Features of the course of the wound process and systemic inflammatory response in acute staphylococcal paraimplant infection

Barkhatova Natalia Anatolievna, Peshikova Margarita Valentinovna, Kiselev Anton Sergeevich, Barkhatova Ekaterina Igorevna

The article presents the results of a comparison of acute para-implant monoinfection caused by Staphylococcus aureus and epidermal Staphylococcus aureus after metal osteosynthesis of bone fractures. The choice of research direction was due to the high incidence of staphylococci in wound complications and their ability to form biofilms on implants, creating conditions for the formation of a chronic focus of infection. In the course of a comparative analysis of data from 97 clinical cases of acute paraimplant infection, the frequency of occurrence of a systemic inflammatory response and its markers (C-reactive protein, lactoferrin) were evaluated. We studied the features and dynamics of local symptoms of inflammation, immune response and morphological manifestations of the change in the phases of the wound process. We assessed the change in the microbial landscape of wounds, antibacterial resistance, studied the timing and completeness of the elimination of pathogens. According to the results of data analysis, acute purulent complications caused by Staphylococcus aureus had a more pronounced systemic response and local symptoms of phlegmonous inflammation, while during treatment, complete elimination of the pathogen was achieved in 31.7% of patients, and in 50% of cases, the addition of epidermal staphylococcus aureus or complete replacement of the original strain by this flora. Paramplant monoinfections of epidermal staphylococcus were distinguished by rapid relief of local symptoms of inflammation with a tendency for the pathogen to remain in the implant area in 86.5% of cases, which increased the risk of developing a chronic focus of infection and required the selection of individual treatment tactics.

Keywords:Staphylococcus aureus, Staphylococcus epidermidis, paraimplant infection, osteosynthesis.