Structure and Antibiotic Resistance of the Main Causative agents of Infections Associated with the Provision of Medical care

N. Voropaeva, U. Nemchenko, E. Grigorova, N. L. Bel'kova, N. Chemezova, E. Savilov
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引用次数: 1

Abstract

Relevance. The problem of healthcare-associated infections (HCAI) is becoming increasingly important in epidemiological, social and economic terms. The most serious threat to hospital patients is multidrug-resistant Gram-negative organisms such as Pseudomonas aeruginosa and Klebsiella pneumoniae. The purpose of the study was to determine the etiological structure and sensitivity to antimicrobial agents of infectious agents associated with the provision of medical care in a children's multidisciplinary hospital. Materials and methods. The strains used in the work were obtained from patients aged from one to 15 years with severe infectious diseases. Additionally, swabs were taken from environmental objects. Bacteriological identification of selected strains was performed using standardized bacteriological algorithms and MALDI-TOF direct protein profiling of non-spore-forming microorganisms. Results. P. aeruginosa and K. pneumoniae were identified as the main causative agents of HAI with multiple resistance to AMPs in the children's multidisciplinary hospital, the source of which was mainly the respiratory tract. Multiple resistance to AMP was higher in K. pneumoniae, 38.9% of the studied isolates showed resistance to four drugs simultaneously. P. aeruginosa in 23.1% of cases was resistant to one AMP, in 15.4% - to two, four and seven AMPs. Conclusion. For a reasonable choice and optimization of antibacterial treatment of hospital patients, it is necessary to take into account the fact of wide circulation of hospital strains. Systematic monitoring of the constantly changing microbiological landscape of hospitals based on microbiological monitoring data and determining the levels of resistance to antimicrobial chemotherapy drugs will help reduce the risk and prevent the development of infections associated with healthcare.
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与提供医疗保健有关的感染的主要病原体的结构和抗生素耐药性
的相关性。卫生保健相关感染(HCAI)的问题在流行病学、社会和经济方面变得越来越重要。对医院病人最严重的威胁是多重耐药革兰氏阴性菌,如铜绿假单胞菌和肺炎克雷伯菌。本研究的目的是确定与儿童多学科医院提供医疗服务相关的感染性病原体的病原学结构和对抗菌药物的敏感性。材料和方法。工作中使用的菌株来自1至15岁患有严重传染病的患者。此外,从环境物体中提取棉签。选择菌株的细菌学鉴定采用标准化细菌学算法和MALDI-TOF非孢子形成微生物的直接蛋白质谱分析。结果。在儿童多学科医院,铜绿假单胞菌和肺炎克雷伯菌是HAI的主要病原体,并对抗菌药物多重耐药,其来源主要是呼吸道。肺炎克雷伯菌对AMP的多重耐药较高,38.9%的分离株同时对4种药物耐药。23.1%的铜绿假单胞菌对一种AMP有耐药性,15.4%的病例对两种、四种和七种AMP有耐药性。结论。为合理选择和优化医院患者抗菌药物治疗方案,必须考虑到医院菌株广泛传播的事实。根据微生物监测数据对医院不断变化的微生物状况进行系统监测,并确定对抗微生物化疗药物的耐药性水平,将有助于降低风险并预防与医疗保健相关的感染的发展。
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