Comparative analysis of the microbial landscape of the surgical departments of multidisciplinary hospitals in Petrozavodsk (Republic of Karelia)

Background: Antimicrobial resistance is one of the most pressing problems in healthcare, including in developed countries. Local monitoring is necessary for timely correction of protocols for empirical antimicrobial therapy of nosocomial infections in a particular medical institution and for implementation of anti-epidemic measures.

Objective: Comparative analysis of the etiological structure and sensitivity of the main pathogens of nosocomial infections in surgical departments to antimicrobial drugs (AMDs) in 2023 in three multidisciplinary hospitals of Petrozavodsk: the Republican Hospital named after V.A. Baranov (RH), the Republican Hospital of Emergency and Intensive Medical Care (RHEIC) and the Republican Oncology Dispensary (ROD).

Materials and methods: An analysis of all microbiological studies performed in 2023 in three third-level hospitals of Petrozavodsk was carried out. A data summary, statistical grouping, and subsequent graphical presentation of the information obtained were carried out.

Results: Among the microbiological studies in the intensive care units, sputum tests prevailed. The main causative agents of nosocomial lower respiratory tract infections in the RH and RHRIC were Klebsiella pneumoniae (34.88 and 35.23%), Staphylococcus aureus (19.77 and 19.32%), Acinetobacter baumannii (15.12 and 10.22%) and Pseudomonas aeruginosa (8.14 and 10.22%). In the RH A. baumannii was resistant to all AMDs and all leading pathogens were not very sensitive to ceftazidime. Wound discharge was examined more often in the surgical departments of all hospitals: S. aureus prevailed in the RH, while Escherichia coli prevailed in the other two hospitals. Low sensitivity of gram-negative pathogens to amikacin was noted in the RH, as well as low sensitivity of K. pneumoniae and P. aeruginosa to AMDs in the ROD. In the urology departments, all microbiological studies were represented by urine cultures, the main pathogens were E. coli, K. pneumoniae and Enterococcus spp. Low sensitivity to all AMDs was typical for K. pneumoniae in the RH and the ROD, to ceftazidime - in the RHEIC, and P. aeruginosa to ceftazidime in the RH. In the traumatology departments of the RH and the RHEIC, wound discharge studies were predominant (84.05 and 86.67%), with S. aureus being the leading pathogen. The sensitivity of K. pneumoniae to amikacin, as well as to ceftazidime in all the main gram-negative pathogens in the RH was below the optimal values. The leading causative agent of wound infection in the neurosurgical department of the RH was S. aureus, in the RHEIC – E. coli. Low sensitivity of K. pneumoniae and Proteus spp. to all AMDs was noted, and P. aeruginosa – to ceftazidime in the RH.

Conclusion: In the surgical departments of the three leading multidisciplinary hospitals of Petrozavodsk, gram-negative microflora in combination with S. aureus predominates as causative agents of nosocomial infections. Lower sensitivity of gram-negative pathogens to AMDs was registered in the RH and the ROD.