Results of 6-year monitoring of antibiotic resistance of leading microorganisms in fracture-related infection of long bones and chronic osteomyelitis as its consequence, in conditions of transosseous osteosynthesis

  • Authors: Tsiskarashvili A.1, Melikova R.2, Nazarenko A.G.2, Otdelionov V.A.3, Vobishevich N.K.4
  • Affiliations:
    1. Federal State Budgetary Institution "National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov" of the Ministry of Health of the Russian Federation
    2. Научный сотр. отд. последствий травм опорно-двигательной системы и костно-суставной инфекции № 5, ФГБУ НМИЦ "Травматологии и Ортопедии им. Н.Н. Приорова врач-травматолог-ортопед высшей квалификационной категории, кандидат медицинских наук
    3. клинический фармаколог, к.м.н. ФГБУ "НМИЦ Травматологии и Ортопедии им. Н.Н. Приорова
    4. Зав. лаборатории микробиологии, к.м.н. ФГБУ "НМИЦ Травматологии и Ортопедии им. Н.Н. Приорова
  • Section: Original study articles
  • Submitted: 05.06.2025
  • Accepted: 30.09.2025
  • Published: 30.09.2025
  • URL: https://journals.eco-vector.com/0869-8678/article/view/683059
  • DOI: https://doi.org/10.17816/vto683059
  • ID: 683059


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Abstract

BACKGROUND: The increasing resistance of pathogenic strains of fracture-related infection (FRI) significantly limits the possibilities of effective antibiotic therapy, which creates serious problems in healthcare.

AIM: To assess the dynamics of antibiotic resistance of leading microorganisms in FRI of long bones and chronic osteomyelitis, as its consequence, treated using transosseous osteosynthesis method in 2019–2024.

MATERIALS AND METHODS: Retrospective observational one-center study. Antibiotic resistance was retrospectively studied in 247 treated patients. The data were processed using the Pearson χ² criterion.

RESULTS: More than 60% of MSSA and 70% of MSSE and Corynebacterium were resistant to fluoroquinolones. MRSE showed stable sensitivity to vancomycin, teicoplanin, and linezolid. E. faecalis remained sensitive to ampicillin (94.4%), vancomycin, linezolid and tigecycline (100%). Multidrug-resistant strains prevailed among non-fermenting Gram-negative and Klebsiella pneumoniae, and ESBL — among representatives of the Enterobacteriaceae family. In 2024, pan-resistant Gram-negative and vancomycin-resistant MRSA were discovered for the first time. Multidrug resistance was mainly found in Gram-negative bacteria. The most resistant in our study were non-fermenting microbes — Acinetobacter baumannii and Pseudomonas aeruginosa. Gram-positive microflora, especially MSSE, remains highly sensitive to the tested antibiotics.

CONCLUSION: The combination of vancomycin with meropenem remains an effective therapy due to the high sensitivity of Gram-positive to vancomycin and Enterobacteriaceae to carbapenems. However, the increasing resistance among Gram-negative pathogens will require a revision of the current regimen in the near future.

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About the authors

Archil Tsiskarashvili

Federal State Budgetary Institution "National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov" of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: armed05@mail.ru

Заведующий отделением последствий травм опорно-двигательной системы и костно-суставной инфекции,  № 5,ФГБУ НМИЦ "Травматологии и Ортопедии им. Н.Н. Приорова
врач-травматолог-ортопед высшей квалификационной категории,
кандидат медицинских наук

Russian Federation

Regina Melikova

Научный сотр. отд. последствий травм опорно-двигательной системы и костно-суставной инфекции № 5, ФГБУ НМИЦ "Травматологии и Ортопедии им. Н.Н. Приорова
врач-травматолог-ортопед высшей квалификационной категории,
кандидат медицинских наук

Email: regina-melikova@mail.ru

Anton Gerasimovich Nazarenko

Email: NazarenkoAG@cito.priorov.ru

Директор ФГБУ "НМИЦ Травматологии и Ортопедии им. Н.Н. Приорова. д.м.н. профессор, Член кор. РАН.

Vitalii Aleksandrovich Otdelionov

клинический фармаколог, к.м.н. ФГБУ "НМИЦ Травматологии и Ортопедии им. Н.Н. Приорова

Email: OtdelenovVA@cito-priorov.ru

Natalia Konstantinovna Vobishevich

Зав. лаборатории микробиологии, к.м.н. ФГБУ "НМИЦ Травматологии и Ортопедии им. Н.Н. Приорова

Email: regina-melikova@mail.ru

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