Microbiological monitoring in a urological hospital as a method for control of antibiotic resistance of uropathogens

Abstract

BACKGROUND: A rational choice of antibacterial therapy for hospital infections is a condition for successful treatment of patients. AIM: The aim of this study is a comparative assessment of the species composition of pathogens and the level of their resistance to antibacterial drugs in patients with complicated urinary tract infections in a urological hospital. MATERIALS AND METHODS: An analysis of the results of microbiological examination of urine samples from 1317 patients (795 men and 522 women) with complicated urinary tract infection who were hospitalized in a urology clinic during the period 2020–2021 was carried out. RESULTS: Gram-negative microflora was detected in 703 (53.4%) patients, gram-positive microflora in 531 (40.3%) patients and mixed microflora in 83 (6.3%) patients. Among gram-negative bacteria Escherichia coli (23.1%) and Klebsiella pneumoniae (16.1%) were predominate, Pseudomonas aeruginosa (4.9%) and Proteus mirabilis (2.8%) were less frequently detected. A high frequency of detection of gram-positive microflora of the genera Enterococcus (21.4%) and Staphylococcus (12.7%) was noted. When compared with the results of a similar study from 2018 to 2020 there is a decrease in the detection rate of E. coli from 28.2% to 23.1%. Antibiotic resistance of hospital strains of uropathogens varies significantly for different antimicrobial drugs. Most often resistance to representatives of three or more groups of antibiotics was observed in K. pneumoniae (46.6%), less commonly in E. coli (19.5%) and rarely in Enterococcus spp. (5.9%). CONCLUSIONS: Microbiological monitoring allows us to assess the etiological structure and level of antibiotic resistance of nosocomial urinary tract infections. Local data on the sensitivity of microorganisms to antibacterial drugs make it possible to rationally carry out perioperative antibiotic prophylaxis and prescribe empirical therapy for urinary tract infections before obtaining the results of a microbiological study.