Structure and Antibiotic Resistance of the Main Causative agents of Infections Associated with the Provision of Medical care

Relevance. The problem of healthcare-associated infections (HCAI) is becoming increasingly important in epidemiological, social and economic terms. The most serious threat to hospital patients is multidrug-resistant Gram-negative organisms such as Pseudomonas aeruginosa and Klebsiella pneumoniae. The purpose of the study was to determine the etiological structure and sensitivity to antimicrobial agents of infectious agents associated with the provision of medical care in a children's multidisciplinary hospital. Materials and methods. The strains used in the work were obtained from patients aged from one to 15 years with severe infectious diseases. Additionally, swabs were taken from environmental objects. Bacteriological identification of selected strains was performed using standardized bacteriological algorithms and MALDI-TOF direct protein profiling of non-spore-forming microorganisms. Results. P. aeruginosa and K. pneumoniae were identified as the main causative agents of HAI with multiple resistance to AMPs in the children's multidisciplinary hospital, the source of which was mainly the respiratory tract. Multiple resistance to AMP was higher in K. pneumoniae, 38.9% of the studied isolates showed resistance to four drugs simultaneously. P. aeruginosa in 23.1% of cases was resistant to one AMP, in 15.4% - to two, four and seven AMPs. Conclusion. For a reasonable choice and optimization of antibacterial treatment of hospital patients, it is necessary to take into account the fact of wide circulation of hospital strains. Systematic monitoring of the constantly changing microbiological landscape of hospitals based on microbiological monitoring data and determining the levels of resistance to antimicrobial chemotherapy drugs will help reduce the risk and prevent the development of infections associated with healthcare.