DOI: https://doi.org/10.22263/2312-4156.2023.6.47
V.Y. Ziamko1, Y.G. Ziamko2, V.K. Okulich1
The influence of coronavirus infection on the policy of using antibiotics and the formation of microflora antibiotic resistance in the resuscitation and anesthesiology department
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
Vestnik VGMU. 2023;22(6):47-59.
Abstract.
Objectives. To evaluate the impact of coronavirus infection on the policy of using antibiotics and the formation of antibiotic resistance of microflora in the resuscitation and anesthesiology department.
Material and methods. Using international computer program WHONET a comparative analysis of general structure of isolates from patients in hospital and intensive care unit was carried out. Antibiotic sensitivity analysis was made on isolation of A. baumannii (n=2835), P. aeruginosa (n=1795), K. pneumoniaе (n=3479) and S. aureus (n=1133) as the most problematic microorganisms. Sensitivity to antibiotics was determined by disk diffusion method using Mueller–Hinton medium and on bacteriological analyzers ATB Expression (bioMerieux, France) and BD Phoenix (Becton Dickinson, USA) at the Republican Scientific and Practical Center «Infection in Surgery».
Results. From 2015 to 2017 the analysis made of microflora structure allowed to establish the predominance of
P. aeruginosa, Acinetobacter spp., K. pneumoniae in intensive care unit and from 2020 – K. pneumoniae, Acinetobacter spp. and Candida spp. which were found 1.9 times more often than other microorganisms, while in general structure of a multidisciplinary hospital S. aureus was found most often during the first three years of reporting period and from 2019
K. pneumoniae also predominated. Tigecycline and colistat that were earlier highly effective lost their activity against 4.3% and 5.7% of K. pneumoniae isolates in 2019, and 38.3% and 40.2% – in 2022.
Conclusions. Coronavirus infection that dominated in 2020-2022 exerted its influence on the policy of antibiotic use and the spread of antibiotic resistance in intensive care unit of multidisciplinary hospital which has been confirmed by an increase of multidrug-resistant K. pneumoniae isolates by 46.8% in 2021 and 30% – in 2022.
Keywords: structure of isolates, antibiotic resistance, coronavirus infection, resuscitation and anesthesiology department.
The work was carried out within the frames of the research topic “The development of a new method for diagnosing and intensive therapy of sepsis”, State Registration No. 20190090 dated 05.02.2019.
References
1. M-vo zdravookhraneniya Resp. Belarus'. An imported case of coronavirus has been registered in Belarus. Available from: https://minzdrav.gov.by/ru/sobytiya/v-belarusi-zaregistrirovan-zavoznoy-sluchay-koronavirusa/ [Accessed 15th January 2024]. (In Russ.)
2. Habboush Y, Guzman N. Antibiotic Resistance. StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513277/ [Accessed 15th January 2024].
3. Bozhkova SA, Gordina EM, Shneyder OV, Rukina AN, Shabanova V. Resistance of carbapenemase-producing strains of Klebsiella pneumoniae isolated from patients with orthopedic infection. Klin Mikrobiologiya Antimikrob Khimioterapiya. 2020;22(1):47-52. (In Russ.). doi: http://dx.doi.org/10.36488/cmac.2020.1.47-52
4. Yakovlev SV, Suvorova MP, Bykov AO. Infections caused by carbapenem-resistant Enterobacteriaceae: epidemiology, clinical significance and opportunities to optimize antibiotic therapy. Antibiotiki Khimioterapiya. 2020;65(5-6):41-69. (In Russ.). doi: http://dx.doi.org/10.37489/0235-2990-2020-65-5-6-41-69
5. Vsemir organizatsiya zdravookhraneniya. WHO publishes list of bacteria for which new antibiotics are urgently needed. Available from: https://www.who.int/ru/news/item/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed [Accessed 15th January 2024]. (In Russ.)
6. Zou Y, Lian J, Di Y, You H, Yao H, Liu J, et al. The quick loss of carbapenem susceptibility in Pseudomonas aeruginosa at intensive care units. Int J Clin Pharm. 2018 Feb;40(1):175-82. doi: http://dx.doi.org/10.1007/s11096-017-0524-5
7. Titov LP, Gorbunov VA, Kharkhal AN, Davydov AV, Levshina NN. Trends in antibiotic resistance of invasive bacterial pathogens: microbiologic monitoring 2012-2017. Zdravookhranenie. 2019;(7):5-16. (In Russ.)
8. Zemko VYu, Okulich VK, Dzyadzko AM. Microflora structure and antibiotic resistance trends in the intensive care and anesthesia unit of a multidisciplinary institution. Novosti Khirurgii. 2022;3(1):61-73. (In Russ.). doi: http://dx.doi.org/10.18484/2305-0047.2022.1.61
9. Bonda NA, Karpova EV, Tapalskiy DV, Stoma IO. Microbiologic monitoring system to assess antibiotic resistance of bloodstream pathogens and its genetic determinants. Klin Infektologiya Parazitologiya. 2023;12(1):6-16. (In Russ.). doi: http://dx.doi.org/10.34883/PI.2023.12.1.021
10. Titov LP, Gorbunov VA, Kharkhal AN, Yanovich OO, Levshina NN, Blyga EG, i dr. The nature of wound microflora and antibiotic resistance: results from monitoring 2012-2020. Izv Nats Akad Nauk Belarusi Ser Med Nauk. 2023;20(1):58-70. (In Russ.). doi: http://dx.doi.org/10.29235/1814-6023-2023-20-1-58-70
11. Dekhnich A. Overcoming antimicrobial resistance in Gram-negative pathogens. Med Vestn. 2022;(8 maya). Available from: https://medvestnik.by/konspektvracha/preodolenie-antimikrobnoj-rezistentnosti-gramotritsatel-nykh-patogenov-2 [Accessed 15th January 2024]. (In Russ.)
12. Meletis G, Oustas E, Botziori C, Kakasi E, Koteli A. Containment of carbapenem resistance rates of Klebsiella pneumoniae and Acinetobacter baumannii in a Greek hospital with a concomitant increase in colistin, gentamicin and tigecycline resistance. New Microbiol. 2015 Jul;38(3):417-21.
13. van Duin D, Cober E, Richter SS, Perez F, Kalayjian RC, Salata RA, et al. Residence in skilled nursing facilities is associated with tigecycline nonsusceptibility in carbapenem-resistant Klebsiella pneumonia. Infect Control Hosp Epidemiol. 2015 Aug;36(8):942-8. doi: http://dx.doi.org/10.1017/ice.2015.118
Information about authors:
V.Y. Ziamko – Candidate of Medical Sciences, associate professor of the Chair of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-6753-2074,
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Viktoriya Y. Ziamko;
Y.G. Ziamko – therapist, Vitebsk Regional Clinical Hospital;
V.K. Okulich – Candidate of Medical Sciences, associate professor of the Chair of Clinical Microbiology, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-8226-6405
