ACUTE STAPHYLOCOCCAL PARI-IMPLANT INFECTION: FEATURES OF LOCAL AND SYSTEMIC REACTIONS OF THE BODY
The article presents the results of comparing the clinical manifestations of acute staphylococcal paraimplant infection after metal osteosynthesis of bone fractures. The comparison groups included cases of monoinfection with Staphylococcus aureus and epidermal Staphylococcus aureus and analyzed the manifestations of local and systemic inflammatory reactions characteristic of each type of infection, the dynamics of the microbial landscape of wounds, the presence of initial antibacterial resistance and the completeness of achieving the elimination of pathogens from the focus of inflammation. The results of the comparisons revealed the characteristic features of local manifestations of acute infection with a predominance of phlegmon in the presence of Staphylococcus aureus and delimited processes in case of infection with Staphylococcus epidermidis. There was a tendency to change the bacterial composition of the focus of paraimplant infection during treatment with a high frequency of superinfection with epidermal staphylococcus, which, despite the low level of CFU = 103-4, was characterized by long-term persistence in the focus and significantly increased the risk of forming a chronic focus of infection. The identified features of the clinical and laboratory manifestations of para-implant infection are designed to accelerate the clinical diagnosis of the type of wound infection and, at the early stages, to form the optimal treatment tactics in relation to the debridement of the focus and decide whether it is possible to save the implant or whether it is expedient to remove it with a different method of immobilization of the damaged limb segment.