EPIDEMIOLOGICAL AND MICROBIOLOGICAL MONITORING OF THE CAUSATIVE AGENTS OF HEALTHCARE-ASSOCIATED INFECTIONS AT MULTIDISCIPLINARY HOSPITAL

Objective. To analyze the prevalence, etiological pattern, and profile of antibiotic resistance in the causative agents of healthcare-associated infections (HCAI) in the septic surgery unit, intensive care unit one (ICU-1), and urology unit, Saint Ioasaf Belgorod Regional Clinical Hospital, over time from 2013 to 2014. Materials and methods. The results of a clinical observation of pyoinflammatory infections and complications were analyzed in the patients from the purulent surgery, ICU-1, and urology units over the last two years. Conventional microbiological methods were applied to isolate the pure culture of a causative agent and to determine its antibiotic sensitivity by the disk-diffusion method. Data of the qLIS laboratory information system containing information about the causative agents of nosocomial infections over time from 2013 to 2014 were used. Results. The microflora of patients from the septic surgery unit showed a preponderance of gram-positive organisms (54.7%); the proportion of gram-negative organisms was 45.3%. In the etiological pattern of nosocomial infections, there was a predominance of the representatives of the Micrococcaceae (41.3%), Enterobacteriaceae (35.8%), and Pseudomonadaceae (9.5%) families. The microflora of clinical materials from ICU-1 patients displayed an increase in the proportion of gram-negative bacteria of the Enterobacteriaceae and Pseudomonadaceae families by 17.6 and 13.7%, respectively; at the same time, the proportion of gram-positive bacteria of the Micrococcaceae family declined by 22.1%. In the urology unit, the total number of the isolated microbial strains remained virtually unchanged (463 in 2013 versus 493 in 2014). Over the last two years, the pattern of nosocomial infections exhibited a preponderance of gramnegative organisms (94.8-93.5%), among which the representatives of the Enterobacteriaceae family (83.8-84.6%) were prominent. The isolated microbial strains were found to be multidrug resistant to most antimicrobial agents used at hospital. Conclusions. The number of registered HCAI cases in the septic surgery, ICU-1, and urology units is much lower than that of microorganisms isolated from the clinical materials, which suggests the incomplete registration of HCAI and requires the optimization of active epidemiological surveillance of its cases in these units. Due to the higher proportion of microorganisms that are multidrug resistant to antibiotics, a range of treatment and preventive agents against infectious diseases, including HCAI, gradually decreases. In this connection, the primary task is to use additional agents to control infectious diseases, which may be bacteriophages.

causative agents of healthcare-associated infections, antibiotic resistance