Dynamics of changes in resistance of escape-group pathogens in intensive care unit conditions during the period of coronavirus pandemic
Abstract. Due to a number of objective factors intensive care units (ICU) epidemiologically are the most vulnerable hospital structures for the spread of drug-resistant microflora.Tkhakokhova G.M., Rodionov E.P., Akimkin V.G., Ploskireva A.A.
The aim: to assess the dynamics of detection of pan-resistant microflora from the group of ESCAPE-pathogens in patients admitted to ICU for extrapulmonary indications during COVID-19 pandemic, as well as to identify potential markers indicating the presence of risk factors for infecting by drug-resistant microorganisms.
Material and methods. A retrospective analysis of 1,123 patient records was performed in the anesthesiology and intensive care unit from 2019 to 2023. Data from 220 patients during this period were included in the study.
Results. From 2019 to 2023 nearly three-fold increase in the incidence of ventilator-associated pneumonia and detection of pan-resistant flora was observed in the studied patients. Absolute lymphopenia, detected in the initial clinical blood test, allows for a high probability of suspecting the presence of pan-resistant microflora from ESCAPE-pathogens group even before microbiological test results are available and is considered to be the basis for prescribing de-escalation antibiotic therapy.
Conclusion. Use of a marker for the detection of resistant flora, accessible to all hospitals, along with a thorough collection of epidemiological anamnesis, lets to make the selection of the most effective empirical antibiotic regimens for ICU patients, which in turn may help reduce the need for mechanical pulmonary ventilation.
Keywords
intensive care unit
pan-resistant ESCAPE microbial strains
absolute lymphopenia
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About the Authors
Galina M. Tkhakokhova, MD, head of the Department of anesthesiology and reanimation No. 30, S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center of the Department of Healthcare of Moscow. Address: 125284, Moscow, 5 2nd Botkinsky Lane.E-mail: thagal09@gmail.com
ORCID: https://orcid.org/0009-0005-3791-4310
Evgeny P. Rodionov, MD, PhD (Medicine), associate professor of the Department of anesthesiology, reanimation, and emergency medicine, Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia, deputy chief physician for anesthesiology and reanimation of S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center of the Department of Healthcare of Moscow. Address: 125284, Moscow, 5 2nd Botkinsky Lane.
ORCID: https://orcid.org/0000-0002-3852-8877
Vasily G. Akimkin, MD, Dr. Sci. (Medicine), professor, academician of RAS, director of Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3a Novogireevskaya St.
Email: vgakimkin@yandex.ru
ORCID: http://orcid.org/0000-0001-8139-0247
Antonina A. Ploskireva, MD, Dr. Sci. (Medicine), professor, professor of RAS, deputy director for clinical work, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3a Novogireevskaya St.
Email: antoninna@mail.ru
ORCID: https://orcid.org/0000-0002-3612-1889
