The Dynamics of the Results of Bacteriological Studies Obtained from Clinical Samples in a Multidisciplinary Surgical Hospital Converted for the Treatment of Patients with COVID-19

Abstract

Nosocomial infections remain a serious problem and are one of the main causes of unfavorable outcomes.
 Local microbiological monitoring of the etiological structure and the level of antibiotic resistance is necessary for the
 development and improvement of surgical, anesthetic and intensive care and for the prevention of nosocomial infection.
 Goal of the study: To evaluate the changes of the microorganisms’ structure and their resistance to antimicrobial drugs
 after conversion of a multidisciplinary surgical hospital into an infectious diseases hospital due to COVID-19 pandemic.
 The study included the patients who were treated at the «City Clinical Hospital» named after Professor A.M. Voino-
 Yasenetsky from 2006 to 2020, including the period of conversion of a multidisciplinary surgical hospital into an
 infectious diseases hospital due to COVID-19 pandemic. 8 411 positive bacteriological tests were studied.
 For 15 years, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Staphylococcus aureus dominated in the
 structure of causative agents of purulent-infl ammatory diseases.
 In 2020, the overwhelming majority of K. pneumoniae isolates were resistant to ampicillin, cefuroxime, cefotaxime,
 ceftazidime, and cefi pime, while maintaining the activity of amoxicillin with clavulanic acid up to 50 % that indirectly
 indicates the production of expanded spectrum of activity (ESBL) plasmid β-lactomases. The increase in K. pneumoniae
 strains resistant to carbapenems to 33,4 % is very alarming, because this is an unfavorable prognostic sign.
 Hospital conversion leads to a change in the microbial landscape and requires a change in antimicrobial therapy
 algorithms. A modern epidemiological feature in patients with COVID-19 is the predominance of spp. Candida (32,8 %)
 and Str. pneumonia (36,4 %) in the structure of microorganisms. The increase of multi-resistant strains of microorganisms
 is associated with respiratory support. It is necessary to monitor the level of resistance of key microorganisms to
 antimicrobial drugs in every hospital.