Analysis of the Structure and Antibiotic Resistance of the Microflora in the Anesthesiology and Intensive Care Unit of a Multidisciplinary Hospital

Introduction. Healthcare-associated infections (HAIs) are one of the global challenges in modern medicine. Anesthesia and intensive care units pose the highest risk of patient infection due to the high number of invasive procedures, their prolonged duration, and the irrational use of antibiotics. Aim of the Study. To analyze the prevalence, etiological structure, and antibiotic resistance of HAI pathogens in the intensive care unit of the Belgorod Regional Clinical Hospital for the period 2022-2023. Materials and Methods. Active surveillance methods were used for an objective assessment of the epidemiological situation. Microorganisms were isolated from diagnostic samples using standard microbiological techniques. The results of microbiological studies were analyzed using the qLIS laboratory information system and the WEB-hospital electronic medical record system. Results. Eighty-seven HAI cases were registered in the intensive care unit during the study period. The dominant pathogens were Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus aureus. Most Klebsiella pneumonia strains were producers of extended-spectrum beta-lactamases (ESBLs) and carbapenemases. Acinetobacter baumannii and Pseudomonas aeruginosa strains were resistant to cephalosporins, carbapenems, fluoroquinolones, and aminoglycosides. Conclusions. During 2022-2023, the leading etiological agents of HAIs in the intensive care unit were Gram-negative bacteria (Klebsiella, Acinetobacter, Pseudomonas) and Gram-positive bacteria (Staphylococcus). The isolated microbial strains exhibited antibiotic resistance to most antimicrobial drugs used in the hospital. Therefore, one of the key factors for HAI control should be the continuous monitoring of the species composition and resistance patterns of dominant pathogens. This allows for the timely adjustment of antimicrobial therapy and anti-epidemic measures, thereby minimizing HAI cases.