Features of Etiological Structure of Agents of Healthcare-Associated Infections in Conditions in a Multidisciplinary Hospital of Tomsk City

INTRODUCTION: Healthcare-associated infections (HAIs) currently present one of the important problems of practical healthcare. For effective planning of organizational and anti-epidemic measures, of prior importance is a continuous study of etiological agents of HAIs in the conditions of a particular medical organization. AIM: To study the etiological structure of agents of healthcare-associated infections and determine resistance of strains to anti-microbial agents (AMAs) in a multidisciplinary hospital in Tomsk. MATERIALS AND METHODS: A retrospective analysis of 286 medical records of inpatients with an established diagnosis of HAI was carried out in the period from 2019 to 2022. The results of bacteriological examination of biological material from patients were analyzed, and sensitivity to AMAs was studied. RESULTS: In 38% of cases, patients had lower respiratory tract infection (LRTI), and in 16% — urinary tract infection (UTI). Surgical site infections (SSIs) in the overall structure of HAIs amounted to 34%, post-injection infections — 7% and bloodstream infections — 5%, respectively. In the etiological structure of HAIs, the key etiological role belonged to three main groups of microorganisms — representatives of the Enterobacterales, Staphylococcaceae and Pseudomonadaceae families. The study revealed resistance of Enterobacterales mainly to cefotaxime — 88%, ceftazidime — 82%, cefepime — 63%, ciprofloxacin — 75%, imipenem — 42%, meropenem — 64%, ertapenem — 46%. The leading etiological agent among the Staphylococcaceae family was Staphylococcus aureus. The proportion of methicillin-resistant strains (MRSA) was 22%. The Pseudomonadaceae family was represented by Pseudomonas aeruginosa in the etiology of HAI. The frequency of resistance of Pseudomonas aeruginosa to antibiotics was: to amikacin — 20%, cefepime — 38%, ceftazidime — 54%, ciprofloxacin — 27%, imipenem — 40%, meropenem — 33%, levofloxacin — 57%. CONCLUSION: The main etiological agents of HAIs are members of the Enterobacterales, Staphylococcaceae and Pseudomonadaceae families. Enterobacterales and Pseudomonas aeruginosa strains were highly resistant to third and fourth generation cephalosporins, as well as to carbapenems. A relatively low level of resistance of Pseudomonas aeruginosa to ciprofloxacin was noted.