Intraabdominal infections and resistance of their causative agents towards antibiotics in surgical stationaries in the City of Kуiv

Keywords: surgery; peritonitis; nosocomial infections; extramural infections; соncurrent diseases; mortality; pathogens; resistance towards antibiotics

Abstract

Objective. To study clinical and microbiological peculiarities of intraabdominal infections (IАI), аs well as resistance towards antibiotics of their causative agents, extracted from the patients, who were admitted to surgical stationaries in the City of Kiev.

Маterials and methods. There were investigated 1622 intraperitoneal isolates, which were bacteriologically confirmed as IAI and obtained from 662 patients, ageing 22-84 yrs old, who were treated in surgical departments of 7 hospitals in City of Kiev from Jan. 2014 yr till Dec. 2016 yr. Identification and determination of sensitivity of the cultures obtained towards 20 аntibiotics were conducted with the help of automated analizer Vitek 2 Compact. Kirby - Bauer disc-diffusion method was applied in some tests. The sensitivity towards antibiotics results were estimated in accordance to recommendation of the Institute of clinical and laboratory standards of the USA.

Results. Among 662 patients in 468 (70.7%) the extramural infections were observed, while in 194 (29.3%) - nosocomial infections. Mortality index in admitted to hospital patients have constituted 10.3% - for extramural infections and 14.4% - for nosocomial. Concurrent diseases and the severity indices were observed more frequently in nosocomial infections, than in extramural. The peritonitis type and localization were different in nosocomial and extramural infections. Distribution of microorganisms, depending on the infection origin (extramural and nosocomial) was different as well. In the patients, who suffered nosocomial infections, increase of the stationary aerobic bacteria was observed, including Enterococcus faecalis - 34.7% and Pseudomonas aeruginosa - 12.9% comparing with extramural infections - 21,6 and 5%, accordingly were observed. While in the patients, suffering nosocomial infections, the proportions of Escherichia coli - 52% and strains of streptococcus - 31%, was lower, than in the patients with extramural infections - 72 and 50%, accordingly. Among antibiotics tested, carbapenems (imipenem and ertapenem) and amicacin were mostly active against Enterobacteriaceae: both - in extramural and nosocomial infections. Against P. aeruginosa аmicacin, imipenem, ceftazidim have appeared mostly active in extramural infections, while imipenem, cefepim and amicacin - in nosocomial infections.

Vancomicin and teycoplanin were mostly active against gram-positive bacteria, both - towards nosocomial, as well as in nosocomial infections,  including strains of E. faecium. Against anaerobic bacteria the largest activity was revealed by imipenem and ertapenem, in extramural as well as nosocomial peritonitis.

Conclusion. The tactics for antibiotics application ought to be established in every surgical stationary, depending on local data for resistance towards them. Taking into account the constant changes and essential differences of the strains resistance, which are specific in different regions, it is necessary to conduct a constant monitoring in every surgical stationary, and, basing on the local data obtained, to elaborate the hospital formulary for antibiotics.

Author Biographies

A. G. Salmanov, Shupyk National Medical Academy of Postgraduate Education, Kyiv

Aidyn Salmanov,- MD. Professor,

Chair of the Department of Microbiology, Epidemiology and Infection Control

Shupyk National Medical Academy of postgraduate education.

E.mail: mozsago@gmail.com

+38 (066) 799 76 31, (063) 604 04 27

 http://orcid.org/0000-0002-4673-1154

A. Yu. Usenko, Shalimov National Institute of Surgery and Transplantology, Kyiv

Aleksandr Usenko - MD. Dr.Sc. Professor,

Director of the O.O. Shalimov National Institute of Surgery and Transplantology

Address: 30 Heroiv Sevastopolia Str., 03680, Kyiv, Ukraine,

 tel.: +38 (044)4971374

usenko1962@gmail.com

https://orcid.org/0000-0003-4957-4104

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Published
2018-09-30
How to Cite
Salmanov, A. G., & Usenko, A. Y. (2018). Intraabdominal infections and resistance of their causative agents towards antibiotics in surgical stationaries in the City of Kуiv. Klinicheskaia Khirurgiia, 85(9), 42-49. https://doi.org/10.26779/2522-1396.2018.09.42
Section
General Problems of Surgery