crushed wounds , as well as in wounds of the hollow organs of the abdominal cavity (e.g. colon ).
Content
Anaerobic Clostridial Infection
Etiology
The classic clostridial etiological agent - the spore-forming obligate anaerobic can be viable for a long time in spore form in the presence of oxygen, and develops only under anaerobic conditions. The products of the metabolism of microorganisms of this kind quickly form an aerobic anaerobic environment suitable for germination of spores into vegetative forms. The risk of infection with Clostridial microflora increases in contaminated soils with low aeration, silty or boggy soils.
Pathogens :
- Clostridium perfringens (44-50%)
- Clostridium oedematiens (15-50%)
- Clostridium histolyticum (2-6%)
- Clostridium septicum (10-30%)
Botulism and foodborne toxicoinfections of Clostridium difficile are not classified as anaerobic infections, despite the fact that they are caused by clostridia.
Clinical picture
Treatment
Prevention
Anaerobic non-clostridial infection
Non-clostridial infectious agents die within 1-2 hours of contact with oxygen and its active forms .
Etiology
Pathogens :
- Gram-positive:
- Peptococcus spp.
- Propionibacterium spp.
- Eubacterium spp.
- Gram-negative:
- Bacteroides spp.
- Fusobacterium spp.
Clinical picture
Anaerobic non-clostridial infection clinically proceeds in the form of phlegmon . Usually these are extensive lesions of subcutaneous fat ( cellulitis ), muscles ( myositis ) and muscle cases ( fasciitis ). A feature of the process can be called a diffuse character, its progression despite the ongoing radical therapeutic measures.
Common symptoms include weakness, subfebrile condition, sometimes anemia , significant general intoxication.
The most common pathogens of putrefactive infection are Escherichia coli, vulgar protea, streptococcal flora, which are in the wound in association with other microorganisms.
Treatment
The components of the treatment are:
- Urgent radical surgical treatment, with excision of necrotic tissue
- Antibiotic therapy
- Detoxification therapy (using extracorporeal detoxification agents)
- Immunotherapy (transfusion of plasma, immunoglobulin preparations, etc.)
- Optional treatment components include oxygenobarotherapy (Meyers. R et al., 1982) and ozone therapy, the use of oxygenated perfluorane in combination with ultrasound.
Forecast
Mortality with adequate treatment is 35-50 percent, according to various sources, depends on the age of the patient and related diseases. If untreated, the prognosis is disappointing.
See also
- Anaerobic organisms
Notes
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Literature
- Stepanov N.G. 100 questions on anaerobic infections of soft tissues. Selected sections of Piology. - Nizhny Novgorod. GIPP Nizhpoligraf , 199. 48 with ISBN 5-7628-0185-3 BBK 55.14