Etiological and epidemiological aspects of nosocomial bacterial infections during the COVID-19 pandemic
Authors:   The National Research Center for Epidemiology and Microbiology named after Honorary Academician N. F. Gamaleya of the Ministry of Health of the Russian Federation, Moscow, Russia, I.V. Davydovsky City Clinical Hospital, Moscow Healthcare Department, Moscow, Russia, Zhukova E. V. , Mirskaya M. A. ,   I.V. Davydovsky City Clinical Hospital, Moscow Healthcare Department, Moscow, Russia, Gotvyanskaya T. P. ,   The National Research Center for Epidemiology and Microbiology named after Honorary Academi - cian N. F. Gamaleya of the Ministry of Health of the Russian Federation, Moscow, Russia, Nozdracheva A. V. ,   The National Research Center for Epidemiology and Microbiology named after Honorary Academi - cian N. F. Gamaleya of the Ministry of Health of the Russian Federation, Moscow, Russia, Semenenko A. V. ,   The National Research Center for Epidemiology and Microbiology named after Honorary Academi - cian N. F. Gamaleya of the Ministry of Health of the Russian Federation, Moscow, Russia, Afonin S. A. ,   The National Research Center for Epidemiology and Microbiology named after Honorary Academi - cian N. F. Gamaleya of the Ministry of Health of the Russian Federation, Moscow, Russia, Nikitina G. Y. ,   S.P. Botkin City Clinical Hospital, Moscow Healthcare Department, Moscow, Russia
Published: January 2025

The most important aspect of the problem of the quality of medical care is the epidemiological
safety of the therapeutic and diagnostic process. The intensive development of high-tech, invasive methods of diagnosis and treatment, combined with the widespread spread of multidrug-resistant microorganisms,
determine the need for continuous improvement of the system of supervision and control of infections
associated with medical care (ISMP). The aim of the study was to identify cases of ventilator-associated
lower respiratory tract infections in intensive care units (ICU) when infected with ESСAPE group bacteria; to study their prevalence, etiological structure and epidemiological significance in intensive care patients
with COVID-19 undergoing invasive artificial ventilation (ventilator). The results of the study showed that in COVID-19 patients who received respiratory support in the ventilator mode, representatives of the ESСAPE group of bacteria (with genetic determinants of multiantibiotic resistance) were found more than 2 times more often than in surgical patients, which indicates the important epidemiological significance of aerobic
gram-negative bacteria and non-fermenting gram-negative bacteria of the ESСAPE spectrum in patients
COVID-19 in the formation of colonization and ventilator-associated infection of the respiratory tract. At the same time, both in COVID-19 patients and in patients with a surgical ICU, gram-negative bacteria of the genus
Klebsiella spp., producing beta-lactamase, as well as non-fermenting gram-negative microorganisms
Acinetobacter spp, were prioritized in the etiological structure. and P. aegidiposa, characterized by pronounced acquired resistance to antibiotics of the carbapenem group and are the prerogative of intensive care units. To ensure the epidemiological safety of medical care during ventilation, it is necessary to implement a strategy of empirical and targeted antibiotic therapy; monitoring of antibiotic resistance; conduct continuous
epidemiological surveillance in the ICU with full collection of information on etiological agents, cases of respiratory tract infection and tighten epidemiological control over the preparation and conduct of ventilation.