TRENDS IN INVASIVE BACTERIAL DISEASES PATHOGENS RESISTANCE TO ANTIBIOTICS: MICROBIOLOGIC MONITORING, 2012-2017
Objective. To collect and analyze data on resistance to the main classes of antibiotics of 1,700 isolates of 8 types of invasive bacterial infections pathogens (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis, Enterococcus faecium) isolated from patients and identify the main trends of resistance variability for 2012-2017. Materials and methods. The Republican Reference Center for Monitoring Antimicrobial Resistance (AMR) of Bacteria has introduced the WHO-NET program for collection and analysis of information on resistance of 1700 isolates of clinically significant bacteria in the country, the methodological basis for the AMR surveillance. A network of bacteriological laboratories including 114 laboratories have been established. In their activities, the laboratories are guided by the normative documents on bacteriological diagnosis, isolation, identification of bacteria, methods for determining their sensitivity and interpretation of the results. Results. While testing the AMR of invasive bacteria populations, the following patterns were separated: 1) a significant decrease in the proportion of resistant forms of 8 species of bacteria to the main classes of antibiotics during the 4-year observation probably indicating at decreasing the number of prescriptions of antibiotics of these classes as less effective: 2) a simultaneous decrease of the share of resistant and multiply resistant forms of bacteria also reflecting positive changes in the tactics of rational prescription of antimicrobial drugs by clinicians: 3) presence of a strong trend of a rapid increase of the proportion of the bacteria isolates resistant to new drugs, namely to the 3rd generation cephalosporins and carbapenems that may be caused by their unnecessarily frequent and widespread administration. Conclusion. The results presented in the article testify that monitoring for the clinical significant bacteria resistance to antibiotics in medical institutions in the country has revealed important trends in the population variability of resistance to antibiotics and can be a kind of tool for assessing and regulating the rational use of antibacterial agents as well as for optimizing bacteriological researches.