pmedpharmФармация и фармакологияPharmacy & Pharmacology2307-92662413-2241Pyatigorsk Medical and Pharmaceutical Institute - branch of Volgograd State Medical Univer10.19163/2307-9266-2024-12-6-378-393pmedpharm-1667Research ArticleОРИГИНАЛЬНАЯ СТАТЬЯRESEARCH ARTICLEМикробиологический пейзаж и параметры антибиотикорезистентности возбудителей у пациентов отделений реанимации и интенсивной терапии новорожденныхMicrobiological landscape and parameters of antibiotic resistance of pathogens in patients of neonatal intensive care unitshttps://orcid.org/0000-0001-7729-2169БутрановаО. И.ButranovaO. I.

кандидат медицинских наук, доцент кафедры общей и клинической фармакологии Медицинского института ФГАОУ ВО РУДН; научный сотрудник ИФХЭ РАН.

1. Россия, 117198, г. Москва, ул. Миклухо-Маклая, д. 6.

2. Россия, 119071, г. Москва, Ленинский проспект, д. 31, корп. 4.

Candidate of Sciences (Medicine), Assistant Professor of the Department of General and Clinical Pharmacology of the Medical Institute, Peoples' Friendship University (RUDN University); Research Fellow of IPCE RAS. 

1. 6 Miklukho-Maklaya Str., Moscow, Russia, 117198.

2. bldg. 4, 31, Russia, Leninsky Prospekt, Moscow, 119071.

butranova-oi@rudn.ruhttps://orcid.org/0009-0003-9721-6931ГорбачеваА. А.GorbachevaA. A.

ассистент кафедры общей и клинической фармакологии Медицинского института ФГАОУ ВО РУДН; инженер-исследователь ИФХЭ РАН; врач-клинический фармаколог ГБУЗ «ММКЦ «Коммунарка» ДЗМ». 

1. Россия, 117198, г. Москва, ул. Миклухо-Маклая, д. 6.

2. Россия, 119071, г. Москва, Ленинский проспект, д. 31, корп. 4.

3. Россия, 108814, г. Москва, ул. Сосенский Стан, д. 8/3

 

Assistant Lecturer of the Department of General and Clinical Pharmacology of the Medical Institute, Peoples' Friendship University (RUDN University); Research Engineer IPCE RAS; Doctor-Clinical Pharmacologist of Kommunarka Center (Moscow, Russia).

1.  6 Miklukho-Maklaya Str., Moscow, Russia, 117198.

2. bldg. 4, 31, Russia, Leninsky Prospekt, Moscow, 119071

3.  8/3 Sosenskiy Stan Str., Moscow, Russia, 108814.

 

gorbacheva_aa@pfur.ruhttps://orcid.org/0000-0002-6348-6867ЗыряновС. К.ZyryanovS. K.

доктор медицинских наук, профессор, заведующий кафедрой общей и клинической фармакологии ФГАОУ ВО РУДН;  главный научный сотрудник ИФХЭ РАН; заместитель главного врача ГБУЗ ГКБ № 24 ДЗМ.

1. Россия, 117198, г. Москва, ул. Миклухо-Маклая, д. 6.

2. Россия, 119071, г. Москва, Ленинский проспект, д. 31, корп. 4

3. Россия, 127015, г. Москва, ул. Писцовая, д. 10.

 

Doctor of Sciences (Medicine), Professor, Head of the Department of General and Clinical Pharmacology of the Peoples' Friendship University (RUDN University); Chief Research Fellow of IPCE RAS; Deputy Chief Physician of the City Clinical Hospital No. 24 (Moscow, Russia). 

1.  6 Miklukho-Maklaya Str., Moscow, Russia, 117198.

2. bldg. 4, 31, Russia, Leninsky Prospekt, Moscow, 119071.

3.  10 Pistsovaya Str., Moscow, Russia, 127015.

zyryanov_sk@rudn.universityhttps://orcid.org/0000-0003-0994-0579НиО. Г.NiO. G.

заведующая отделением клинической фармакологии ГБУЗ «ММКЦ «Коммунарка» ДЗМ». 

Россия, 108814, г. Москва, ул. Сосенский Стан, д. 8/3.

Head of the Department of Clinical Pharmacology of the Kommunarka Center (Moscow, Russia). 

8/3 Sosenskiy Stan Str., Moscow, Russia, 108814

ni.oksana@gmail.com1. Федеральное государственное автономное образовательное учреждение высшего образования «Российский университет дружбы народов имени Патриса Лумумбы». 2. Федеральное государственное бюджетное учреждение науки Институт физической химии и электрохимии им. А.Н. Фрумкина Российской академии наук.Россия1. Peoples’ Friendship University (RUDN University). 2. Institute of Physical Chemistry and Electrochemistry of Russian Academy of Sciences.Russian Federation1. Федеральное государственное автономное образовательное учреждение высшего образования «Российский университет дружбы народов имени Патриса Лумумбы». 2. Федеральное государственное бюджетное учреждение науки Институт физической химии и электрохимии им. А.Н. Фрумкина Российской академии наук. 3. Государственное бюджетное учреждение здравоохранения города Москвы «Московский многопрофильный клинический центр «Коммунарка» Департамента здравоохранения города Москвы».Россия1. Peoples’ Friendship University (RUDN University). 2. Institute of Physical Chemistry and Electrochemistry of Russian Academy of Sciences. 3. Kommunarka Center.Russian Federation1. Федеральное государственное автономное образовательное учреждение высшего образования «Российский университет дружбы народов имени Патриса Лумумбы». 2. Федеральное государственное бюджетное учреждение науки Институт физической химии и электрохимии им. А.Н. Фрумкина Российской академии наук. 3. Государственное бюджетное учреждение города Москвы «Городская клиническая больница № 24 Департамента здравоохранения города Москвы».Россия1. Peoples’ Friendship University (RUDN University). 2. Institute of Physical Chemistry and Electrochemistry of Russian Academy of Sciences. 3. City Clinical Hospital No. 24.Russian FederationГосударственное бюджетное учреждение здравоохранения города Москвы «Московский многопрофильный клинический центр «Коммунарка» Департамента здравоохранения города Москвы»РоссияKommunarka Center.Russian Federation202407072025126378393Copyright © Бутранова О.И., Горбачева А.А., Зырянов С.К., Ни О.Г., 20252025Бутранова О.И., Горбачева А.А., Зырянов С.К., Ни О.Г.Butranova O.I., Gorbacheva A.A., Zyryanov S.K., Ni O.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pharmpharm.ru/jour/article/view/1667

Неонатальные инфекции остаются одной из значимых причин младенческой смертности в мире. Изменение спектра возбудителей, а также их чувствительности к основным антибактериальным препаратам (АБП) является динамически протекающим процессом, характеризующимся постепенным ростом удельного веса наиболее опасных возбудителей, в частности, относящихся к группе ESKAPE-патогенов. Изучение структуры патогенов и параметров их антибиотикорезистентности является основным инструментом повышения эффективности антибиотикотерапии.

Цель

Цель. Проанализировать структуру возбудителей нозокомиальных инфекций пациентов отделений реанимации и интенсивной терапии (ОРИТ) новорождённых и оценка параметров их антибиотикорезистентности.

Материалы и методы

Материалы и методы. Проведено ретроспективное эпидемиологическое исследование данных за период с 1 мая 2022 по 1 мая 2024 гг. лабораторной информационной системы ЛИС-Алиса ГБУЗ «ММКЦ «Коммунарка» ДЗМ и медицинской документации пациентов с выявленным ростом микроорганизмов (МО) в бактериологических посевах.

Результаты

Результаты. Общее число посевов составило 5179. Рост МО отмечен в 39,3% (n=2036) — были получены от 734 пациентов, из них 87,1% — недоношенные). Грамположительная микрофлора обнаружена в 59,6%. Топ-5 идентифицированных МО составили: S. epidermidis (n=386 — 19%), S. haemolyticus (n=264 — 13%), S. aureus (n=218 — 10,7%), K. pneumoniae (n=210 — 10,3%) и E.coli (n=188 — 9,2%). Доля МО, относящихся к группе ESKAPE, составила 28,6% (S. aureus — 10,7%; K. pneumoniae — 10,3%; Enterobacter spp. — 3,6%; P. aeruginosa — 2,3%; A. baumannii — 1,1%; E. faecium — 0,5%). Среди Staphylococcus spp. — 71,2% были резистенты к оксациллину, 53,9% — к гентамицину. При этом 100% чувствительности ни к одному из протестированных АБП выявлено не было. Максимально высокие показатели резистентности к оксациллину имели S. epidermidis (93,8%) и S. haemolyticus (86,7%). Также 17% штаммов S. aureus были резистентны к оксациллину. Среди K. pneumonia  48,8% были резистентны к цефтазидиму и 100% — к ампициллину; E. coli 28,2% штаммов были резистентны к цефтазидиму, 64,9% — к ампициллину, 28,2% — к сульфаметоксазолу / триметоприму.

Заключение

Заключение. Установлена высокая частота выделения патогенов (с преобладанием грамположительной микрофлоры) у новорождённых, госпитализированных в ОРИТ (средний гестационный возраст <35 нед.). Результаты демонстрируют тревожные тенденции в отношении параметров резистентности МО и свидетельствуют о необходимости динамического мониторинга чувствительности возбудителей к основным АБП, применяющимся в ОРИТ.

Neonatal infections remain one of the significant causes of infant mortality in the world. The change in the spectrum of pathogens, as well as their sensitivity to the main antibacterial drugs (ABDs), is a dynamically occurring process, characterized by a gradual increase in the proportion of the most dangerous pathogens, in particular, those belonging to the ESKAPE pathogen group. The study of the structure of pathogens and the parameters of their antibiotic resistance is the main tool for increasing the effectiveness of antibiotic therapy.

The aim

The aim. To analyze the structure of pathogens of nosocomial infections in patients of neonatal intensive care units (NICU) and assess the parameters of their antibiotic resistance.

Materials and methods

Materials and methods. A retrospective epidemiological study of data from May 1, 2022 to May 1, 2024 of the laboratory information system LIS-Alice of the Kommunarka Center (Moscow, Russia) and medical documentation of patients with identified growth of microorganisms (MOs) in bacteriological cultures was carried out.

Results

Results. The total number of crops was 5179, MOs growth was noted in 39.3% (n=2036) obtained from 734 patients, of which 87.1% were premature. Gram-positive pathogens were found in 59.6%. The top 5 identified MOs were: S. epidermidis (n=386 — 19%), S. haemolyticus (n=264 — 13%), S. aureus (n=218 — 10.7%), K. pneumoniae (n=210 - 10.3%) and E. coli (n=188 — 9.2%). The proportion of MOs belonging to the ESKAPE group was 28.6% (S. aureus — 10.7%; K. pneumoniae — 10.3%; Enterobacter spp. — 3.6%; P. aeruginosa — 2.3%; A. baumannii — 1.1%; E. faecium — 0.5%). Among Staphylococcus spp. — 71.2% were resistant to oxacillin, 53.9% — to gentamicin. At the same time, 100% sensitivity to any of the tested ABDs was not detected. The highest rates of resistance to oxacillin were observed in S. epidermidis (93.8%) and S. haemolyticus (86.7%). Also, 17% of S. aureus strains were resistant to oxacillin. Among K. pneumonia 48.8% were resistant to ceftazidime and 100% to ampicillin; E. coli 28.2% of strains were resistant to ceftazidime, 64.9% to ampicillin, 28.2% to sulfamethoxazole trimethoprim.

Conclusion

Conclusion. We found a high frequency of pathogen isolation (with a predominance of gram-positive pathogens) in newborns hospitalized in the ICU (mean gestational age <35 weeks). The results demonstrate alarming trends in relation to MOs resistance parameters and indicate the need for dynamic monitoring of the sensitivity of pathogens to the main ABDs used in the ICU.

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The authors declare that there are no conflicts of interest present.