A clinical pharmacologist's view on the local microbiological profile and antibiotic resistance in a multidisciplinary emergency medical ward

Prostakishina Yu.M., Karyagina M.S., Smakotina S.A.

Kuzbass Clinical Hospital of Emergency Medical Care named after M.A. Podgorbunsky, Kemerovo, Russia
Kemerovo State Medical University, Kemerovo, Russia

Aim. To evaluate the microbiological profile and the level of antibiotic resistance of clinically significant microorganisms in hospitalized patients in a multidisciplinary emergency hospital.
Materials and methods. A retrospective analysis of 107 clinical isolates isolated from January to August 2025 was carried out. The analysis was performed according data from bacteriological studies conducted in accordance with generally accepted standards, the determination of the sensitivity of microorganisms to antibiotics was carried out according to clinical guidelines. Data on the species of microorganism, localization of infection, separation and sensitivity to antimicrobial drugs were analyzed. Resistance markers (ESBL, CRP, MRSA, AmpRE) were separately analyzed. Statistical processing was carried out using the AMRcloud platform and included the calculation of absolute and relative frequencies (percentages).
Results. The predominant sources of excretion were sputum (48.6%) and urine (21.5%). The most frequently isolated were Klebsiella pneumoniae (31.8%), Pseudomonas aeruginosa (15.0%), Enterobacter agglomerans (9.3%), Staphylococcus aureus (9.3%) and Acinetobacter baumannii (7.5%). A high incidence of resistance to cephalosporins of the III-IV generation (up to 62.8%), fluoroquinolones (up to 72.4%) and piperacillin/tazobactam (52.4%) was noted. ESBL production was detected in 33 of 34 K. pneumoniae isolates (97.1%), carbapenem resistance in 22 of 107 isolates (20.6%), including K. pneumoniae, A. baumannii and P. aeruginosa. MRSA was not detected among S. aureus; all strains were sensitive to vancomycin and linezolid. Resistance to fluconazole was detected in 66.7% of Candida isolates.
Conclusion. There is a high load of polyresistant gram-negative pathogens in the hospital, especially in intensive care, anesthesiology and pulmonology departments. The absence of MRSA is a favorable epidemiological indicator. The data obtained indicates the need to strengthen antiepidemic control and implement local protocols of empirical antibiotic therapy based on the current antibiotic resistance profile. To slow the spread of resistance, it is recommended to limit irrational use of third-generation cephalosporins, carbapenems and fluoroquinolones in clinical practice.