Abstract
Introduction. Cross-resistance of microorganisms to antibiotics against the background of the use of biocides in subinhibitory concentrations is an urgent problem of modern health care.
 The aim of the work is to study the effect of povidone-iodine on the sensitivity of clinical isolates of Klebsiella pneumoniae to antibiotics.
 Materials and methods. The work analyzed the effect of povidone-iodine at subinhibitory concentrations on changes in the sensitivity of clinical isolates of K. pneumoniae (n = 9) to antibacterial agents (n = 15). Adaptation of bacteria to povidone-iodine was carried out using periodic cultivation of microorganisms, which was carried out in 96-well culture plates for suspension cultures (non-treated) without stirring. The sensitivity of bacteria to antibiotics was assessed using an automatic analyzer Vitek2Compact (BioMerieux) using AST-204 charts.
 Results. During the adaptation of clinical isolates of K. pneumoniae to povidone-iodine, an increase in the sensitivity of bacteria to antibiotics was shown. The minimum inhibitory concentrations (MIC) of 11 antibacterial agents in relation to the studied cultures decreased by an average of 2.3523.2 times compared with the control values. Under the experimental conditions, the sensitivity of the studied cultures increased to amoxicillin/clavulanic acid by 2 8 times, piperacillin/tazobactam by 2 32 times, ceftazidime by 4 16 times, ami-kacin 2 16 times, ertapenem 2.08.0 times, meropinem 28 times, cefepim 4 64 times, ciprofloxacin 4 16 times, gentamicin 2 8 times, norfloxacin 28 times, nitrofurantoin 24 times. An increase in the level of sensitivity to antibiotics was found in 50100% of the studied clinical bacterial isolates. A similar effect has not been established for ampicillin, cefotaxime, imipenem, and trimethoprim/sulfamethoxazole. It should be noted that under the conditions of the experiment, intraspecific heterogeneity of clinical isolates of K. pneumoniae was revealed in terms of the level of acquired sensitivity to antibacterial agents.
 Discussion. Our results are not described in the scientific literature and require further study and explanation.
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