The purpose of the study – determination of antibiotic sensitivity in pathogens of healthcare-associated infections isolated in Ukraine in 2023.
Research materials and methods: The studied strains of microorganisms were received by the Reference Laboratory for the diagnosis of tuberculosis, bacterial, parasitic and especially dangerous pathogens of the State Institution "Center for Public Health of the Ministry of Health of Ukraine" from regional centers for disease control and prevention and health care institutions of Ukraine. Identification of microorganisms and determination of resistance were carried out using the VITEK 2 microbiological analyzer, MICTests trips and the WHONET computer program.
Research results. In 2023, 1471 cultures of microorganisms were isolated and identified from wounds, blood, cerebrospinal fluid (CSF), urine and the external environment. The bacteria belonged to 9 species, namely: K.pneumoniae, E.coli, E.cloacae, P.aeruginosa, A.baumannii, S.aureus, S.epidermidis, E.faecium, S.haemolyticus.
The largest number of bacterial strains, isolated from various biological materialis, were represented by K.pneumoniae, A.baumannii and P.aeruginosa. The pathogens S.aureus, S.epidermidis, E.faecium, S.haemolyticus were detected only in wounds and blood samples.
Analysis of the results of determining the sensitivity of the isolated strains to antimicrobial drugs showed their high variability in the range from 100% to 27% and the need to determine the antibiogram for each isolate.
Conclusions.
1. According to the results of the microbiological analysis, the sensitivity to antibiotics of pathogens of infections associated with the provision of medical care, which were isolated in Ukrainein 2023, was determined.
Based on the results of the microbiological analysis, the sensitivity to antibiotics of pathogens of infections associated with the provision of medical care, which were isolated in Ukraine in 2023, was determined.
2. The largest number of strains of bacteria K.pneumoniae and A.baumannii and P.aeruginosa were isolated from all types of biological material. The pathogens S.aureus, S.epidermidis, E.faecium, S.haemolyticus were detected only in wounds and blood samples.
3. Analysis of the results of determining the sensitivity of the isolated strains to antimicrobial drugs showed their variability and the need to determine the antibiogram for each isolate.
4. A high level of resistance (90-100%) to penicillin, cephalosporin and aminoglycoside drugs was shown in the isolated strains of K. pneumoniae, E. coli, S.aureus, S.epidermidis, E.faecium, S.haemolyticus, P.aeruginosa.
5. A.baumannii strains were found to be insensitive to most of the tested antimicrobial drugs (88.9-100%).
6. Detection of S.aureus, A.baumannii, P.aeruginosa in the external environment may indicate the circulation of these resistant strains in health care facilities

healthcare-associated infections, antibiotics, sensitivity, resistance

1. Holmes AH, Moore LS, Sundsfjord A, Steinbakk M, Regmi S, Karkey A, Guerin PJ, Piddock LJ. Understanding the mechanisms and drivers of antimicrobial resistance. The Lancet. 2016 Jan ;387(10014):176-87. https://doi.org/10.1016/s0140-6736(15)00473-0

2. MacLean RC, San Millan A. The evolution of antibiotic resistance. Science. 2019 Sep 12 ;365(6458):1082-3. https://doi.org/10.1126/science.aax3879

3. Mudenda S, Mufwambi W, Mohamed S. The burden of antimicrobial resistance in Zambia, a sub-Saharan African country: a one health review of the current situation, risk factors, and solutions. Pharmacology & Pharmacy. 2024 ;15(12):403-65. https://doi.org/10.4236/pp.2024.1512024

4. Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Robles Aguilar G, Gray A et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022 Feb ;399(10325):629-55. https://doi.org/10.1016/s0140-6736(21)02724-0

5. World Health Organization (WHO). Antimicrobial resistance; Key facts. 23 Nov 2023. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance

6. Kondratiuk V, Jones BT, Kovalchuk V, Kovalenko I, Ganiuk V, Kondratiuk O. et al. Phenotypic and genotypic characterization of antibiotic resistance in military hospital-associated bacteria from war injuries in the Eastern Ukraine conflict between 2014 and 2020. Journal of Hospital Infection. 2021 Jun; 112:69-76. https://doi.org/10.1016/j.jhin.2021.03.020

7. Latina NO, Surmasheva OV. Etiolohiia hniino-zapalnykh infektsii u postrazhdalykh vid viiny ta chutlyvist zbudnykiv do antymikrobnykh preparativ [Etiology of purulent-inflammatory infections in injuries caused by combat operations and sensitivity of pathogens to antimicrobial preparations]. Dovkillia ta zdorovia [Environment & Health]. 2024 Mar; (1 (110)):50-6. https://doi.org/10.32402/dovkil2024.01.050. Ukrainian

8. Pro zatverdzhennia Poriadku provedennia posylenoho epidemiolohichnoho nahliadu za protymikrobnoiu rezystentnstiieiu mikroorhanizmiv, shcho sprychyniaiut hniino-zapalni infektsii ran u poranenykh vnaslidok boiovykh dii [On approval of the Procedure for carrying out enhanced epidemiological surveillance for antimicrobial resistance of microorganisms that cause purulent-inflammatory infections of wounds in wounded as a result of combat operations : Order of the Ministry of Health of Ukraine № 403, 2023 Feb 27]. Ukrainian https://zakon.rada.gov.ua/laws/show/z0489-23#Text

9. Pro zatverdzhennia Poriadku zdiisnennia dozornoho epidemiolohichnoho nahliadu za protymikrobnoiu rezystentsiieiu [On approval of the Procedure for carrying out enhanced epidemiological surveillance for antimicrobial resistance : Order of the Ministry of Health of Ukraine № 1766, 2021 Aug 19]. Ukrainian https://zakon.rada.gov.ua/laws/show/z1316-21#Text

10. Rosada MO, Hlushkevych TG, Sboieva AM, Surmasheva OV, Molchanets OV. Mikrobiolohichnyi spektr zbudnykiv infektsii, poviazanykh z nadanniam medychnoi dopomohy, vydilenykh v Ukraini u 2022-2023 rokakh [Microbiological spectrum of pathogens of infections associated with the provision of medical care, isolated in Ukraine in 2022-2023]. Dovkillia ta zdorovia [Environment & Health]. 2024 Dec ; (4 (113)):60-4. Ukrainian https://doi.org/10.32402/dovkil2024.04.060.