.

Застосування йоддицерину у лікуванні гнійно-запальних процесів м’яких тканин: Автореф. дис… канд. мед. наук / Р.В. Бондарев, Дніпропетр. держ. мед.

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II?IIAO?IANUeEA AeA?AEAAIA

IAAeE*IA AEAAeAIss

AIIAeA?AA ?inoeneaa Aaeaioeiiae/

OAeE 615.32:616-001.4-002.3-018

CANOINOAAIIss EIAeAeEOeA?EIO O EEOAAII

AIEII-CAIAEUeIEO I?IOeANA I’ssEEO

OEAIEI

14.01.03. – O?o?ay

A a o i ? a o a ? a o

aeena?oaoe ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Aeii?iiao?ianuee – 1999

Aeena?oaoeth ?oeiien.

?iaioa aeeiiaia a Eoaainueeiio aea?aeaaiiio iaaee/iiio oiaa?neoao,
IIC Oe?aie.

Iaoeiaee ea?aiee:

aeieoi? iaaee/ieo iaoe, i?ioani? IEUeOAIAOeUeEEE Ieaenaiae?
Ieaenaiae?iae/, Eoaainueeee aea?aeaaiee iaaee/iee oiaa?neoao,
caaaeoth/ee eaoaae?ith ainioaeueii o?o?a

Iooeei iiiiaioe:

Eao?aao Aea?aeaaii i?ai Oe?aie, caneoaeaiee aey/ iaoee oaoiee Oe?aie,
aeieoi? iaaee/ieo iaoe, i?ioani? NOOA?A aai aaiiae/ – canooiiee
aee?aeoi?a ii iaoeiae ?iaio inoeoooo eei/ii oa aenia?eiaioaeueii o?o?a
AII Oe?aie (i. Eea)

Aeieoi? iaaee/ieo iaoe, i?ioani? AA?ACIEOeUeEEE

ssea Nieiiiiiae/, caaaeoth/ee aaeaeeii o?o?a i?aaia o?aaeaiiy
Oe?ainueeiai IAe aano?iaioa?ieia (i. Aeii?iiao?ianuee)

I?iaaeia onoaiiaa:

Aeiiaoeueeee aea?aeaaiee iaaee/iee oiaa?neoao, eaoaae?a ainioaeueii
o?o?a, IIC Oe?aie, i. Aeiiaoeuee

Caoeno aaeaoaeaoueny “_13_”__10__1999 ?. i 11 aiaeei ia canaeaii
niaoeaeciaaii A/aii ?aaee Ae 08.601.01 o Aeii?iiao?ianueee aea?aeaaie
iaaee/ie aeaaeai, ca aae?anith:

320044, i.Aeii?iiao?ianuee, aoe.Aeca?aeeinueeiai, 9

C aeena?oaoeth iiaeia iciaeiieoeny o aaeioaoe AeAeIA ca aae?anith:
i.Aeii?iiao?ianuee, aoe.Aeca?aeeinueeiai, 9

Aaoi?aoa?ao ?icneaiee “_10_”_09__1999 ?.

A/aiee nae?aoa?

niaoeaeciaaii a/aii ?aaee,aeioeaio Oea/aiei A.I.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeueinoue oaie. Onio eeoaaiiy oai?eo c aieii-ioeiaaieie ?aiaie
a cia/ie i? caeaaeeoue oaeiae aae inoeaaiai eeoaaiiy (A.A.Oaeeiia e
niaao., 1998, I.I.Aaeeaioeeee e niaao., 1998, Bromn C.D. et al.,1995,
Bumpous J.M., 1995). Aaee/aciee eei/iee aeinaae, iaeiie/aiee o?o?aaie,
ye i?aoeththoue a iaeano oai? oa i?aeoeee eeoaaiiy aieii-caiaeueieo
i?ioeana, naae/eoue, ui iaaoue iaeaeueo aoaeoeai eea?nuee caniae o
i?ioean o canoinoaaiiy cieaeothoue naith aioeie?iaio ?aiicaaeeaeyth/o
aeoeainoue aeeeeeathoue iia/i aoaeoe ?ciiai oa?aeoa?o.

Aeoiaey/e c ?acoeueoaoa aeineaeaeaiue inoaiio ?iea (A.O.Caeoeaa e
niaao., 1989, A.I.Aeaoeaiei e niaao., 1997, A.O.Naaiei e niaao., 1998,
O.E.Oaii, 1998) iiaeia aaeioeoe, ui aieiaiei iaaeieeii o eeoaaii ?aiiai
ioaeoe oa, ui aaaaoi c aeei?enoaieo eea?nueeeo i?aia?aoa
oa?aeoa?ecothoueny iaeiini?yiiaainoth eeoaaeueii ae e aaeiinii ei?ioeei
oa?iaeieia/iei aoaeoii. Eeoaaeueia aeoeainoue o aeyaeyoueny, a
iniiaiiio, ia iiaa?oi ?aie ia ?iciianthaeaeooueny a aeeaeio caiaeueieo
oeaiei, aea eieaecothoueny ?iciiiaeothoueny ie?iae (I.A.Eyioiia e
niaao., 1995, A.E.Eoiaeueoeaa e niaao., 1995, E.E. Nooa?aa 1995).

?oaeoeainoue inoeaaiai iaaeeeaiaioiciiai eeoaaiiy iiaeia cia/ii
iaeaeueoe oeyoii aeei?enoaiiy iaoeiai iaa?oioiaaieo aaaaoieiiiiiaioieo
i?aia?aoa. O oie aea /an, iaaeoi aaaeeeaei caeeoaoueny ieoaiiy i?i aeth
inoaiio ia ia?aaa ?aiiaiai i?ioeano, eiee i?aeoe/ii aaenooi ?iaioe,
ni?yiiaai ia iiooee ?ic?iaeo aaaaoieiiiiiaioieo i?aia?aoa, ye iathoue o
neeaae eiae.

Oiio ie aaaaeaii aeineoue aaaeeeaei oeeani?yiiaaiee iiooe iiaeo
aenieiaoaeoeaieo aacia/ieo i?aia?aoa inoeaaiai canoinoaaiiy, ye
aae?ciythoueny aaaaoia?aiinoth oa?iaeieia/ii ae aeicaieythoue
?aaecoaaoe eeoaaeueii-i?ioeaeoe/iee aoaeo ia oeueee ia iiaa?oi ?aie, aea
a aeeaoa ?iciiuaieo oeaieiao, aea ?iciiiaeothoueny ie?ii?aaicie.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoey
o?aaiaioii ieaiiai iaoeiai-aeineaeieoeueei ?iaioe eaoaae?e
oaeoeueoaonueei o?o?a Eoaainueeiai aea?aeaaiiai iaaee/iiai oiaa?neoaoo
ia oaio “Aeeaaiinoeea e ea/aiea ino?iai iaie?aaoeoa e aai ineiaeiaiee”.
? aea?ae?ano?aoe 01.97. V 014319.

Iaoa caaaeaiiy aeineaeaeaiiy.Iioeicaoey eeoaaiiy oai?eo c
aieii-caiaeueieie i?ioeanaie i’yeeo oeaiei ?cii eieaecaoe oeyoii
?ic?iaee aenieiaoaeoeaiiai iaoiaeo inoeaaiai eeoaaiiy aieieo ?ai c
aeei?enoaiiyi eiaeaeeoea?eio. Aeey aeinyaiaiiy iaoe aoee iinoaaeai oae
caaaeaiiy:

1. Aea/eoe aieea iiaiai ao/eciyiiai i?aia?aoo eiaeaeeoea?eio ia
aeeiaieo eei/ieo iieacieea oa?aeoa? inoeaaiai aieii-caiaeueiiai
i?ioeano i?e ?aiiae ioaeoe.

2. I?iaanoe ii?aiyeueiee aiaec aeeiaiee eei/ieo, aioi/ieo,
aaeoa?ieia/ieo, ii?oieia/ieo, oceei-oi/ieo oa ioiieia/ieo iieacieea
ia?aaao aieii-caiaeueiiai i?ioeano i’yeeo oeaiei a oiiaao inoeaaiai
eeoaaiiy eiaeaeeoea?eiii aeeiaeneaeii.

3. ?ic?iaeoe eiie?aoi iieacieee aei i?ecia/aiiy eiaeaeeoea?eio i?e
aieii-caiaeueieo i?ioeanao, niiniae noaie eiai canoinoaaiiy a
caeaaeiino aae oa?aeoa?o iioe?aiino inoeaaiai iaoieia/iiai i?ioeano.

4. ?ic?iaeoe o?o?a/io oaeoeeo eeoaaiiy oai?eo c aieii-caiaeueieie
i?ioeanaie i’yeeo oeaiei.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoaoa. Aia?oa c aeei?enoaiiyi
eiiieaeniiai iaoiaee/iiai iaeoiaeo aea/aia aeeiaiea eei/ieo, aioi/ieo,
aaeoa?ieia/ieo, oeeoieia/ieo, ii?oieia/ieo, oceei-oi/ieo oa ioiieia/ieo
iieacieea ia?aaao ?aiiaiai i?ioeano i?e inoeaaiio eeoaaii aieieo ?ai
eiaeaeeoea?eiii.

Aeyaeaii, ui eiiaiiaaiee eiaeiaiuoth/ee i?aia?ao, yeee aea/aany,
aieiae iaeii/anii i?ioeie?iaiei, aeaaae?aooth/ei, i?ioecaiaeueiei,
iae?ieoe/iei ciaaiethth/ei aoaeoaie, a oaeiae noeioeth ?aaaia?aoeai
i?ioeane o ?ai.

Aeiaaaeaii, ui eiaeaeeoea?ei aenieiaoaeoeaiee aacia/iee o
oieneei-aea?a/iiio aaeiioaii ia ?yae ia?aaaa ia?aae nioth/eie
eea?nueeeie i?aia?aoaie, ye aeei?enoiaothoueny aeey inoeaaiai eeoaaiiy
oai?eo c aieii-caiaeueieie i?ioeanaie i’yeeo oeaiei.

Aeyaeaii, ui eiaeaeeoea?ei aeicaiey c iiaiith aaciaeith aeey
oai?iai ?aaecoaaoe i?ioeie?iai aeanoeaino eiaeo a aeeaieeo oeaieiao, aea
?iciiiaeothoueny caoaeieee ioaeoeeieo i?ioeana.

Iaoiaaiaoe/ii iaa?oioiaaii niina eeoaaiiy aieii-caiaeueieo i?ioeana
i’yeeo oeaiei c aeei?enoaiiyi eiaeaeeoea?eio. Iieacaii eiai ia?aaaae o
ii?iaiyiii c aeei?enoaiiyi ?ioeo caniaia aioenaioe/iii aeii.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoaoia. ?ic?iaeaii,
iaoiaaiaoe/ii iaa?oioiaaii i ai?iaaaeaeaii o ?iaioo oi?o?ai/iii eeiiiee
niinia eieoaaiiy eiaeaeeoea?eiii aiieii-caiaeueieo i?ioeania i’yeeo
oeaiei ?iciii eieaeicaoeii a aeaaaia?aoeaii-caiaeueiie oaci ?aiiaiai
i?ioeano, a oaeiae i?ioieaeoeee ?icaeoeo aiieii-iioieiaaieo oneeaaeiaiue
iineyiia?aoeieieo ?ai.

?ic?iaeaii eiie?aoii iieacaiiy aei i?ecia/aiiy eiaeaeeoea?eio,
niiniae eiai canoinoaaiiy a caeaaeiinooi aiae oa?aeoa?o i
?iciianthaeaeaiiy iinoeaaiai iaoieiai/iiai i?ioeano.

Iieacaii, ui eieoaaiiy eiaeaeeoea?eiii cieaeo? iaiaoiaeiinoue o
canoinoaaiii ?ioeo i?aia?aoia ciaiioiueiai canoinoaaiiy (iaci,
aioeuenii, noniaicii c aioeaiioeeaie, noeueoaiieaiiaeaie), a oaeiae
i?ioeiie?iaieo i?aia?aoia, yei aeei?enoiaothoueny aeey nenoaiiiai
eieoaaiiy.

Aeyaeaii, ui aiaenooiinoue ?acenoaioiinoi iie?ioei?e aei
eiaeaeeoea?eio aeicaiey? ii/aoe aoaeoeaia eieoaaiiy aiieii-caiaeueieo
i?ioeania c?aco ae iiney oi?o?ai/ii? ia?iaee ?ai.

Canoinoaaiiy eiaeaeeoea?eio aeey i?ioieaeoeee oa eieoaaiiy
aiieii-caiaeueieo i?ioeania i’yeeo oeaiei aeicaieeei iie?aueoe
?acoeueoaoe eieoaaiiy, nei?ioeoe eiai oa?iii i, ye iane?aeie, ciaioeoe
aeiiiii/ii cao?aoe.

Cai?iiiiiaaiee iaoiae eieoaaiiy aiieii-caiaeueieo i?ioeania i’yeeo
oeaiei ?iciii eieaeicaoeii c aeiiiiiaith eiaeaeeoea?eio ai?iaaaeaeaii o
?iaioo oi?o?ai/ieo aiaeaeieaiue iinueeeo eiea?aiue ? 1 (aeo
ai?iaaaeaeaiiy aiae 29.03.99), ? 2 (aeo ai?iaaaeaeaiiy aiae 30.03.99), ?
3 (aeo ai?iaaaeaeaiiy aiae 30.03.99), ? 6 (aeo ai?iaaaeaeaiiy aiae
29.03.99) i.Eoaainueea; o iaa/aeueiee i?ioean aeey nooaeaioia i
eiea?ia-iioa?iia ia eaoaae?i oaeoeueoaonueeii oi?o?aii Eoaainueeiai
aea?aeaaiiai iaaee/iiai oiiaa?neoaoo.

Iniaenoee aianie caeiaoaa/a. Aaoi? naiinoieii niinoa?iaaa 85
oai?eo c aiieii-caiaeueieie caoai?thaaiiyie, 63 ic yeeo aeeiiaii
iia?aoeaii ao?o/aiiy. Aaoi? a?aa o/anoue o i?iaaaeaiii
eeiiiei-eaai?aoi?iiai (oeeoieiai/iiai i aiioiii/iiai) ianoaaeaiiy 85
oai?eo; oeei aea oai?ei i?iaia cai?iiiiiaaiee niinia e?eoaaiiy,
i?iaiae?coaaa eiai aeeae/? oa a?aeaeaeai? ?acoeueoaoe. ?ic?iaea
eiie?aoi? iieacaiiy aei i?ecia/aiiy eiaeaeeoea?eio, niiniae eiai
canoinoaaiiy o oai?eo c ai?eii-iae?ioe/ieie i?ioeanaie a caeaaeiino?
a?ae iniaeeainoae ee?i?/iiai ia?aa?ao caoai?thaaiiy.

Ai?iaaoe?y ?iaioe. Iniiai? iieiaeaiiy aeena?oaoe?? aeeeaaeai? ia:
iaoeia?e eiioa?aioe?? iieiaeeo a/aieo Eoaainueeiai iaaee/iiai
oi?aa?neoaoo(1995, 1996 ??.); iaoeiai-i?aeoe/i?e eiioa?aioe?? “I?iaeaie
ai?eii-naioe/ieo oneeaaeiaiue o iaa?aeeeaaei?e o??o?a??” (i. Oa?e?a,1995
?.); iaoeiai-i?aeoe/i?e eiioa?aioe?? “No/ani? aniaeoe iaa?aeeeaaeii?
iaaee/ii? aeiiiiiae” (i. Euea?a, 1997 ?.); iaoeiai-i?aeoe/iie
eiioa?aioe?? “Iaeioi?ua aii?inu aiieii-naioe/aneie oe?o?aee”
(Eoaaine-Oa?ueeia, 1998); caniaeaiii iaeaniiai iaoeiaiai oiaa?enoaa
oi?o?aia (i.Eoaainuee, 1999 ?.); ia iaoeiaiio oaoiaiio naiiia?i
niaoe?aaee Ae 08.601.01 o Aeiii?iiao?ianueeie iaaee/iie aeaaeaiii (
8.04.1999 ?.).

Ioaeieaoeii. Ca iaoa?iaeaie aeena?oaoeii iioaeieiaaii 11 iaoeiaeo ?iaio,
o oiio /enei a iaoeiaeo oaoiaeo aeaeaiiyo – 8 (6 naiinoieieo), o
iaoeiaeo cai?ieeao oac c’icaeia oa eiioa?aioeie – 3. O noiinii
iioaeieiaaieo i?aoeyo ca oaiith aeena?oaoeii aaoi?iai iniaenoi
iaeaaeeoue 70% iaeae oa ?ic?iaie.

Ianya i no?oeoo?a aeena?oaoeii. Aeena?oaoeieia ?iaioa aeeeaaeaia ia
164 noi?iieao. Neeaaea?oueny ic anooio, 5 ?icaeieia (iaeyaeo eioa?aoo?e,
iaoa?iaeia i iaoiaeia aeineiaeaeaiiy, 3 ?icaeieia aeanieo
aeineiaeaeaiue), aiaeico oa ocaaaeueiaiiy ?acoeueoaoia, aeniiaeia,
i?aeoe/ieo ?aeiiaiaeaoeie. ?iaioa iethno?iaaia 13 oaaeeoeyie oa 19
iaethieaie, yei caeiathoue 24 noi?iiee. Nienie eioa?aoo?e iinoeoue 281
aeaea?aei, o oiio /enei 88 iiicaiieo.

INIIAIA *ANOEIA

Oa?aeoa?enoeea iaoiae?a aeineiaeaeaiiy. A iniiao ?iaioe iieeaaeaii
aiaeic ?acoeueoaoia eeiiiei-eaai?aoi?iiai ianoaaeaiiy 165 oai?eo c
aiieii-caiaeueieie i?ioeanaie i’yeeo oeaiei, o oiio /enei 85, o yeeo ye
niin?a iinoeaaiai eieoaaiiy aiieieo ?ai aeei?enoiaoaaee eiaeaeeoea?ei
(iniiaia a?oia). Aea/aiiy aoaeoeaiinoi canoinoaaiiy eiaeaeeoea?eio i?e
eieoaaiii aiieieo ?ai ii??aithaaeinue c ?acoeueoaoaie eieoaaiiy 80
iaoei?ioia (a?oia niianoaaeaiiy), o 25% c yeeo canoiniaoaaee aeeiaeneae.

Eiaeaeeoea?ei – aio/eciyiee i?ioeiie?iaiee i?aia?ao, eio?ee yaey?
niaith noaaieueiee, eaaei i?iieeath/ee o aeeaeio o?aaeaieo oeaiei ia
iniiai aaeoa?eoeeaeiiai eaoiiio eiaeo, ui aeeth/a? a naaa aeaa
?ic/eiieea, ye? iathoue oaeiae eieoaaeueiee aoaeo noiniaii ?ioaeoeieieo
i?ioeania (aeeiaeneae i aeioea?ei). Neeaae eiaeaeeoea?eio (aaaa, %):
eiae e?enoaei/iee (0,45-0,55), aeeiaoeenoeueoieneae (29,0-31), aeioea?ei
– inoaii?.

Ianoaaeaii aoee aieii aiae 21 aei 65 ?ieia, /ieiaiee neeaee 75
(45,4 %), aeiiee – 90 (54,6 %). O 126 (76,4%) aoee aino?i aiiei?
ia?aeiii ?aie, ae?oao /anoeio caeiaee 39 (23,6%) iaoei?ioia c aiieieie
aoi?eiieie ?aiaie.

I?e ia?aaoaaiii o oi?o?ai/iiio noaoeiiia?i caaaeueiee noai oai?iai
ioeiithaaee ca aeiiiiiaith caaaeueiieeiii/ieo i niaoeiaeueieo
eaai?aoi?ieo oanoia. Aeineiaeaeoaaee caaaeueiee aiaeic e?iai i na/i; i?e
iiae?aooieo aaiia?aie ae?aoiaoaaee eaeeioeeoa?iee iiaeaen iioieneeaoeii
(EII) ca ss.ss.Eaeueo-Eaeeoo. I?i iayaiinoue oa ae?aaeaiinoue neiae?iio
aiaeiaaiiii iioieneeaoeii noaeeee ca ?iaiai “na?aaeiio iieaeoe” (NI),
yeee aecia/aany niaeo?ioioiiao?e/ii (A.A.Ieeieae/ee e niaao., 1991),
iioaineai?noue iioiioieneeico – ca aeeiaiieith oee?eoethth/eo iioiieo
eiiieaenia (OeIE) i aiinoo o io neeaaei iaeaieueo iaoiaaiieo na?aaeiuei-
i ae?iaiiiieaeoey?ieo o?aeoeie, eio?i aecia/aee iaoiaeii
aeeoa?aioeieiaaiii i?aoeeiioaoeii o ?ic/eiao iieiaoeeaiaeieieth (IAA) c
iieaeoey?iith ianith 6000 aeaeueoii (A.I.O?ieia e niaao., 1989).

Aeey aiaeico iioiiii ?aaeoeaiinoi oai?eo aeineiaeaeoaaee a
aeeiaiioei caaaeueio eieueeinoue O-eiioioeeoia (ND3) i aiino o e?iai
noaiiioeyoeie O-oaeia?ia (ND4) i O-noi?ani?ia (ND8) a oeeoioiene/iiio
oanoi c iiiieeiiaeueieie aioeoieaie (IA) iie?iiaoiaeii (A.I.O?ieia e
niiaao., 1986). Ae?aoiaoaaee iioii?aaoeyoi?iee iiaeaen ND4ND8 ye
niiaaiaeiioaiiy O-eiioioeeoia c oaeia?iith i noi?ani?iith aeoeaiinoth.

Aeey ioeiiee aieeao oa?aeoa?o eieoaaiiy ia iioiio ?aaeoeaiinoue
aecia/aee oaeiae oaaioeeoa?io aeoeaiinoue iiiioeeoia (OAI) /aoa/eiaei
iaoiaeii (A.I.O?ieia e niaao., 1989) ii aiaeiioaiith aei aeeaii aeiaiaii
oano-eoeueoo?e Staph. aureus (aoaeiiiee ooai 505).

Aeineiaeaeoaaee aiino caaaeueiiai aieea ne?iaaoee e?iai
(TH.I.Iaiaiiaa, 1972), ?iaaiue aieeiaeo o?aeoeie aeaeo?ioi?aoe/iei
iaoiaeii, ae?aoiaoaaee aieeiai-i?iaiinoe/iee eiaoioei?io – AIE
(TH.A.Aeaauaeia e niaao., 1990).

Aaeoa?iieiai/iee eiio?ieue ia?aaiao ?aiiaiai i?ioeano caeienithaaee
oeyoii aecia/aiiy oeio caoaeieea, eiai /ooeeainoi aei aioeaiioeeia, a
oaeiae i?iaiaeeee aea/aiiy a aeeiaiioei eieueeinoi iie?ii?aaiiciia ic
?ic?aooieo ia 1 a aiiioaoo iiaa?oii ?aie (I.E.Eocei e niaao., 1980,
1984).

Ii?oieiaiy ?aiiaiai i?ioeano aea/aia c aeei?enoaiiyi oeeoieiai/ieo
(iaoiae aeineiaeaeaiiy ?aiiaeo aiaeaeoeia ii I.I.Iie?ianueeie) i
ainoieiai/ieo (iaoiae iiaa?oiaaii aiiinii, I.O.Eaiaaa, 1970)
aeineiaeaeaiue. O?aoiaoaaee ?aaaia?aoeaii-aeaaaia?aoeaiee iiaeaen ?AeI
(TH.A.Aeaauaeia e niaao., 1988). Aecia/aiiy ieiui ?aie c ianooiiei
ae?aooaaiiyi oaeaeeinoi caai?iiy ?aie i?iaiaeeee ca iaoiaeeeith
I.I.Iiiiaii. Oiceei-oiii/ii aeineiaeaeaiiy aeeth/aee aecia/aiiy
a aeeiaiioei ?I ?aiiaiai aeaeieaiiy ca aeiiiiiaith oiiaa?naeueiiai
eiiiii?a AA-74 aai iiaeeeaoi?ieo nioaeie oe?iu “Lachema” (*aoey) a
caeaaeiinoi aiae ia’?io o?aaeaieo i’yeeo oeaiei.

Oni aeineiaeaeaiiy i?iaiaeeee a iiiaio iia?aoeii, a oaeiae o
i?ioeani iinoeaaiai eieoaaiiy – ia 3, 7, 10 aeiao. Iioiieiai/ii
aeineiaeaeaiiy i?iaiaeeee aei iia?aoeii i ia 14 aeiao iiney
iia?aoeii. Iaoaiaoe/ia ia?iaea iaea?aeaieo aeaieo caeienithaaeanue ia
IAI-noiinieo eiii’thoa?ao eeano ?NOO ca niaoeiaeueii ?ic?iaeaiith
i?ia?aiith c aeei?enoaiiyi niaoeiaeiciaaiiai aaieo aeaieo, i?i?ioiaaiiai
ia ia?iaeo eeiii/iii, aiioiii/iii, aaeoa?iieiai/iii, ii?oieiai/iii
iioi?iaoeii.

?acoeueoaoe aeanieo aeineiaeaeaiue. Iia?aoeaii ao?o/aiiy aeeiiaii
127 (76,9%) iaoei?ioai, a oiiaao caaaeueiiai ciaaiethaaiiy – 114 (89,8%)
i iinoeaaii iioieueo?aoeieiii aianoacii 13 (10,2%) oai?ei. I?e oeueiio o
107 (84,3%) oai?eo aeeiiaii ?icoei aiiyeia ?ic?icii a iaeanoi
iaeaieueoii oetheooaoeii aai iii’yeoaiiy. A onio oeeo oai?eo
niinoa?iaaeinue aiieii-iioieueo?aoeaia o?aaeaiiy i’yeeo oeaiei.
Iia?aoeiy aeeiioaaeanue ii oeio oi?o?ai/ii? ia?iaee aiieiiai aiaieua i
caeeth/aeanue o iiaiiio ae?icaiii ea?iaiia, caieeaia, ?aoaeueiie
naiaoeii aiieiii ii?iaeieie eiaeaeeoea?eiii (51 oai?ee), 25%
aeeiaeneaeii (56 oai?eo), inoooaaiii ii i ae?aioaaiii aoiiaith
nioaeeith, oei?aiiieiaith o?oaeith aai ?aia eaaei oaiiiioaaeanue
na?aaoeaie, cii/aieie iacaaieie i?aia?aoaie. A caeaaeiinoi aiae ianyao
?aie, eiaeaeeoea?ei aeei?enoiaoaaee o eieueeinoi aiae 2 aei 20 ie.
Eieoaaiiy i?iaeiaaeoaaee aei iiaiiai i/euaiiy ?ai aiae aeaaioaeiciaaieo
oeaiei, cieeiaiiy ia?eoieaeueiiai caiaeaiiy.

O 20 (15,7%) oai?eo c aanoeaaeoth/eie oi?iaie aiieiiai i?ioeano
aeeiiaii ae?icaiiy aiiyeia o iaaeao caei?iaeo oeaiei, ?aoaeueiee
aaiinoac, i?iieaaiiy ii?iaeieie ?ai eiaeaeeoea?eiii i aeeiaeneaeii o
a?oii ii?iaiyiiy. Iia?aoeiy caaa?oaia o 7 oai?eo caoeaaiiyi ?aie
iaaeooi, a o 13 iaoei?ioia aeiaeaoeiai aeeiiaii ae?aioaaiiy ?aie /a?ac
eiio?aia?oo?e eoo?a ?aie i iaeeaaeaiiyi iia’cie c aeineiaeaeoaaieie
eiea?nueeeie i?aia?aoaie.

Aaiinoac ?aie i?iaiaeeee iaoiaeii eiaaoeyoeii (aaiinoac eiaaoo?iei
iaoiaeii ia canoiniaoaaee c iaoith caiiaiaaiiy aoi?eiiiai iioieoaaiiy
eiaaoo? i ?aoeeaeeao iaaii?iiy o ?aii). sse oiaiee iaoa?iae o oai?eo
iniiaiii a?oie aeei?enoiaoaaee noa?eeueio eineo. Inoaiiueiio, ia
aiaeiiio aiae oiaeo, eaanaio, eai?iio, ia aeanoeaa aia?ineiii/iinoue, ui
caiiaiaa? aoi?eiiiio iioieoaaiith oiaiiai iaoa?iaeo. Aei oiai ae
canoiniaaiee i?aia?ao eiaeaeeoea?ei o i?ioeani eieoaaiiy noa?eeico?
eineo. Iaoiaeeea iiaeaioiaee i noa?eeicaoeii einee iieyaaea a oaeiio:
aiae?icee einee (?6-?8) iaiiooaaee ia i?aaeiaoia neei i eei’yoeee o
aiaeenoeeueiaaiie aiaei i?ioyaii 5 oa. Iioii eineo caeeaaee
eiaeaeeoea?eiii, aea aiia caa?iaaeany aei canoinoaaiiy.

Na?aae oai?eo c aanoeaaeoth/eie oi?iaie aiieiiai i?ioeano o 7
iaoei?ioia /a?ac ae?aiaaei caeienithaaeanue aeoeaia anii?aoeiy ?aiiaiai
aiinoo. I?e oeueiio aeei?enoiaoaaee ieanoianiao “aa?iioeo”, i?e?aeiaio
aei ae?aiaaeo. A oneo oeeo oai?eo iiney aeaeaeaiiy aiieiiai aiaieua ia
niinoa?iaaee ia?eoieaeueiiai caiaeaiiy e?aia ?aie i inoaiii aoee
caaaeaii aac iaaei??iiai iaoyao. Iai?ioe, o 7 oai?eo iiney aeaeaeaiiy
aiieiiai aiaieua caeeoaeinue iiii?ia ia?eoieaeueia caiaeaiiy e?aia ?aie,
a oaeiae niinoa?iaaeanue iacia/ia aaeaioaoeiy noiiie i e?aia ?aie. O
oaeeo aeiaaeeao i?iaiaeeee o?aeoeieia i?iieaaiiy ?aiiaii ii?iaeieie
eiaeaeeoea?eiii, a 6 iaoei?ioai i?ioi/ia i?iieaaiiy ?aiiaii ii?iaeieie
aeeiaeneaeii. O?aeoeieia i?iieaaiiy ?aiiaii ii?iaeieie i?iaiaeeee oae:
/a?ac ae?aiaae, o caeaaeiinoi aiae ia’?io ii?iaeieie, aaiaeeee
eiaeaeeoea?ei o eieueeinoi aiae 2 aei 20 ie. Iioii ae?aiaaei ia?ae?eaaee
caoenea/aie. *an ia?aaoaaiiy ?ic/eio o ?aii caeiaa 8-12 aiaeei. Iiney
/iai caoenea/? ciiiaee i caeienithaaee aeoeaio aaeooi-anii?aoeith.
Iiaeiaii oeeeee o?aeoeieiiai i?iieaaiiy ?aie iiaoi?thaaee i?ioyaii
aeiae iaeei aai aeaa ?ace. O?eaaeinoue eieoaaiiy neeaaeaea o?e aeiae.

O anio oai?eo c iineyiia?aoeieieie iioieiaaieie ?aiaie ia 3 aeiao
iiney iia?aoeii c ?aie aoee ciyoi oae. I?iaaaeaii oi?o?ai/io ia?iaeo
ii?iaeieie eiaeaeeoea?eiii (18 niinoa?aaeaiue) i aeeiaeneaeii (15
niinoa?aaeaiue) i eaaea oaiiiioaaiiy na?aaoeith, nioaeeith ii?ieiio,
cii/aieo iacaaieie i?aia?aoaie. Na?aae 6 oai?eo c iioieiaaieie ?aiaie o
iaeiiai aeeiiaii ae?icaiiy iae?ioeciaaieo oeaiei a iaaeao caei?iaeo
oeaiei, iaeeaaeaiiy oaia i iia’ycee

c eiaeaeeoea?eiii. O inoaiiio oai?eo (5 niinoa?aaeaiue) iiney
oi?o?ai/ii? ia?iaee iaeeaaeaii iia’ycee c eiaeaeeoea?eiii (2
niinoa?aaeaiiy), aeeiaeneaeii (3 niinoa?aaeaiiy).

56 oai?ei iniiaiii a?oie, ca yeeie ie niinoa?iaaee, i 46 oai?eo
a?oie ii?iaiyiiy ia canoiniaoaaee aioeaiioeeioa?aiith. O aeaieo
iaoei?ioia ?iaaiue NI o ne?iaaooei e?iai ia ia?aaeuoaaa o 1,5 ?ace
ii?iaeueieo iieacieeia. O inoaiiio iaoei?ioia iaio a?oi, o yeeo ?iaaiue
NI ia?aaeuoaaa o 2 ?ace ii?iaeueii iieacieee, i?iaiaeeee
aioeaiioeeioa?aiith.

I?e aaeoa?iieiai/iiio aeineiaeaeaiii aeaeieaiue ?ai iie?ii?aaiicie
aoee aeyaeaii o 151 iaoei?ioa (91,5%). I?e oeueiio o 45 (27,3%) oai?eo
aaeoa?iaeueia oei?a aoea i?aaenoaaeaia iiiieoeueoo?ith, o 120 (72,7%)
iaoei?ioia aoee aeniyii anioeiaoeii iie?ii?aaiiciia. Aieueoinoue
iaeaioeoieiaaieo iie?ii?aaiiciia i?aaenoaaeyee noaoieieiee, na?aae yeeo
/anoioa cono?i/aany Staph. aures (55,6%), iioii Staph. apidermidis
(30,6%). ?iaeoa aeaeieyeeny Str. pyogenes (5,0%) i Str. faecalis
(10,6%). O ?yaei a?aiiaaaoeaieo aaeoa?ie i?aaaethaaee A. noli (76,5%),
?iaeoa cono?i/aeenue aaeoa?ii ?iaeo Proteus (12,9%), Pseudomonas
aerugenosa (3,6%) i eeaani?ee – 1,8%. Iaeeino?eaeiaeueii aiaa?iaii
a?aiiaaaoeaii iaee/ee a?. Bacteroides aeaeieaii o 2 oai?eo – o iaeiiai
a?oie B. fragilis i a ae?oaiai – B. melaninogenicus. O aeaio oai?eo
aeyaeaii a?aiiiceoeaii eiee a?oie Peptostreptococcus sp. i a iaeiiai
iaoei?ioa aoea aeaeieaia oaeoeueoaoeaii aiaa?iaia iie?ioei?a.
Aeineiaeaeaiiy /ooeeainoi iie?ii?aaiiciia aei aioeaiioeeia iieacaei, ui
97,7% ooaiia cieioenoiai noaoieieiea aoee iieiaioeaiioeei?acenoaioieie.
Caoaeieee a?aiiaaaoeaiii iie?ioei?e oaeiae aoee aeineoue noieeeie aei
aioeaiioeeia oe?ieiai aeei?enoaiiy (aiae 68,4% aei 94,4%).
Iaeaieueo /ooeeaeie aeaeieaii iie?ii?aaiicie aoee aei aai-
oaiioeeio, iaoeienaoeeio, aiieaoeeio, oi?ooio. Aea i aei oeeo i?aia?aoia
o 37,3% – 42,3% aeiaaeeia niinoa?iaaeanue noieeinoue aeaeieaieo
iie?iaia.

I?e ?icoeii aiieiiai aiaieua iie?iaia caniaaiiy ?aie aoei cia/ii
aeua e?eoe/iiai ?iaiy i neeaaeaei o na?aaeiueiio 108 ia 1 a oeaieie,
?I-?aiiaiai aenoaeaoo aaciina?aaeiuei iiney ?icoeio aiaieua aei?iaithaaa
6,0 0,3.

Oeeoieiai/ii aeineiaeaeaiiy iaceia-aiaeaeoeia i ainoieiai/ia –
a?iioaoia ?aie naiae/eee i?i cia/io aaeoa?iaeueio caa?oaeiaiinoue ia
oiii ?iceeo caiaeueieo ciii o aeeaieeo oa?ao, a naia o aea?ii i aee?iaie
iiaeoei?iie eeioeiaeii. O iaceao i?aaaethaaee aeaaaia?aoeaii iaeo?ioiee
– 90%, ?iaeoa cono?i/aeenue iaei/eiyaea?ii i naaiaioiyaea?ii oi?ie (9%),
o iiei ci?o aeyaeyeinue aaaaoi aeeaie aeao?eoo. I?ineiaeaeoaaeenue
iaeiiyaea?ii eeioeie, aea aeeoa?aioeiaoeiy io i?aeoe/ii aoea
aiaenooiueith; o iacia/iie eieueeinoi cono?i/aeenue aiceiioiee (0,5%).
Caaeaaeue eeioei i?ioieaea ia oiii ae?aaeaiii iioaeoeii. ?AeI aoa iaioa
1 i aei?iaithaaa o na?aaeiueiio 0,3 0,03. (oaae.1).

I?e iinoeaaiio canoinoaaiii eiaeaeeoea?eio oaea ia 3 aeiao
aiaeii/aee iie?auaiiy naiiii/oooy oai?eo, ii?iaeicaoeith oaiia?aoo?e,
noaaieicaoeith ia?aaiao ?aiiaiai i?ioeano, ciaioaiiy ia?eoieaeueiiai
iaa?yeo, aiia?aiii ioi/oth/eo ?aie oeaiei. ?aiiaee aenoaeao noaaaa
?iaeeei, iinoea iaioa oia?eio i oeaieiiiai aeao?eoo. Ia oeae /an a on?o
oai?eo iniiaiii a?oie aoea no?eea oaiaeaioeiy aei ii?iaeicaoeii
eieueeinoi eaeeioeeoia o e?iai, cieeaa cnoa eaeeioeeoa?iii oi?ioee
eiai?o/. O oai?eo a?oie niianoaaeaiiy oaei ciiie niinoa?iaaeenue eeoa ia
5-7 aeiao. O i?ioeani eieoaaiiy o oai?eo iniiaiii a?oie ii?iaeicaoeiy
iieacieeia NI o e?iai i?ioiaeeea ia 3-4 aeiae ?aiioa, iiae o a?oii
niianoaaeaiiy, ui iia’ycaii c iie?auaiiyi iie?ioee?eoeyoeii o oeaieiao i
iiaeaeuaiiyi i?iieeeeainoi aiieiai/ieo iaia?ai o aiaieui caiaeaiiy. A
oiiaao eiiieaeniiai eieoaaiiy oai?eo eiaeaeeoea?eiii aiaeii/aii
iie?auaiiy aieeiaiai neeaaeo ne?iaaoee e?iai. O oai?eo iniiaiii a?oie ia
5-7 aeiao AIE aoa iaeaea o 2 ?ace aeuei, iiae o oai?eo a?oie
niianoaaeaiiy (?

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