G.R. MIFTAKHOVA^1, 2, ZH.G. EREMEEVA^1, 3, N.D. SHAYKHRAZIEVA^2, 4, L.G. MUKHAMEDZYANOVA²

 ¹Kazan State Medical University, Kazan

²City Clinical Hospital No. 7 named after M.N. Sadykov, Kazan

³Republican Clinical Dermatovenerologic Dispensary, Kazan

⁴Kazan State Medical Academy — branch campus of the FSBEI FPE RMACPE MOH Russia, Kazan

 Contact details:

Eremeeva Zh.G. — PhD (Medicine), epidemiologist, Senior Lecturer of the Department of Epidemiology and Evidence-Based Medicine

Address: 49 Butlerov St., 420012 Kazan, Russian Federation, tel.: +7-927-448-83-80, e-mail: Z.Eremeeva@tatar.ru

 The purpose — to characterize the microbial landscape of patients in the Anesthesiology and Intensive Care Units based on the results of a microbiological monitoring.

Material and methods. We conducted a retrospective analysis of 992 samples from various biotopes (sputum, urine, blood, drainage fluid, etc.). The samples were collected from 190 patients in the Anesthesiology and Intensive Care Unit of City Clinical Hospital No. 7 over a six-month period in 2025. Patients ranged in age from 18 to 90 years and older (mean age 66 years). Statistical processing was performed in Microsoft Office Excel with calculation of absolute and relative values (as percentages), 95% confidence intervals.

Results. The proportion of samples with microorganism cultures was 55.5% (95% CI 52.4–58.6%). Gram-negative flora predominated among the pathogens (64.2%, 95% CI 60.2–68.2%). The leading positions were occupied by Klebsiella pneumoniae (37.0% of all positive results) and Acinetobacter baumannii (14.9%). The main biotope for Klebsiella pneumoniae was the lower respiratory tract (56% of isolates of this species), while 87.3% of patients with K. pneumoniae isolated from sputum were on mechanical ventilation.

Conclusion. The microbial landscape is characterized by a predominance of multidrug-resistant gram-negative bacteria, primarily localized in the respiratory tract, which is associated with mechanical ventilation and determines the high risk of ventilator-associated pneumonia. The data obtained substantiate the need for continuous microbiological monitoring for timely adjustment of antimicrobial therapy and the prevention of healthcare-associated infections.

Key words: microbiological monitoring, biotopes, patients, Klebsiella pneumoniae

REFERENCES

1. Briko N.I., Zuyeva L.P., Pokrovskiy V.I. et al. Epidemiologiya i profilaktika infektsiy, svyazannykh s okazaniyem meditsinskoy pomoshchi [Epidemiology and prevention of infections associated with healthcare]. Moscow: GEOTAR-Media, 2019. 528 p.
2. VOZ. Global′nyy plan deystviy po bor′be s ustoychivost′yu k protivomikrobnym preparatam [WHO. Global action plan on antimicrobial resistance]. Zheneva, 2016, available at: https://www.who.int/ru/publications/i/item/9789241509763
3. SanPiN 3.3686-21 «Sanitarno-epidemiologicheskiye trebovaniya po profilaktike infektsionnykh bolezney»: utv. postanovleniyem ot 28.01.2021 no. 4 [SanPiN 3.3686-21 «Sanitary and Epidemiological Requirements for the Prevention of Infectious Diseases»: approved by Resolution No. 4 of January 28, 2021], available at: https://docs.cntd.ru/document/573660140 (accessed on: 06.07.2025).
4. Lobzin Yu.V., Sidorenko S.V., Guchev I.A. et al. Antimikrobnaya terapiya i profilaktika infektsiy v ORIT []. Moscow, 2018.
5. Hussain Z. et al. Patients and surfaces: integrated clinical-environmental surveillance of MDR gram-negative bacteria in critical-care units (Karachi, 2024–2025). Microorganisms, 2025, vol. 13 (12), p. 2762.
6. Agarwal R., Walkey A.J. Letter to perpetual observational study of the clinical and microbiological epidemiology of ventilator-associated pneumonia in Europe. Critical Care, 2026, vol. 30, art. 167.
7. Kulagina L.Yu., Valiullina I.R., Kadyseva E.R., Shikaleva A.A. Features of antibiotic resistance according to microbiological monitoring data in a multidisciplinary hospital. Prakticheskaya meditsina, 2021, vol. 19, no. 4, pp. 79–83 (in Russ.).
8. Orlova O.A., Tutel′yan A.V. Organization and implementation of microbiological monitoring of pathogens associated with healthcare in a medical organization. Epidemiologiya i Infektsionnyye bolezni. Aktual′nyye voprosy, 2025, no. 4 (in Russ.).
9. Polibin R.V., Brusina E.B., Kovalishena O.V., Glushkov E.V., Gridina A.A., Aslanov B.I., Briko N.I. Epidemiological interregional multicenter study of healthcare-associated infections in intensive care units (ICUs). First results. Pervyye rezul′taty. Epidemiologiya i Vaktsinoprofilaktika, 2025, vol. 24, no. 1, pp. 4–9 (in Russ.). DOI: 10.31631/2073-3046-2025-24-1-4-9
10. Belotserkovskiy B.Z., Kruglov A.N., Ni O.G., Matyash M.I., Kostin D.M., Shifman E.M. Etiological structure of infections in patients of the surgical intensive care unit in the post-COVID era. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya, 2024, vol. 26, no. 2, pp. 124–140 (in Russ.). DOI: 10.36488/cmac.2024.2.124-140
11. Kulagina L.Yu., Valiullina I.R., Kadyseva E.R., Shikaleva A.A. Features of antibiotic resistance according to microbiological monitoring data in a multidisciplinary hospital. Prakticheskaya meditsina, 2021, vol. 19, no. 4, pp. 79–83 (in Russ.).
12. Dar′ina M.G., Zakhvatova A.S., Fomenko E.V. et al. Results of microbiological monitoring of clinically significant microorganisms circulating in hospitals of St. Petersburg. Zdorov′ye — osnova chelovecheskogo potentsiala, 2024, vol. 19, no. 1, pp. 227–236 (in Russ.).
13. Naser N.R., Shlyapnikov S.A. Optimization of antibacterial therapy of infections caused by carbapenem-resistant enterobacteria. Vestnik Natsional′nogo mediko-khirurgicheskogo tsentra im. N.I. Pirogova, 2023, vol. 18, no. 1, pp. 91–93 (in Russ.). DOI: 10.25881/20728255_2023_18_1_91
14. Gouda A.M., Soliman A.F., Allam A.S., Aboelkhair N.T. Exploring ventilator-associated pneumonia: microbial clues and biomarker insights from a retrospective study. Medicina (Kaunas), 2024, vol. 60 (8), p. 1346. DOI: 10.3390/medicina60081346
15. Wernly B., Bruno R.R., Beil M., et al. Frailty ‘s influence on 30-day mortality in old critically ill ICU patients: a bayesian analysis evaluating the clinical frailty scale. Ann. Inten. Care, 2023, vol. 13 (1), p. 126. DOI: 10.1186/s13613-023-01223-9