Microbial Landscape of the Respiratory Tract of Children with Cystic Fibrosis: Monitoring Results
Authors:   Republican Clinical Infectious Diseases Hospital, Ufa, Russian Federation, Mukhametzyanov A. M. ,   Bashkir State Medical University, Ufa, Russian Federation, Kaydanek T. V. ,   Bashkir State Medical University, Ufa, Russian Federation, Latypov A. A. ,   Bashkir State Medical University, Ufa, Russian Federation, Valeeva D. S. ,   Republican Pediatric Clinical Hospital, Ufa, Russian Federation, Ponomareva D. N. ,   Republican Pediatric Clinical Hospital, Ufa, Russian Federation, Ermolenko I. A. ,   Republican Pediatric Clinical Hospital, Ufa, Russian Federation, Gazizova A. G. ,   Republican Pediatric Clinical Hospital, Ufa, Russian Federation
Published: November 2024

Background. The article presents the results of microbiological monitoring of microorganisms of the respiratory tract of patients with cystic fibrosis (CF), changes in the spectrum, palette, and antibacterial resistance during repeated hospitalizations in a specialized hospital. Purpose of the study. To analyze the results of microbiological examination of respiratory tract biomaterial of children with CF hospitalized in a multidisciplinary pediatric hospital to optimize epidemiological surveillance at the local level. Materials and methods. The material for the study was the results of a microbiological study of smears from the pharynx, nose, or induced sputum of patients with cystic fibrosis observed at the Children's Center for Cystic Fibrosis (CF). Identification of isolated cultures was carried out by classical bacteriological methods. Subsequently, the isolated microorganisms were systematized to species. The analysis was carried out for 2019-2023. Determination of sensitivity to antibacterial drugs was carried out using the disk diffusion method. Indicators of the frequency (%) of isolation of various microorganisms and the frequency (%) of resistant microorganisms to the antimicrobial drugs used in a medical organization (MO) were calculated. A comparison was made of the frequency (%) and spectrum of isolated cultures during initial and subsequent hospitalizations at the Children's Cystic Fibrosis Center. Confidence intervals CI (95%) were calculated for relative values. Calculations were carried out using the epidemiological calculator Confidence Interval Calculator. Results. In the structure of isolated cultures from the biomaterial of the respiratory tract of children with cystic fibrosis, 45.4% were gram-negative microorganisms. During initial and subsequent hospitalizations, the highest frequency of isolation were Pseudomonas aeruginosa, Klebsiella pneumoniae, Stenotrophomonas maltophilia. Gram-positive microorganisms in the spectrum of isolated cultures amounted to 37.9%. The majority of the isolated gram-positive microorganisms are represented by Staphylococcus aureus (75.7%). During repeated hospitalizations to the Children's CF Center, based on the monitoring results, changes in the spectrum, frequency of isolation, and spectrum of resistance to antimicrobial drugs were determined. An increase in the frequency (p<0.05) of the isolation of Pseudomonas aeruginosa and Staphylococcus aureus was determined. During repeated hospitalizations, the frequency of isolation of associations of microorganisms increased from 50.5% CI [55.7; 45.3] to 81.4% CI [83.8; 79.0] (p<0.05). An increase in the frequency (p<0.05) of isolation of Pseudomonas aeruginosa strains resistant to reserve antibacterial drugs was determined by 3.2 times during subsequent hospitalizations. Conclusion. The revealed changes in the spectrum, frequency, palette and antibiotic resistance of microorganisms of the respiratory tract of CF patients at the local level of epidemiological surveillance indicate the need to develop algorithms of action in outpatient and inpatient management of CF patients to ensure epidemiologic safety of medical activity and improve the quality of medical care.