Non-Clostyridial anaerobic infection is a pathological process that can be triggered by pathogenic microorganisms in conditions favorable for their development and vital activity. Characteristic signs of infection are the presence of intoxication symptoms, gas-forming processes in the wound, putrefactive exudate, rapidly progressing tissue necrosis.
Such an infection is very easily recognized on the basis of existing symptoms, which is confirmed by a comprehensive diagnosis. Treatment involves the surgical treatment of the lesion, as well as drug therapy.
Features of anaerobic infection
Non-clostridial anaerobes do not form a spore and are representatives of the ordinary human flora. They completely cover the mucosa from the oral cavity to the rectum. Under normal conditions, such microorganisms are completely safe, however, in the presence of certain disorders, microbes become causative agents of dangerous surgical infections.
There are a number of predisposing factors for the formation of non-clostriadial anaerobic infection, in particular, such as:
- necrosis occurring with trauma or purulent-inflammatory processes;
- weakening of defenses;
- violation of blood supply to tissues;
- tissue acidosis.
The disease mainly proceeds in the form of phlegmon. The pathological process affects the skin, muscles and subcutaneous tissue. It is characterized by a sharp onset and rapid course. The doctor can make a 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 also decomposing organic compounds can act as a source of infection. Pathogens have a pathogenic effect with a combination of a number of provoking factors. Damage to the wound surface barriers leads to the penetration of pathogenic microflora into sterile tissues. If the affected areas have sufficient oxygen access, then after a certain time the microbes die without causing any harm. According to the available classification, anaerobic non-clostridial infection can be:
- monoinfection - a single anaerobic lesion;
- polyinfection - with two or more anaerobes;
- mixed infection - a combination of anaerobes and aerobes.
The course of an existing infection can be lightning fast, acute and subacute. Often anaerobic non-clostridial infection occurs in surgery and gynecology. Depending on the ability of pathogens to spore, such a disease proceeds differently, however, it has similar symptoms.
What is characterized by the disease
Many patients are interested in what anaerobic infection is, for what reasons it forms, what signs it has and how the treatment is carried out. If there are non-spore-forming anaerobes in the body, such disorders as chronic sinusitis, periodontal abscess, necrotic pneumonia, abscess of the brain and lung, phlegmon, infection of bones and joints, sepsis and many other serious diseases can occur.
Anaerobes very often provoke the development of infections of the abdominal cavity, liver, as well as 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 others.
It is worth noting that with the course of all these diseases, the symptoms are quite lubricated, 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, such types of pathology are distinguished as:
- skin infections;
- bone damage
- bloodstream;
- 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 involved in the pathological process of bone tissue, septic arthritis develops , as well as purulent-necrotic osteomyelitis.
Infection of internal organs leads to the occurrence of bacterial vaginosis in women, gynecological and intrauterine infections, abscesses of the genital organs, as well as to septic abortion.
Causes of occurrence
Non-clostriadial 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 mainly refers 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 distinguish such as:
- microbial pathologies of tissues and organs;
- intrauterine infection and prematurity;
- long-term antibiotic therapy, hormone therapy and chemotherapy;
- long stay in a hospital.
There are certain provoking factors that significantly enhance the pathogenic properties of anaerobes. These include enzymes produced by bacteria. They provoke very severe violations of blood microcirculation, destroy red blood cells, and also increase vascular permeability. Bacteria lead to tissue destruction and contribute to the spread of infection.
Endotoxins and exotoxins lead to damage to the walls of blood vessels, leading to thrombosis. Clostridia release toxic substances, under the influence of which purulent accumulation and fluid are formed in the tissues, muscles begin to gradually die. The pathogenesis of non-clostridial anaerobic infection is mainly associated with:
- soil contamination with excrement;
- the presence of extraneous wounds on the body;
- tissue necrosis and ischemia;
- damage to the skin and mucous membrane;
- the penetration of bacteria into the blood;
- malignant neoplasms.
In addition, neuropsychic overstrain, significant blood loss, and immunodeficiency can provoke a pathological spread of pathogens.
Main symptoms
Anaerobic clostridial and non-clostridial infection provokes inflammation of organs and the brain, which often occurs with an abscess of soft tissues and the development of sepsis. Signs of infection begin suddenly. In patients, signs of intoxication predominate. Their health deteriorates very sharply before the onset of local symptoms, when the wounds begin to acquire a black color.
The incubation period lasts for approximately 3 days. A sick person begins a fever, and signs such as:
- weakness and severe weakness;
- drowsiness;
- dyspepsia;
- pressure drop;
- apathy;
- retardation;
- palpitations.
Gradually, inhibition is replaced by overexcitation, confusion and anxiety. In humans, breathing and pulse become much faster. He also experiences severe 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, they have a lack of coordination.
It is absolutely necessary to know exactly the features of the clinic, the diagnosis and treatment of non-clostridial anaerobic infection, in order to understand exactly what pathology consequences can lead to. Among local signs, it is necessary to distinguish such as:
- severe bursting pain, which gradually increases;
- swelling of the extremities;
- the presence of gas in the affected tissues, which can be detected by palpation;
- inactivity and impaired mobility of the limbs;
- purulent-necrotic inflammation.
In the absence of the required treatment, soft tissues begin to collapse very quickly, which makes the prognosis of the pathology quite unfavorable.
Diagnostics
To determine how to conduct treatment, diagnosis of non-clostridial anaerobic infection is required. Depending on the location of the focus of the infectious lesion, various specialists carry out the diagnosis, namely, otolaryngologists, surgeons of various directions, 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, since many of them are uncultivated.
More accurate methods include gas-liquid chromatography and spectrometric analysis, which will determine the number of metabolites and volatile liquid acids. No less good and accurate methods is to determine the presence of bacteria or their antibodies in the blood using enzyme-linked immunosorbent assay. Also, to determine the presence of anaerobic clostridial and non-clostridial infections, rapid diagnostics are used. In this case, biomaterials are studied in ultraviolet light. To do this:
- bacteriological culture 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, one can detect an accumulation of gases in the affected tissues or body cavity. During the diagnosis, it is necessary to exclude the presence in the body of erysipelas, deep vein thrombosis, frostbite, pneumothorax, as well as purulent-necrotic lesions.
Treatment features
An integrated approach to the treatment of non-clostridial anaerobic infection involves the surgical treatment of the lesion, as well as the use of antibacterial and detoxification therapy. Surgical intervention must be carried out as early as possible, since the patient’s life will largely depend on this.
Basically, a deep dissection of the lesion is performed, followed by removal of necrotic tissue, 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 is 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 given antitoxic serum.
Surgical intervention
During the surgical treatment, the existing wound is widely dissected, pathological tissues are excised, foreign bodies are removed, and then 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 an anaerobic clostridial and non-clostridial infection in surgery develops against a fracture of the extremities, its immobilization using a plaster cast is indicated. Extensive tissue destruction may be an indication for amputation.
Conservative therapy
Anaerobic non-clostridial infection is most sensitive to broad-spectrum antibacterial drugs, in particular:
- cephalosporins;
- semisynthetic penicillins;
- aminoglycosides.
In the most severe cases, the maximum possible dosage of drugs is prescribed. Medicines are selected purely individually after an analysis of the sensitivity of the pathogen to antibiotics. In addition, conservative therapy implies:
- detoxification treatment;
- immunotherapy;
- painkillers, anticoagulants, hormones, vitamins.
Detoxification therapy involves the intravenous administration of crystalloid and colloidal solutions, in particular, such as "Hemodez", "Reopoliglyukin", glucose, saline. Immunotherapy implies the use of immunoglobulins, as well as plasma transfusion. A good result is the implementation of physiotherapeutic procedures that contribute to faster recovery.
Patient Care Feature
Patients with anaerobic infection do not need strict isolation. However, the patient must be constantly monitored, since complications from the respiratory system, blood circulation, and the nervous system may occur. The room should be aired as needed, but at least 2 times a day.
Food consumed must be high-calorie with a sufficient amount of protein, fats, carbohydrates, trace elements, vitamins. In addition, 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 are overly excited, they need to use not only sedatives, but it is also important to ensure complete peace of mind, as well as perform all prescribed procedures.
Possible complications
The development of anaerobic infection provokes a very sharp deterioration in well-being. With severe tissue damage, serious necrosis can occur, as a result of which the patient will need amputation of the limb. In especially dangerous cases, a person may die from blood poisoning.
Forecast and Prevention
The prognosis of the course of the pathology largely depends on the form of infection, the characteristics of pathogens, the timeliness and accuracy of the 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 disease is disappointing.
There is as yet no specific prevention of anaerobic infection. However, in order to reduce the risk of developing the disease, it is imperative to conduct quality timely treatment of the wound.