Antimicrobial resistance of nosocomial strains Staphylococcus aureus isolates from surgical patients in Kyiv regional clinical hospital, ukraine

Abstract

Objective — to determine antimicrobial resistance of nosocomial strains Staphylococcus aureus isolates from surgery patients.
 Materials and methods. The clinical strains of S. aureus (574) isolated from surgical patients from January 2015 to December 2017 in Kyiv Regional Clinical Hospital of the Ukraine have been studied. Clinical isolates were allocated and identified in Central microbiological laboratory in Kyiv Regional Clinical Hospital. The identification and antimicrobial susceptibility of the cultures were determined, using automated microbiology analyzer VITEK 2 Compact (bioMerieux, France). Susceptibility to antibiotics was determined using AST card (bioMerieux, France). Some antimicrobial susceptibility test used K-B (Kirby – Bauer antibiotic testing). Sensitivity of S. aureus strains has been studied up to 51 antibiotics: penicillum, ampicillin, amoxicillin, azlocillin, ampicillin/sulbactam, amoxicillin/clavulanic acid, oxacillin, cefoperazone/sulbactam, piperacillin/tazobactam, piperacillin, cefazolin, cefuroxime, cefamandolum, cefotaximum, cefoxitin, ceftriaxone, cefixime, cefpodoxime, ceftazidime, cefepim, imipenem, meropenem, ertapenem, kanamycin, gentamicin, tobramyinum, netilmicin, amikacinum, eritromicin, azithromycin, clindamycin, tetracyclin, doxycyclinum, vancomycin, teicoplaninum, ofloxacinum, levofloxacin, ciprofloxacin, moxifloxacin, gatifloxacin, norfloxacin, chloramphenicol, nitrofurantoinum, rifampicin, linezolidum, tigecycline, fosfomicin, acidum fusidicum, mupirocinum, trimethoprimum, and trimethoprim/sulfamethoxazole. Interpretative criteria were those suggested by the European Committee on Antimicrobial Testing (EUCAST).
 Results and discussion. To S.aureus the drug sensitive rates of piperacillin/tazobactam and ertapenem were both 100 %, but most of the drug resistant rates were over 65—70 %. The highest activity to S. aureus had nitrofurantoinum, cefoxitin, linezolid, trimethoprimum, tigecycline, and trimethoprim/sulfamethoxazole. The high rates of resistance were registered for cefpodoxime (91.7 %), ampicillin (85.0 %), ceftazidime (80.0 %), penicillin (75.0 %), cefixime (73.0 %), cefoperazone/sulbactam (71.5 %), and to azithromycin (69.5 %). The vancomycin — resistant S. aureus (VRSA) accounted for 21.1 % [95 % CI 19.4—22.8 %]. The frequency of isolation of MRSA among tested strains was 37.8 % [95 % CI 35.2—39.2 %] varying from 28.7 % to 44.8 % in different surgical departments in Kyiv Regional Clinical Hospital.
 Conclusions. Antibiotic resistance to S. aureus in surgical hospitals, being a subject of the research is considered to be a serious therapeutic and epidemiologic problem. Taking into account the constant changes and significant differences of the S. aureus resistance levels observed in various regions, the constant monitoring of antibiotic resistance to antimicrobials in every in-patient medical institution is required and on the base of the local obtained results to elaborate the hospital record sheets. Antibiotics application tactics should be determined in accordance with the local data of resistance to them in each surgical in-patient institution. The system of epidemiologic surveillance over microbial resistance should be established on the local, regional, and national levels.