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[Etiologic features of nosocomial sinusitis]
A I Kryukov1,2, A V Gurov1,2, D S Cherkasov1,3
1Pirogov Russian National Research Medical University, Moscow, Russia.
Abstract:
The article presents a study of the qualitative and quantitative structure of etiologically significant microorganisms received from patients with nosocomial sinusitis from intensive care units of multiprofile and infectious diseases hospitals.
Objective:
To evaluate the qualitative and quantitative composition of the causative agents of nosocomial sinusitis and their sensitivity to antibacterial chemotherapy drugs in modern conditions.
Material And Methods:
During the period 2022-2023, we selected 45 patients from 6 ICU based on a multidisciplinary hospital and 11 patients from the ICU based on an infectious profile hospital, who were diagnosed with nosocomial sinusitis based on anamnesis, clinical picture, and computed tomography results. The qualitative and quantitative composition of microorganisms in the discharge obtained during therapeutic and diagnostic puncture of the maxillary sinuses in all patients was studied.
Results:
According to the results it was revealed that in the multidisciplinary hospital the following microorganisms were the most frequently detected in patients with nosocomial sinusitis: Klebsiella pneumoniae, Acinetobacter baumannii, Proteus mirabilis, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus haemolyticus, Enterococcus faecium, Enterococcus faecalis, Ochrobactrum anthropi. In patients with nosocomial sinusitis in the infectious diseases hospital the most frequently isolated were Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Proteus mirabilis. Fungal microorganisms were isolated much less frequently than bacterial microorganisms in both hospitals and were represented only by Candida albicans. In the multiprofile hospital the isolated strains of bacterial microorganisms were characterized by multidrug resistance in 89% of cases, and in the infectious diseases hospital - in 91% of cases.
Conclusion:
In the treatment of patients with nosocomial sinusitis, it is necessary to adjust empirical antibiotic therapy based on individual results of a bacteriological study. In case of ineffectiveness of antibacterial therapy, it is possible to use personalized biotherapy with virulent bacteriophage preparations in addition to prescribed antibacterial chemotherapy drugs, which makes it possible to enhance the antimicrobial effect of the therapy due to the additive action of drugs of two groups.
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