Features of the Etiological Structure of Purulent and Septic Complications in Patients of Different Specialty Surgical Hospitals

Introduction: Prevention of healthcare-associated infections (HAI) is a current global challenge. Their relevance is determined by high prevalence and adverse consequences for national economies, life and health of patients and medical personnel.

Objective: To study the etiological structure of postoperative wound infections in patients of different specialty surgical departments of hospitals in the Lipetsk Region.

 Materials and methods: In 2007–2024, 10,408 strains of microorganisms isolated from clinical specimens of patients with various types of surgical site infections were tested. The range of aerobic and facultative anaerobic organisms was identified using standard bacteriological methods. Resistance to antibiotics was determined in accordance with the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Collected data were analyzed using Microsoft Excel and the “Automated Workplace of a Bacteriologist” software developed with the participation of bacteriology laboratory specialists for microbiological monitoring.

 Results: The analysis of laboratory test results revealed distinct differences in the microbiota species composition between different specialty hospitals. Gram-positive bacteria prevailed in surgical departments of multidisciplinary hospitals while gram-negative bacteria were more frequently found in cancer centers. Mixed infections were established in 60.9 % of cases. We noted an increase in the proportion of Candida spp. in the etiological structure of the microbiota of patients. Gram-negative bacteria were resistant to carbapenems (meropenem) (96.9 %), amikacin (94.6 %), ciprofloxacin (90.4 %), and cefuroxime (90.1 %). The proportions of staphylococci sensitive to amikacin, gentamicin, and vancomycin were 99.7 %, 98.0 %, and 96.2 %, respectively.

1. Akimkin VG, Tutel’yan AV. Current directions of scientific researches in the field of infections, associated with the medical care, at the present stage. Zdorov’e Naseleniya i Sreda Obitaniya. 2018;(4(301)):46-50. (In Russ.) doi: 10.35627/2219-5238/2018-301-4-46-50

2. Abramov IuE, Timurzieva AB, Orlova OA, Akimkin VG. Improving the system of preventing healthcare-associated infections and combating antibiotic resistance by optimizing participant interaction in the diagnostic and treatment process. Zdorov’e Naseleniya i Sreda Obitaniya. 2023;31(8):88-97. (In Russ.) doi: 10.35627/2219-5238/2023-31-8-88-97

3. Andryukov BG, Somova LM, Matosova EV, Lyapun IN. Phenotypic plasticity as a strategy of bacterial resistance and an object of advanced antimicrobial technologies (review). Sovremennye Tekhnologii v Medicine. 2019;11(2):164-182. doi: 10.17691/stm2019.11.2.22

4. Barantsevich NE, Barantsevich EP. Species diversity and methicillin resistance in Staphylococcus spp. in nosocomial infections. Klinicheskaya Mikrobiologiya i Antimikrobnaya Khimioterapiya. 2019;21(3):207-211. (In Russ.) doi: 10.36488/cmac.2019.3.207-211

5. Brusina EB, Zuyeva LP, Kovalishena OV, Stasenko VL, Feldblium IV, Briko EI. Healthcare-associated infections: Modern doctrine of prophylaxis. Part I. Historical background. Epidemiologiya i Vaktsinoprofilaktika. 2018;17(5):17-24. (In Russ.) doi: 10.31631/2073-3046-2018-17-5-17-24

6. Brusina EB, Zuyeva LP, Kovalishena OV, et al. Healthcare-associated infections: Modern doctrine of prophylaxis. Part II. Basic concept. Epidemiologiya i Vaktsinoprofilaktika. 2018;17(6):4-10. (In Russ.) doi: 10.31631/2073-3046-2018-17-4-10

7. Dyatlov IA. [On the protective mechanism of a bacterial cell, which can be used to combat antibiotic resistance: Editorial]. Bakteriologiya. 2021;6(1):5-7. (In Russ.)

8. Gelnina TP, Brusina EB. Efficiency of epidemiological monitoring in prevention of helhcare-associated infections. Epidemiologiya i Vaktsinoprofilaktika. 2019;18(3):84-88. (In Russ.) doi: 10.31631/2073-3046-2019-18-3-84-88

9. Zakhvatova AS, Daryina MG, Svetlichnaya YS, Zueva LP, Aslanov BI, Chervyakova MA. Antimicrobial resistance monitoring of potential pathogens causing bloodstream infections. Infektsiya i Immunitet. 2022;12(1):185-192. (In Russ.) doi: 10.15789/2220-7619-ARM-1552

10. Ivanov FV, Gumilevskii BY. Microbiological monitoring of healthcare-associated infections. Mezhdunarodnyy Nauchno-Issledovatel’skiy Zhurnal. 2023;(12(138)). (In Russ.) doi: 10.23670/IRJ.2023.138.210

11. Kudlay DA, Bakirov BA, Iksanova GR, Allayarov ND. Assessment of microbiological environment and the level of antibiotic resistance in a multidisciplinary hospital. Tuberkulez i Bolezni Legkikh. 2022;100(8):43-53. (In Russ.) doi: 10.21292/2075-1230-2022-100-8-43-53

12. Kutsevalova OYu, Rozenko DA, Kozel YuYu, et al. Etiological characteristics in causative agents of infectious complications in cancer patients. Antibiotiki i Khimioterapiya. 2022;67(5-6):30-38. (In Russ.) doi: 10.37489/0235-2990-2022-67-5-6-30-38

13. Naygovzina NB, Popova AYu, Biryukova EE, et al. Optimization of the system of measures for control and prevention of healthcare-associated infections, in the Russian Federation. Epidemiologiya i Infektsionnye Bolezni. Aktual’nye Voprosy. 2018;(1):6-14. (In Russ.)

14. Perfil’yeva DYu, Miroshnichenko AG, Perfil’yev VYu, et al. Features of etiological structure of agents of healthcare-associated infections in conditions in a multidisciplinary hospital of Tomsk city. Nauka Molodykh (Eruditio Juvenium). 2024;12(3):377-385. (In Russ.) doi: 10.23888/HMJ2024123377-385

15. Sergevnin VI, Kudryavtseva LG, Pegyshina OG. Rate of detection and antibiotic resistance pathogens of purulent-septic infections in cardiac surgery patients. Epidemiologiya i Vaktsinoprofilaktika. 2022;21(1):74-80. (In Russ.) doi: 10.31631/2073-3046-2022-21-1-74-80

16. Sergevnin VI, Kudryavtseva LG, Pegyshina OG, Volkova EO, Reshetnikova NI. Group incidence by purulent-septic infections of clebsiellous etiology in cardiosurgical patients. Epidemiologiya i Vaktsinoprofilaktika. 2020;19(1):90-98. (In Russ.) doi: 10.31631/2073-3046-2020-19-1-90-98

17. Skachkova TS, Zamyatin MN, Orlova OA, et al. Monitoring methicillin-resistant staphylococcus strains in the Moscow medical and surgical center using molecular-biological methods. Epidemiologiya i Vaktsinoprofilaktika. 2021;20(1):44-50. (In Russ.) doi: 10.31631/2073-3046-2021-20-1-44-50

18. Suborova TN, Svistunov SA, Kuzin AA, Zharkov DA. Exercise of dynamics of the selection of gram-negative bacteria in patients with a multidisciplinary stationary. Vestnik Rossiyskoy Voenno-Meditsinskoy Akademii. 2018;(S1):195-196. (In Russ.)

19. Ulyanov EV, Vlasova AYu, Melnikov VL, Mitrofanova NN. [Analysis of ecological and epidemiological features of purulent-septic infections in surgical departments of multidisciplinary hospitals in the Russian Federation.] Vestnik Penzenskogo Gosudarstvennogo Universiteta. 2021;(3(35)):37-42. (In Russ.)

20. Stavchikov EL, Fedzianin SD, Zinovkin IV, Marochkov AV, Stavchikova MA. Etiology and antibiotic resistance of microflora in patients with purulent wounds. Zhurnal Grodnenskogo Gosudarstvennogo Meditsinskogo Universiteta. 2025;23(3):254-260. (In Russ.) doi: 10.25298/2221-8785-2025-23-3-254-260

21. Yarovoy SK, Voskanian ShL, Tutelyan AV, Gladkova LS. Antibacterial prophylaxis of surgical site infections: An epidemiologist’s view. Epidemiologiya i Infektsionnye Bolezni. Aktual’nye Voprosy. 2020;10(1):21-29. (In Russ.) doi: 10.18565/epidem.2020.10.1.21-9

22. Brouqui P, Boudjema S, Soto Aladro A, et al. New approaches to prevent healthcare-associated infection. Clin Infect Dis. 2017;65(suppl_1):S50-S54. doi: 10.1093/cid/cix433

23. Nabhan AF, Allam NE, Hamed Abdel-Aziz Salama M. Routes of administration of antibiotic prophylaxis for preventing infection after caesarean section. Cochrane Database Syst Rev. 2016;2016(6):CD011876. doi: 10.1002/14651858.CD011876.pub2

24. Theuretzbacher U, Gottwalt S, Beyer P, et al. Analysis of the clinical antibacterial and antituberculosis pipeline. Lancet Infect Dis. 2019;19(2):e40-e50. doi: 10.1016/S1473-3099(18)30513-9