Staphylococcus bacteria are ubiquitous and often circulate in the biological systems of the hospital environment. Staphylococci have developed antibiotic resistance mechanisms resulting in a significant medical and economic burden to the healthcare system. The goal of our research was to conduct a comparative analysis of resistance to antibiotics in S. aureus and S. epidermidis isolates found in surgical hospitals in Kharkiv and Poltava regions. In 2013 through 2019, 151,015 and 98,754 tests were made by disc-diffusion method to identify the sensitivity in the S. aureus strains to antibiotics in Kharkiv and Poltava regions respectively. In 2013–2015, 15,589 tests were made in Kharkiv region to identify antibiotics sensitivity in S. epidermidis strains. Comparison of antibiotic resistance of the S. aureus strains in Kharkiv and Poltava regions was performed using the Pearson Chi-square test (χ2) and Fisher’s exact test. The proportion of S. aureus strains resistant to penicillins, cephalosporins, carbapenems, aminoglycosides, and macrolides was higher in Kharkiv region in terms of statistical validity than in Poltava region. Overall, the proportion of S. aureus strains resistant to lincozamids, tetracycline antibiotics, and fluoroquinolones in Poltava region was higher in terms of statistical validity than in Kharkiv region. An analysis of resistance of S. aureus strains to linezolid demonstrated that in Poltava region the proportion of resistant microorganisms was higher in terms of statistical validity in 2013–2014 and in 2016–2018. In Kharkiv region, in 2013 and in 2014, 96.3% and 89.1% of isolated strains of S. aureus respectively, were resistant to vancomycin. In 2019, more than a quarter of the located isolates (26.6%) in Poltava region were resistant to this antibiotic. The analysis of the dynamic of resistance in S. epidermidis isolates demonstrated that in 2015 nearly half of the isolates located in Kharkiv region were insensitive to penicillin antibiotics. Between 2013 and 2015, the spread of resistance to cephalosporins, aminoglycosides, macrolides, and fluoroquinolones among the S. epidermidis isolates noticeably increased. When S. epidermidis resistance to vancomycin was analyzed, a decrease in the proportion of resistant strains from 88.0% in 2013 to 8.7% in 2015 was noted. A promising direction for further research is the creation of passports of microorganism resistance in the regions and various health-care settings, as well as the creation of a unified national database network on microorganism resistance using modern methodologies for determining the phenotypes and genotypes of microorganisms.
Introduction. The outcomes of potential complications of surgical interventions in neurosurgical patients can cause a death. Efficient antibiotic prophylaxis decreases the risks of infection and improves the quality of health care. Purpose. To estimate the appropriateness of prescribing antibiotics in a neurosurgical ward from the perspective of evidence-based medicine. Material and method. A retrospective cohort study has been carried out in a neurosurgical ward of multidisciplinary healthcare setting of Ukraine. Data from 131 in-patient medical cards (MC) of neurosurgical patients has been analyzed. Descriptive statistics methods have been used for data analysis. The relative risk (RR) with the 95% confidence interval (95% CI) has been calculated. Results. We found that among the patients, females prevailed (n = 81 / 61.8%). The patients’ mean age was 49.83 ± 13.90 years. The frequency of antibiotics prescriptions was higher significant in patients, who received surgical procedures in comparison with patients, who did not receive surgical procedures (RR = 1.827; 95% CI: 1,137 – 2.935). Antibiotics were prescribed mostly during the postoperative period. The use of interchangeable antibiotics of the same group has been occurred. The use of antibiotics for prevention in the most cases was of unreasonably long duration. Conclusion. The practice of the use of antibiotics in neurosurgical ward does not correspond to scientifically founded recommendations. It is needed to clearly define the indications for prescribing antibiotics. Duration of antibiotic use should depend on specialization of wards in multidisciplinary healthcare setting. It is expedient to conduct an audit on the use of antibiotics at healthcare settings on a regular basis with involving a specialist in infection control, a clinical pharmacist, and a clinical microbiologist.
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