PROBIOTIC SANITATION OF THE ABDOMINAL CAVITY IN THE TREATMENT OF DISSEMINATED PERITONITIS
DOI:
https://doi.org/10.32782/2226-2008-2025-3-5Keywords:
peritonitis, abdominal sepsis, endogenous intoxication, antibiotic resistance, probioticsAbstract
The aim of the study was to determine the effectiveness of probiotic sanitation of the abdominal cavity in the treatment of disseminated peritonitis.Materials and methods. The study included 98 patients with disseminated peritonitis. Patients were divided into 3 groups. Group I (main group) included 31 patients in whom the abdominal cavity was cleaned with a 5% solution of probiotic disinfectant. Group II (comparison group) consisted of 32 patients, in whom the abdominal cavity was cleaned with a solution of the sorbent “Enterosgel”. Group III (placebo control group) included 35 patients in whom the abdominal cavity was cleaned with 0.9% NaCl solution. In order to determine the level of intoxication and the dynamics of peritonitis, we determined the functional activity of phagocytic cells of peripheral blood.Results. Sanitation of the abdominal cavity with probiotic disinfectants in patients of Group I caused a decrease in the manifestations of endogenous intoxication already on the 3rd day of the study. These trends contributed to the optimization of the functional activity of neutrophil granulocytes and their bactericidal properties. A tendency to restore the function of monocytes was established. In patients of Group II, a positive dynamic of the studied indicators was noted on day 7 of the study. While in patients of Group III, these changes did not have a clearly pronounced positive dynamic throughout the study.Conclusions. The study showed that the use of probiotic disinfectants for the sanitation of the abdominal cavity is an effective treatment for disseminated peritonitis, which significantly improves the treatment outcomes of such patients.
References
Hecker A, Reichert M, Reuß CJ, et al. Intra-abdominal sepsis: new definitions and current clinical standards. Langenbecks Arch Surg. 2019 May; 404(3): 257–271. doi: 10.1007/s00423-019-01752-7. Epub 2019 Jan 26. PMID: 30685836.
Sartelli M, Coccolini F, Kluger Y, et al. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra- abdominal infections. World J Emerg Surg. 2021 Sep 25; 16(1): 49. doi: 10.1186/s13017-021-00387-8. PMID: 34563232. PMCID: PMC8467193.
Biliaieva OO, Karol IV. Novi pidkhody do borotby z antybiotykorezystentnistiu [New approaches to combating antibi- otic resistance]. Kharkivska khirurhichna shkola. 2024; 5(128): 93–99. doi: https://doi.org/10.37699/2308-7005.5.2024.16 (in Ukrainian).
Wang X, Hao G, Zhou M, Chen M, Ling H, Shang Y. Secondary metabolites of Bacillus subtilis L2 show antiviral activity against pseudorabies virus. Front Microbiol. 2023 Oct 30; 14: 1277782. doi: 10.3389/fmicb.2023.1277782. eCollection 2023. PMID: 37965547. PMCID: PMC10642297.
Paunel-Görgülü A, Kiricevska T, Løgters T, Windolf J, Flohe S. Molecular mechanisms underlying delayed apoptosis in neutrophils from multiple trauma patients with and without sepsis. Mol Med. 2012 May9; 18(1): 325–335. doi: 10.2119/ molmed.2011.00380. PMID: 22231730. PMCID: PMC3356414.
Tak T, van Groenendael R, Pickkers P, Koenderman L. Monocyte subsets are differentially lost from the circulation during acute inflammation induced by human experimental endotoxemia. J Innate Immun. 2017 Jun 23; 9(5): 464–474. doi: 10.1159/000475665. PMID: 28641299. PMCID: PMC6738874.
Boudesson de Chanville C, Chousterman BG, Hamon P, et al. Sepsis triggers a late expansion of functionally impaired tissue-vascular inflammatory monocytes during clinical recovery. Front Immunol. 2020 Apr 30; 11: 675. doi: 10.3389/ fimmu.2020.00675. PMID: 32425929. PMCID: PMC7212400.
Doughty C, Oppermann L, Hartmann NU, Dreschers S, Gille C, Orlikowsky T. Monocytes in neonatal bacterial sepsis: think tank or workhorse? BioChem. 2022 Jan 7; 2(1): 27–42. doi: 10.3390/biochem2010003.
Berkalo LV, Bobovych OV, Bobrova NO, ta in. Metody klinichnykh ta eksperymentalnykh doslidzhen v medytsyni [Meth- ods of clinical and experimental research in medicine]. Kaidashev IP, redaktor. Poltava: Polimet; 2003. 320 p. (in Ukrainian).
Cheng SC, Scicluna BP, Arts RJ, et al. Broad defects in the energy metabolism of leukocytes underlie immunoparalysis in sepsis. Nat Immunol. 2016 Apr; 17(4): 406–413. doi: 10.1038/ni.3398.PMID: 26950237.
Biliaieva OO, Znaievskyi MI, Karol IV. Modern innovative strategies in education and science: Collective monograph. Compiled by V. Shpak; Chairman of the Editorial Board S. Tabachnikov. Sherman Oaks, California: GS Publishing Services; 2024. Obhruntuvannia zastosuvannia probiotychnykh dezinfektantiv v kompleksnomu likuvanni eksperymentalnoho perytonitu. p. 38–54. doi: 10.51587/9798-9895-14663-2024-119-38-54 (in Ukrainian).
Tarricone R, Rognoni C, Arnoldo L, Mazzacane S, Caselli E. A Probiotic-Based Sanitation System for the Reduction of Healthcare Associated Infections and Antimicrobial Resistances: A Budget Impact Analysis. Pathogens. 2020 Jun 23; 9(6): 502. doi: 10.3390/pathogens9060502. PMID: 32585922. PMCID: PMC7350316.