Problems of antibacterial therapy of hospital infections in the post-pandemic period of COVID-19 and ways to solve them

Abstract

Due to the coronavirus pandemic in Russia, a significant increase in the emergence of strains of microorganisms with multiple drug resistance was noted.Objective: improvement of the effectiveness of prophylactic and therapeutic measures aimed at prevention of hospital pathogens circulation in the intensive care unit by using bacteriophages active against multidrug-resistant strains of Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii.Materials and methods. The study was conducted on the basis of the Intensive Care Unit No. 2 of L.A. Vorohobov City Clinical Hospital No. 67 of Moscow Healthcare Department. Personalized selection of bacteriophages was carried out on the basis of G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology. The study included two groups of patients, a total of 20 people, who were on prolonged mechanical ventilation in the intensive care unit.Results. No toxic and allergic reactions were detected from the patients in all cases of bacteriophages application. Pathological changes of blood biochemical parameters were not observed in connection with the use of bacteriophages. Complete eradication of pathogens occurred in 60 % of cases.Conclusion. The effectiveness of treatment of various nosological forms of HAIs caused by MDR strains of hospital pathogens increased by 30%, and the effectiveness of the starting antibiotic therapy regimen was 70% and more as a result of the use of personalized phage therapy.