LOCAL IMMUNITY PATTERNS IN PURULENT WOUNDS

Abstract

The aim of present study was to determine the microbial pattern and a significance of local pustular immune factors for the progression of local pyogenic infection in surgical patients. To these purpose, specific infectious pathogens were identified and scored by means of conventional microbiological methods in the patients with pyogenic inflammatory diseases of skin and subcutaneous fat tissues. The numbers of purulent leukocytes were determined in the pustular exudates, and concentrations of TNFα, IL-1β, IL-8, IFN-γ, IL-4, IL-1ra, IgM, IgG, and IgA were measured in the samples, using enzyme immunoassay techniques. Appropriate parameters of effluents obtained from "clean" (non-infected) surgical lesions were taken as сontrols. It has been shown that Staphylococcus aureus plays a leading role in etiology of bacterial infections in our patients. The amounts of blood cells in pustular samples showed a direct and significant correlation with number of viable microorganisms derived from the effluent. Purulent wound exudates were characterized by high IL-1β and IL-8 concentrations, along with relatively low TNFα levels, as compared with "clean" wounds. Mean amounts of IgG in the pustular contents of dissected lesions proved to be five-fold higher that IgG levels in sterile incisions. As compared with young individuals, the elderly persons are characterized by lesser TNFα production, as well as by more active IL-8 synthesis in the areas of bacterial inflammation. The indexes of local immunity show sufficient differences between the areas of suppurative inflammation and sterile wound lesions.