Structure and antibiotic resistance of bacterial pathogens in high-risk departments of healthcare-associated infections during the COVID-19 pandemic

Abstract

The article presents the results of the evaluation of epidemiologically significant bacterial pathogens spectrum representative of healthcare-associated infections (HAIs). Antibiotic resistance was determined in patients with a confirmed diagnosis of severe and extremely severe COVID-19 in comparison with these characteristics in patients of the intensive care unit (ICU) of surgical profile. The predominance of gram-negative bacteria producing extended-spectrum beta-lactamases (ESBLs) +: Enterobacteriaceae and nonfermenting gram-negative bacilli (NFGNB) in patients with COVID-19 and NFGNB in surgical patients was established. Gram-positive coccal microflora in the structure of nosocomial bacterial pathogens was present in a smaller number of cases. Multiple antibiotic resistance of isolated pathogens associated with HAIs was revealed in ICU patients, regardless of the profile, especially manifested in relation to beta-lactam antibiotics. It is shown that the most epidemiologically significant carbapenem-resistant pathogens received priority distribution in the ICU for patients with COVID-19, where they accounted for almost half of all microorganisms associated with HAIs. Resistance to carbapenemic antimicrobials is due to the production of extended-spectrum carbapenemase by nosomial bacterial pathogens isolated from ICU patients. The data obtained supports the strategy of adequate selection of antibacterial therapy regimens taking into account the sensitivity of the pathogen, including in patients with COVID-19. The intensive development of high-tech, invasive methods of diagnosis and treatment, combined with the widespread spread of multidrug-resistant microorganisms, determine the need for continuous improvement of the system of supervision and control of HAIs.