vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2016-2-56-64vtio-639Research ArticleКлиническая трансплантологияClinical TransplantologyВОЗБУДИТЕЛИ БАКТЕРИАЛЬНОЙ И ГРИБКОВОЙ ИНФЕКЦИЙ В ЦЕНТРЕ ТРАНСПЛАНТОЛОГИИ И ДИАЛИЗА. АНАЛИЗ ДИНАМИКИ ЗА ВОСЕМНАДЦАТЬ ЛЕТ (1998–2015)BACTERIAL AND FUNGAL PATHOGENS IN THE TRANSPLANTATION AND DIALYSIS CENTER. ANALYSIS FOR EIGHTEEN YEARS (1998–2015)ВатазинА. В.VatazinA. V.

Хирургическое отделение трансплантологии и диализа

Surgical Division of Transplantation and Dialysis

ЗулькарнаевА. Б.ZulkarnaevA. B.

Хирургическое отделение трансплантологии и диализа. 

Для корреспонденции: Зулькарнаев Алексей Батыргараевич. Адрес: 129110, Москва, ул. Щепкина, 61/2, корпус 6. Тел.: (916) 705-98-99, (495) 684-57-91. Е-mail: 7059899@gmail.com.

Surgical Division of Transplantation and Dialysis. 

For correspondence: Zulkarnaev Aleksey Batyrgaraevich. Address: Building 6, 61/2, Shchepkina St., Moscow, 129110, Russian Federation. Tel.: (916) 705-98-99, (495) 684-57-91. Е-mail: 7059899@gmail.com.

7059899@gmail.comРусановаЕ. В.RusanovaE. V.

Лаборатория клинической микробиологии

Laboratory of Clinical Microbiology

БудниковаН. Е.BudnikovaN. E.

Хирургическое отделение трансплантологии и диализа

Surgical Division of Transplantation and Dialysis

Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского, МоскваРоссияM.F. Vladimirsky Moscow Regional Research and Clinical Institute, MoscowRussian Federation2016250620161825664Copyright © Ватазин А.В., Зулькарнаев А.Б., Русанова Е.В., Будникова Н.Е., 20162016Ватазин А.В., Зулькарнаев А.Б., Русанова Е.В., Будникова Н.Е.Vatazin A.V., Zulkarnaev A.B., Rusanova E.V., Budnikova N.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/639Цель

Цель: проанализировать динамику микрофлоры и ее чувствительности к антибиотикам у пациентов центра трансплантологии и диализа.

Материалы и методы

Материалы и методы. Проанализированы результаты посевов 1282 пациентов с 5-й стадией хронической болезни почек (реципиенты почечного трансплантата и диализные пациенты) за 1998–2015 годы: 1998–2003 («2003» период), 2008–2011 («2011» период) и 2012–2015 («2015» период). Биоматериал: моча, кровь, раневое отделяемое, мокрота.

Результаты

Результаты. Частота встречаемости (доля от общего числа посевов) грамотрицательных, грамположительных бактерий и грибов составила в «2003»: 38, 56, 7% соответственно; в «2011»: 48, 69, 13%; в «2015»: 61, 54, 18%. Значительно повысилась встречаемость грамотрицательных бактерий в крови: «2003» – 22%, «2011» – 13%, «2015» – 45%. Частота встречаемости грибов рода Candida растет в мокроте (15, 33, 41%) и моче (8, 14, 18%) за 2003, 2011, 2015-й периоды соответственно. Видовой состав флоры также значительно изменился. В «2003» доли Staphylococcus spp. и Enterococcus spp. были 50 и 33%, в «2015» – 34 и 53% соответственно. Доли E. coli, Klebsiella spp., P. aeruginosa и Acinetobacter spp. были в «2003» 32, 21, 15, 11% соответственно, а в «2015» – 17, 32, 9, 22% соответственно. Выросла доля «проблемных» родов грибов рода Candida: C. glabrata и C. krusei. Их общая доля выросла с 26 до 38% (2003–2015). Отмечается значительный рост резистентности к антибиотикам, который наиболее выражен у Enterococcus spp., Klebsiella spp. и Acinetobacter spp. Все грамположительные бактерии в «2003» были чувствительны к ванкомицину и линезолиду, а в «2015» уже 6% Enterococcus были резистентны к ванкомицину.

Заключение

Заключение. Микробный пейзаж подвержен значительным изменениям. Этот факт, а также растущая резистентность к антибактериальным препаратам диктуют необходимость периодического анализа бактериальной микрофлоры. 

Aim

Aim: to analyze the dynamics of the microflora and its sensitivity to antibiotics in patients of dialysis and transplantation center.

Materials and methods

Materials and methods. We have examined the bacteriological test results of 1282 patients with chronic kidney disease, stage 5 (renal transplant recipients and dialysis patients) in 1998–2015: 1998–2003 («2003» period), 2008–2011 («2011» period) and 2012–2015 («2015» period). Biomaterial: urine, blood, wound effluent, sputum.

Results

Results. The incidence (share of all samples) of gram «–», gram «+» and fungi was 38, 56, 7% for «2003» period; 48, 69, 13% for «2011» period; 61, 54, 18% for «2015» period. The incidence of gram «–» in blood has significantly increased: 22% in «2003», 13% in «2011», and 45% in «2015», respectively. The incidence of Candida fungi is growing in sputum and urine: 15, 33, 41% and 8, 14, 18% (in 2003, 2011, 2015 respectively). The species composition of the fl ora has also significantly changed. In «2003» the shares of Staphylococcus spp. and Enterococcus spp. were 50 and 33%, in «2015» – 34 and 53% respectively. The shares of E. coli, Klebsiella spp., P. aeruginosa and Acinetobacter spp. were in «2003» 32, 21, 15, 11% respectively, and in «2015» – 17, 32, 9, 22%, respectively. The share of a «problem» genus of Candida: C. glabrata and C. krusei has significantly increased. Their combined share increased from 26 to 38% (2003–2015). There was a significant increase in antibiotic resistance, which is mostly pronounced in Enterococcus spp., Klebsiella spp. and Acinetobacter spp. All gram «+» bacteria in «2003» were susceptible to vancomycin and linezolid, but in «2015» 6% of Enterococcus were resistant to vancomycin.

 Conclusion

 Conclusion. Bacterial profile has significantly changed. Regular analysis of the bacterial fl ora is necessary due to the growing antibiotic resistance. 

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The authors declare that there are no conflicts of interest present.