Prevention of Antibiotic Resistance Micro Flora Spreading by Analysing Surgical Infections' Microbiological Profile

摘要

Background: Antibiotic resistance can be found among the top five most problematic issues that the international medical community pays a special attention to. The strategy of combating antibiotic resistance includes the rationalization of the antibiotic therapy, based on the regional specificity of the microbiological spectrum of diseases. Objective: To investigate the microbiological profile of main groups of soft tissue surgical infections and acute surgical abdominal diseases in the Department of Surgery and develop further regional recommendations for the antimicrobial therapy. Method: Retrospective analysis (2012-2013 years) of operated patients' bacteriological cultures in the Surgical Department of Lviv Communal City Clinical Emergency Hospital (Ukraine). The microflora of 646 samples (primary and secondary) was analyzed. 416 primary samples (2015 year) were studied separately to identify the resistance of the main pathogens. The analysis was carried out with the usage of the WHONET 5 database (standardized microbiological laboratory software). Result: In total, 12 microorganisms were detected: Gram-negative (58,3%) and Gram-positive (41,7%) bacteria. All results were sorted into the main surgical nosological groups: superficial infections of the skin and subcutaneous tissue (66%), necrotic infections of soft tissues and deep phlegmons (8,5%), acute surgical abdominal diseases (25,5%). S.aureus was the dominant pathogen in superficial infections of the skin and subcutaneous tissue (243 samples; 63,9%) and in necrotic infections and deep phlegmons (26 samples; 53,1%), and E.coli was in acute surgical abdominal diseases (49 samples; 33,3%). Particular attention was paid to antibiotic resistance of the clinical isolates of the dominant pathogen: generally, 37.3% strains of S.aureus were methicillin-resistant (MRSA), including multidrug-resistant strains. Conclusion: The data of the microbiological profile is the objective basis for the regional clinical antibiotic therapy recommendations in the Department of Surgery. Antimicrobial resistance research and surveillance may be effective to prevent the spread of antibiotic resistance microflora.