[Prevention of the formation of drug resistance in bacterial populations by using biologically active substances].

Abstract

The patients with infected wounds of the extremities were treated with kanamycin electrophoresis in combination with chlorhexidine bigluconate, an antiseptic. As compared to the patients treated with kanamycin alone, the rate of the wound size decrease in such patients was 2 times higher. The levels of microbial contamination in these patients were much lower. The contamination level with the aerobic flora was 4.8 times lower, including staphylococci, the level of contamination with which was 5.9 times lower. The contamination level with the kanamycin-resistant bacteria was 22 times lower. The treatment with kanamycin alone resulted in a 2.6-fold increase in the number of the antibiotic-resistant variants in the microbial populations of the wounds. In 48.2 per cent of the patients, this was accompanied by development of resistance to kanamycin in the whole microbial population of the wound. The development of the kanamycin resistance in the staphylococcal populations of 18.1 per cent of the patients was associated with changed sensitivity of the initial strains and in 81.9 per cent of the patients, with superinfection by the resistant strains. No changes in the kanamycin sensitivity of the initial gram-negative organisms during the treatment were observed. The use of chlorhexidine bigluconate, as a biologically active substance in combination with kanamycin potentiated the action of the antibiotic, prevented development and accumulation of the antibiotic-resistant variants in the microbial populations of the wounds and development of the drug resistance in these populations.