Non-clostiridial anaerobic infection is a pathological process that can be triggered by pathogens under conditions favorable for their development and vital activity. The characteristic signs of the course of infection are the presence of symptoms of intoxication, gas-forming processes in the wound, putrefactive exudate, rapidly progressive tissue necrosis.
Such an infection is very easily recognized on the basis of the existing symptoms, which are confirmed by a comprehensive diagnosis. Treatment involves surgical treatment of the lesion, as well as drug therapy.
Features of anaerobic infection
Non-clostridial anaerobes do not form spores and are members of the normal human flora. They completely cover the mucous membrane from the oral cavity to the rectum. Under normal conditions, such microorganisms are completely harmless, however,in the presence of certain disorders, microbes become the causative agents of dangerous surgical infections.
There are a number of predisposing factors for non-clostriadial anaerobic infection such as:
- necrosis occurring during trauma or purulent-inflammatory processes;
- weakening of defenses;
- impaired blood supply to tissues;
- tissue acidosis.
The disease mainly occurs in the form of phlegmon. The pathological process affects the skin, muscles and subcutaneous tissue. It is characterized by an acute onset and a rapid course. The doctor can make the final diagnosis only after a comprehensive examination.
The causative agents of non-clostridial anaerobic infection can also exist in anoxic conditions, which is why contaminated clothing, soil, and decaying organic compounds can act as a source of infection. Pathogenic microorganisms have a pathogenic effect when a number of provoking factors are combined. Damage to the barriers of the wound surface leads to the penetration of pathogenic microflora into sterile tissues. If the affected areas have sufficient access to oxygen, then after a certain time the microbes die without causing any harm at all. According to the existing classification, anaerobic non-clostridial infection can be:
- monoinfection - defeat by one anaerobe;
- polyinfection with two or more anaerobes;
- mixed infection -combination of anaerobes and aerobes.
The course of an existing infection can be fulminant, acute and subacute. Anaerobic non-clostridial infection is common in surgery and gynecology. Depending on the ability of pathogens to sporulate, such a disease proceeds in different ways, however, it has similar symptoms.
What characterizes the disease
Many patients are interested in what an anaerobic infection is, why it is formed, what symptoms it has and how it is treated. In the presence of non-spore-forming anaerobes in the body, disorders such as chronic sinusitis, periodontal abscess, necrotic pneumonia, brain and lung abscess, phlegmon, bone and joint infections, sepsis and many other serious diseases can occur.
Anaerobes very often provoke the development of infections of the abdominal cavity, liver, and many other organs. In gynecology, non-clostridial anaerobic infection can cause many pathologies of the female genital tract, in particular, such as:
- endometritis;
- salpingitis;
- infected abortion and many more.
It is worth noting that with the course of all these diseases, the symptoms are quite blurred, therefore, to confirm the diagnosis, it is necessary to conduct a diagnosis.
Classification
According to the classification of anaerobic non-clostridial infection by area of localization, there are such types of pathology as:
- skin infections;
- defeatbones;
- blood stream;
- internal organs;
- serous cavities;
- bacteremia.
Anaerobic bacteria provoke superficial skin diseases, as well as subcutaneous or postoperative infections. With a deep lesion, necrosis is observed. When bone tissue is involved in the pathological process, septic arthritis develops, as well as purulent-necrotic osteomyelitis.
Infection of the internal organs leads to bacterial vaginosis in a woman, gynecological and intrauterine infections, genital abscesses, and septic abortion.
Causes of occurrence
Nonclostriadial anaerobic infection occurs with damage to internal organs and is characterized by mortality. This pathology is characterized by damage to the connective and muscle fibers. Anaerobic clostridial and non-clostridial infection in surgery develops within 30 days after surgery. Such a pathology is mainly related to nosocomial and significantly increases the time a person stays in a hospital.
Among the main factors that provoke a violation in the composition of the normal microflora of the body, it is necessary to highlight such as:
- microbial pathologies of tissues and organs;
- intrauterine infection and prematurity;
- long-term antibiotic therapy, hormone therapy and chemotherapy;
- Long hospital stay.
There are certain provokingfactors that significantly enhance the pathogenic properties of anaerobes. These include enzymes produced by bacteria. They provoke very severe disorders of blood microcirculation, destroy red blood cells, and also increase vascular permeability. Bacteria lead to tissue destruction and promote the spread of infection.
Endotoxins and exotoxins lead to damage to the walls of blood vessels, leading to thrombosis. Clostridia secrete toxic substances, under the influence of which purulent accumulation and fluid are formed in the tissues, the muscles begin to gradually die off. The pathogenesis of nonclostridial anaerobic infection is mainly associated with:
- contamination of the wound with soil with excrement;
- presence of extraneous wounds on the body;
- necrosis and tissue ischemia;
- damage to the skin and mucous membranes;
- penetration of bacteria into the blood;
- malignant neoplasms.
In addition, neuropsychic overstrain, significant blood loss, and immunodeficiency can provoke the pathological spread of pathogens.
Main symptoms
Anaerobic clostridial and non-clostridial infection provokes inflammation of the organs, as well as the brain, which often occurs with soft tissue abscess and the development of sepsis. Signs of infection begin suddenly. In patients, signs of intoxication predominate. Their well-being deteriorates very sharply until local symptoms appear, when the wounds begin to turn black.
The incubation period continues forfor about 3 days. The sick person develops a fever and also has symptoms such as:
- brokenness and severe weakness;
- drowsy;
- dyspepsia;
- pressure drop;
- apathy;
- retardation;
- heartbeat increase.
Gradually lethargy is replaced by overexcitation, confusion and anxiety. A person's breathing and heart rate increase significantly. He also experiences intense thirst and dry mouth. The skin of the face becomes very pale, while acquiring a somewhat gray tint, and the eyes are somewhat sunken. Patients become depressed and lack coordination.
It is imperative to know exactly the features of the clinic, diagnosis and treatment of non-clostridial anaerobic infection in order to understand exactly what consequences the pathology can lead to. Among the local signs, it is necessary to highlight such as:
- severe arching pain that gradually increases;
- swelling of limbs;
- the presence of gas in the affected tissues, which can be detected by palpation;
- lack of mobility and impaired mobility of the limbs;
- purulent-necrotic inflammation.
In the absence of the required treatment, soft tissues begin to break down very quickly, which makes the prognosis for the course of the pathology rather unfavorable.
Diagnostics
Nonclostridial anaerobic infection needs to be diagnosed to determine how to treat. Depending on the location of the hearthinfectious lesions are diagnosed by various specialists, namely, otolaryngologists, surgeons of various fields, traumatologists, gynecologists.
Only microbiological studies will help confirm the presence of anaerobic bacteria. However, it is worth noting that a negative answer does not guarantee the absence of pathogens, as many of them are uncultivated.
More highly accurate methods include gas-liquid chromatography and spectrometric analysis, which will determine the amount of metabolites and volatile liquid acids. No less good and accurate methods are the determination of the presence of bacteria or their antibodies in the blood using enzyme immunoassay. Also, express diagnostics are used to determine the presence of anaerobic clostridial and non-clostridial infections. Biomaterials are studied in ultraviolet light. To do this, spend:
- bacteriological seeding of the contents of the abscess or discharge from the wound;
- blood culture for bacteria;
- blood sampling for biochemical analysis.
The presence of infection in the body is indicated by an increase in the blood of creatine, urea, bilirubin, as well as an increased content of peptides. When conducting an x-ray examination, you can detect the accumulation of gases in the affected tissues or body cavities. When conducting diagnostics, it is necessary to exclude the presence in the body of erysipelas, deep vein thrombosis, frostbite, pneumothorax, as well as purulent-necrotic lesions.
Features of treatment
An integrated approach to the treatment of non-clostridial anaerobic infection involves surgical treatment of the lesion, as well as the use of antibacterial and detoxification therapy. Surgical intervention must be carried out as soon as possible, since the patient's life will largely depend on this.
Basically, a deep dissection of the lesion is carried out, followed by removal of necrotic tissues, open drainage and washing of wounds and existing cavities with antiseptic solutions. In some cases, repeated surgical intervention, treatment of the wound surface with a laser and ultrasound, as well as ozone therapy are required. With extensive tissue damage, amputation of the limb may be indicated.
An important stage of therapy is intensive antibiotic therapy with broad-spectrum drugs. If necessary, the patient is injected with antitoxic serum.
Surgery
During the surgical treatment, the existing wound is widely dissected, pathological tissues are excised, foreign bodies are removed, and after that, the resulting cavity is treated and drained.
The wound surface is plugged with a bandage soaked in a solution of potassium permanganate or peroxide. The operation is performed under local anesthesia. When clamping edematous, deeply located tissues, a wide fasciotomy is indicated. If aanaerobic clostridial and non-clostridial infection in surgery develops against the background of a fracture of the limbs; its immobilization with a plaster splint is indicated. Extensive tissue destruction may be an indication for limb amputation.
Conservative Therapy
Anaerobic non-clostridial infection is most sensitive to broad-spectrum antibiotics, in particular:
- cephalosporins;
- semi-synthetic penicillins;
- aminoglycosides.
In the most severe cases, the maximum possible dosage of drugs is prescribed. Medications are selected purely individually after analyzing the sensitivity of the pathogen to antibiotics. In addition, conservative therapy implies:
- detoxification treatment;
- immunotherapy;
- painkillers, anticoagulants, hormones, vitamins.
Detoxification therapy implies the intravenous administration of crystalloid and colloid solutions, in particular, such as Hemodez, Reopoliglyukin, glucose, saline. Immunotherapy involves the use of immunoglobulins, as well as plasma transfusion. A good result is the conduct of physiotherapy procedures that contribute to a faster recovery.
Feature of nursing
Patients with anaerobic infection do not need strict isolation. However, the patient must be constantly monitored, sincepossible complications from the respiratory, circulatory, and nervous system. The room should be ventilated as needed, but at least 2 times a day.
Consumed food must be high-calorie with a sufficient amount of proteins, fats, carbohydrates, trace elements, vitamins. Additionally, it is necessary to carry out hygiene measures, monitor the condition of the skin, oral cavity and perineum of patients. Given that patients experience apathy or excessive agitation, they require the use of not only sedatives, but it is also important to ensure complete calm, as well as follow all prescribed procedures.
Possible Complications
The development of anaerobic infection provokes a very sharp deterioration in well-being. With severe tissue damage, severe necrosis can occur, as a result of which the patient will need amputation of the limb. In especially dangerous cases, a person can die from blood poisoning.
Forecast and prevention
The prognosis of the course of pathology largely depends on the form of infection, the characteristics of pathogens, the timeliness and correctness of diagnosis and treatment. Doctors give a cautious prognosis, however, it is often quite favorable. In the absence of competent timely treatment, the outcome of the course of the disease is disappointing.
So far there is no specific prevention of anaerobic infection. However, to reduce the risk of developing the disease, it is necessary to carry outhigh-quality timely treatment of the wound.
