Dynamics of antibiotic resistance in the surgical departments of a multidisciplinary hospital using the example of the Republican Hospital n.a. V.A. Baranov

Background. The problem of antibiotic resistance is one of the most pressing public health problems. Antibiotic resistance monitoring is necessary at all levels (global, national, local).

Objective. Assessment of the etiological structure and dynamics of antibiotic resistance of nosocomial pathogens in the leading multidisciplinary institution of the Republic of Karelia (Republican Hospital n.a. V.A. Baranov, Petrozavodsk) for 2019–2022.

Methods. All microbiological studies performed in 2019 and from June 2021 to June 2022 were analyzed. A summary of the data, statistical grouping, followed by a tabular and graphical presentation of the information obtained are presented.

Results. The largest number of cultures was performed in the intensive care unit № 1 (ICU-1), sputum tests predominated. The main pathogens were Acinetobacter baumannii (A. baumannii) (30.82% in 2019 and 30.71% in 2021-2022), Klebsiella pneumoniae (K. pneumoniae) (29.45 and 35.71%) and Pseudomonas aeruginosa (P. aeruginosa) (17.12 and 16.43%). The microflora was resistant to most antibiotics. In the surgical department, wound discharge was examined more often; K. pneumoniae predominated (33.77 and 36.17%). In the neurosurgical department – cultures of wound discharge (26.72 and 31.53%), sputum (28.44 and 29.73%) and urine (36.20 and 26.42%) were examined. The following microorganisms were isolated from wound discharge in 2019: K. pneumoniae (31.25%), sensitive to meropenem and amikacin in all cases, Enterococcus spp. (25%), in all cases sensitive only to vancomycin and linezolid, Staphylococcus aureus (S. aureus) (18.75%), in all cases sensitive to cefoxitin. Wound discharge in 2021–2022: S. aureus (45.16%), 50% sensitive to cefoxitin, K. pneumoniae (16.13%, of which 20% of strains are sensitive to cefotaxime, cefepime, ciprofloxacin, 60% – to meropenem, 40% – to amikacin). K. pneumoniae (40 and 45.45%), P. aeruginosa (20 and 10%) and A. baumannii (16.67 and 15.15%) predominated as the causative agent of lower respiratory tract infection in the neurosurgical department in both periods.

Conclusion. In surgical departments, gram-negative microflora dominated as causative agents of nosocomial infections. A significant decrease in the sensitivity of all types of pathogens to antimicrobial drugs was revealed.