Biological properties of the major causes factors of purulently inflammatory diseases of surgical patients in Zaporizhzhia Clinical Hospital of Emergency and Critical Care Medicine

Abstract

The problem of antibiotic resistance of purulent-inflammatory diseases pathogens that arise in patients during treatment in surgery units is urgent and requires a thorough knowledge of the spectrum of circulating strains of microorganisms and changes in the profile of their antibiotic resistance in hospital environment. Detection of resistant strains of microorganisms requires empirical antimicrobial therapy correction and introduction of preventive and anti-epidemic measures. The study objective is to conduct a retrospective analysis of the clinically significant pathogens circulation and changes in their antibiotic resistance for cases of purulent-inflammatory diseases in patients undergoing treatment in surgery units of Emergency Care Hospital of Zaporizhzhia City Council in 2013–2019. Materials and methods Using the data of the reporting documentation, we carried out the analysis of the bacteriological studies results for clinical samples obtained from patients who were treated in the surgical departments of the Emergency Care Hospital of Zaporizhzhia in the period from 2013 to 2019. The prevailing pathogens for purulent-inflammatory conditions of patients and the main trends in the antibiotics resistance change of microorganisms have been determined. Results It has been retrospectively established that for the indicated period 21 301 clinical samples were studied and 21 369 strains of opportunistic microorganisms were isolated. It was determined that the main causative agents of purulent-inflammatory diseases were strains of E. faecalis, S. aureus, E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, while the specific gravity of enterococci was significantly larger than other microorganisms. The sensitivity of these strains to antibiotics underwent annual changes. So, in recent years, the number of vancomycin-resistant enterococci has significantly decreased (from 4 % to 1 %), but the number of methicillin-resistant staphylococci has significantly increased (from 42 % to 82 %). The number of Escherichia and Klebsiella resistant to ceftriaxone (from 49 % to 60 % and from 54 % to 63 %, respectively) and gentamicin (from 46 % to 57 % and from 47 % to 56 %, respectively) increased. 90 % of the strains of acinetobacteria were resistant to fluoroquinolones and carbapenems, 80 % – to amikacin and gentamicin. 80 % of pseudomonad cultures were insensitive to the action of ceftazidime, cefepime, carbapenems, 90 % to the action of fluoroquinolones, 60 % to the action of aminoglycosides. Conclusion. Monitoring the circulation of the main pathogens of purulent-inflammatory diseases with the determination of the spectrum of resistance of the isolated microorganism strains to antibiotics is one of the stages of substantiation of empirical antibacterial therapy within the hospital.

Keywords

• drug resistance microbial
• inflammation
• suppuration