Pancreatogenic infections: importance of microbiological monitoring and penetration of antimicrobial chemotherapeutic agents into the pancreas when defining therapeutic approach

Аннотация

The review provides the information on the spectrum of microorganisms initiating the development of clinical and morphological forms of pancreatogenic infections. It is shown that when analyzing pathological conditions, no features in the microbiological landscape of the secondary infection in the pancreas and the surrounding extraperitoneal cellular tissue are registered. It provides the information on the particular structure of the microorganisms spectrum in acute pancreatitis in the Italian, Mexican, Indian, Chinese and Russian patient populations. Special attention has been paid to the choice of antibacterial medications in acute pancreatitis; the choice is based on sensitivity of allocated microorganisms to these medications, and particularities of medication therapeutic concentrations formation in the pancreas tissues or its secret. Foreign researchers’ experimental and clinical data regarding the penetration degree of various antibacterial agents into pancreatic tissue in the presence of pancreatic necrosis and efficiency of the agents in the process of drug correction of necrotizing pancreatitis. The analyzed information predetermines the need for a continuous microbiological pattern monitoring on the local level in association with assessment of its sensitivity and specificity to the prescribed antibacterial therapy of acute pancreatitis in the early stages of its infectious complications.