Local microbiological monitoring as a basis for rational procurement and consumption of antibacterial preparations in surgery

Ruina O. V., Konishkina T. M., Borisov V. I., Hazov M. V., Gladkova O. N., Stroganov A. B., Zhukova O. V.

The study was conducted to optimize the procurement and consumption of antibacterial drugs in the surgical departments of a multidisciplinary hospital. 165 strains derived from biosubstrates of patients in surgical departments were analyzed. It is revealed that the spectrum of microbes and the level of resistance differ significantly depending on the department. In general, the Gram-negative flora prevails in the surgical clinic. The proportion of microorganisms with a high level of resistance prevails in the organ transplantation department. The level of extended-spectrum beta-lactamase producers by microorganisms of the Enterobacteriaceae family in the organ transplantation department averaged 60%, in the oncology department - 30%, in the surgical department - 10%. Thus, in the department of organ transplantation, starting empirical antibiotic therapy with reserve drugs (carbapenens, vancomycin, tigecycline) is justified, and cephalosporins therapy is not justified. In the general surgery department, in the treatment of infections, starting therapy is optimal with cephalosporins protected by penicillins, fluoroquinolones. In the oncology department, the choice of antibiotic should be approached differentially. The resulting patterns should be used for procurement planning in the hospital.

Keywords:microbiological monitoring, antibiotic resistance, surgical departments.