CUMULATIVE ANTIBIOGRAM IN THE SELECTION OF EMPIRIC ANTIBIOTIC THERAPY

Local microbiological monitoring was carried out based on the results of bacteriological studies of clinical samples from 892 patients in the departments of anesthesiology, intensive care and surgical departments in a multidisciplinary hospital. 1086 microorganisms were isolated, of which 837 isolates of bacterial pathogens (77.07 %) and 249 isolates of Candida fungi were isolated. Among the detected bacterial pathogens, gram -negative bacteria probably prevailed (p<0.001) over gram -positive ones (568 (67.86 %) and 269 (32.14 %), respectively). Among gram -negative bacteria, Escherichia coli (46.83 %) (p<0.001) was isolated more often, Pseudomonas aeruginosa (20.77 %) (p<0.05) and Klebsiella pneumoniae (15.67 %) were less frequently detected. Probably (p<0.001) more often (in 258 out of 568 cases) the indicated pathogens were detected in clinical samples of washings from the skin area around the installed peripheral vascular catheter: E. coli (44.57 %), Ps. aeruginosa (21.71 %), Kl. pneumoniae (16.28 %) and other gram -negative bacteria (17.44 %). The results of the cumulative antibiogram indicate the low sensitivity of E. coli to most antimicrobial drugs, which is a very threatening situation, taking into account the fact that as empirical antibiotic therapy, a drug with a sensitivity of at least 80.0 % can be used according to the results of local microbiological monitoring according to previous year The actual results of the study indicate the need to implement a cumulative antibiogram in the work of medical institutions that provide round-the-clock inpatient care. The need for dynamic assessment of the susceptibility of pathogens causing healthcare -associated infections to antibacterial drugs is vital, especially for the sick departments of anesthesiology and intensive care and the surgical profile. The introduction of the results of the cumulative antibiogram into the standard operating procedures is a primary task in the administration of the use of antibacterial and antifungal drugs.