Microbiological monitoring and epidemiological surveillance of nosocomial infections at a multiprofile hospital of the Belgorod Region

Objective. To analyze the prevalence, etiological pattern, and profile of antibiotic resistance in pathogens of healthcare-associated infections (HAI) in surgical and intensive care units at Saint Ioasaf Belgorod Regional Clinical Hospital over time in 2014-2015. Materials and methods. The study material was the results of a clinical observation of pyoinflammatory infections and bacterial complications in patients over the last two years. Conventional microbiological methods were used to isolate the causative agent in the pure culture and to determine its antibiotic susceptibility by the disk diffusion method, as well as with a WalkAway bacteriological analyzer. A BACTEC Becton Dickinson analyzer was applied to examine blood cultures. The study used the data of a qLIS laboratory information system containing data on the causative agents of HAI over time in 2014-2015. Results. S. aureus (15.6%), S. epidermidis MRS (9%), S. epidermidis (13.7%), K. pneumoniae (11.3%), and Ent. aerogenes (3.5%) were dominant causative agents in the etiological pattern of catheter-related blood stream infections. Str. species (31.6%), S. aureus (7%), P. aeruginoza (6.5%), K. pneumoniae (6.3%), and Candida fungi (8.8%) were leading microorganisms in the microflora in respiratory tract and lung infections. The problem pathogens in the etiology of skin and soft tissue infections were P. aeruginoza (11.7%), E. coli (6.6%), K. pneumoniae (3.9%), S. aureus (20.7%), and S. epidermidis (8.8%). Urinary tract infections were mainly caused by E. coli (28.5%), K. pneumoniae (9.1%), E. aerogenes (7.5%), E. faecalis (7%), and E. faecium (11%). Those in the etiology of intraabdominal infections were P. aeruginoza (10.7%), E. coli (6.9%), K. pneumoniae (4.9%), and S. aureus (17%), and S. epidermidis (8.6%). All cases of nosocomial CNS infections were caused by E. aerogenes (33.3%), K. pneumoniae (16.7%), A. baumannii (16.7%), S. epidermidis (16.7%), and S. haemolyticus (16.7%). The isolated microbial strains were characterized by multidrug resistance to most antimicrobial agents used at hospital. Conclusions. To elaborate reasonable treatment algorithms for each specific hospital remains a rather relevant problem. If microbiological monitoring is absent, there are considerable difficulties in predicting the efficiency of HAI treatment. Investigation of trends in the spread of epidemically significant types of causative agents allows the prediction of the intensity and nature of contamination. The antibiotic resistance of HAI pathogens is the most important parameter for reasonable empirical and further etiotropic treatment and the mainstay for the prevention of pyoinflammatory infections in critically ill patients.

nosocomial infections, causative agents of healthcare-associated infections, antibiotic resistance