Sovremennye rekomendatsii po antibakterial'noy terapii nozokomial'noy pnevmonii v ORIT na osnovanii mnogotsentrovogo monitoringa vozbuditeley i rezistentnosti v lechebno-profilakticheskikh uchrezhdeniyakh Rossii


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Abstract

A multicenter study examined the sensitivity of clinically important pathogens of nosocomial pneumonia (NP) and NP associated with mechanical ventilation in the 18 ED, isolated from the lower airways (bronchoalveolar lavage, tracheal aspirate) in 2006 and 2012. Interpretation of the sensitivity in both periods of study was performed in accordance with the CLSI criteria (USA) and MR 2004 (Russia). Total in 2006 and 2012 in all clinical centers, 2133 and 5055 of clinically relevant strains of microorganisms were isolated from the lower respiratory tract, and in both periods Gram-negative bacteria (80%) dominated. The ratio of gram-positive and gram-negative microorganisms in the comparative periods was not significantly changed. Currently, 4 microorganisms are dominated in the etiological structure of NP - Klebsiella spp. and Acinetobacter spp. (both 24%), Pseudomonas aeruginosa (16.2%) and Staphylococcus aureus (14.5%). From 2006 to 2012, the frequency of MRSA decreased from 60.7 to 42%. All Gram-negative pathogens of NP were characterized by high resistance to cephalosporins and fluoroquinolones. Compared with 2006, in 2012 there was a significant increase in the frequency of resistance of Klebsiella spp., Escherichia coli and Acinetobacter spp. to carbapenems - from 1 to 10%, from 0 to 3-4%, from 8-12 to 61-78%, respectively. These microorganisms had a lowest resistance to tigecycline.

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