Authors
Nasser N.R. 1, 2, Shlyapnikov S.A.1
1 Research Institute Of Emergency Medecine named after I.I. Djanelidzе, St. Petersburg
2 NWSMU named after I. I. Mechnikov, St. Petersburg
Abstract
The result of treatment of patients with severe sepsis directly depends on timely prescribed adequate antimicrobial therapy. An increase in the number of infections caused by carbapenem-resistant Enterobacteriales, including Kl.pneumoniae, complicates the selection of an adequate empirical antibiotic therapy regimen. Early detection of the ability to produce carbapenemase in Kl.pneumoniae is a real opportunity to optimize antibiotic therapy, timely appointment of an adequate antimicrobial therapy regimen. The assessment of risk factors for carriage of carbapenem-resistant strains of Enterobacteriales makes it possible to identify a group of patients at risk of carrying such strains of Enterobacteriales, to use methods of early detection of antibiotic resistance genes in Enterobacteriales more widely in this group and to use appropriate effective antibiotics as a starting empirical therapy.
Keywords: аntibiotic therapy, antibiotic-resistant pathogens, resistance to carbapenems Kl.pneumoniae, early diagnosis of carbapenemase gene production.
References
1. Shlyapnikov SA, Shchegolev AV, Naser NR, et al. Sepsis. A short course for a practitioner. St. Petersburg: Man and His Health, 2018. 322 p. (In Russ.)
2. Shlyapnikov SA, Afonchikov VS, Nasser NR, et al. Clinical guidelines for the diagnosis and treatment of severe sepsis and septic shock in treatment-and-prophylactic organizations of St. Petersburg. St. Petersburg: BMN, 2017. 76p. (In Russ.)
3. Yakovlev SV, Suvorova MP, Bykov AO. Infections Caused by Carbapenem-Resistant Enterobacterales: Epidemiology, Clinical Significance, and Possibilities for Antibiotic Therapy Optimization. Antibiotics and Chemotherapy. 2020; 65(5-6): 41-69. (In Russ.) doi: 10.37489/0235-2990-2020-65-5-6-41-69.
4. Shlyapnikov SA, Naser NR, Borodina MA, Ryazanova EP. Modern problems of antibiotic therapy of sepsis. Collection of materials of the conference of the Association of General Surgeons, timed to the anniversary of the Department of General Surgery of YSMU. Yaroslavl, 2020: 194-196. (In Russ.)
5. Bykov AO, Suvorova MP, Burmistrova EN, Protsenko DN, et al. Infections in ICU caused by Kl.pneumoniae resistant to carbapenem: prevalence, mechanisms of resistance and clinical significance. XVIII Congress of the Federation of Anesthesiologists and Resuscitators. 2019: 37-38. (In Russ.)
6. Beloborodov VB, Gusarov .G, Dekhnich AV, Zamyatin MN, et al. Guidelines of the Association of Anesthesiologists-Intensivists, the Interregional Non-Governmental Organization Alliance of Clinical Chemotherapists and Microbiologists, the Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC), and NGO Russian Sepsis Forum Diagnostics and antimicrobial therapy of the infections caused by multiresistant microorganisms. Messenger of anesthesiology and resuscitation. 2020; 17(1): 52-83. (In Russ.) doi: 10.21292/2078-5658-2020-16-1-52-83.