Геронтология и гериатрия
FEATURES OF THE MICROBIAL LANDSCAPE OF RESPIRATORY TRACT SECRETIONS WITH COVID-19 TAKING INTO ACCOUNT THE STRATEGIES OF ANTIBACTERIAL THERAPY IN ELDERLY AND SENILE PERSONS
Yu.V. Evnevich1,2, E.P. Davydova1,2, S.A. Rukavishnikova1,2,3, A.S. Pushkin1,2,3, M.A. Evnevich4, L.V. Borisova1,2, O.N. Titiva3
1. St. Petersburg Institute of Bioregulation and Gerontology, St. Petersburg
2. St. Petersburg State Medical Institution "City Multidisciplinary Hospital No. 2", St. Petersburg
3. Pavlov First Saint Petersburg State Medical University, St. Petersburg
4. LLC "DentIdeal Lakes", St. Petersburg
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Summary:
Introduction. Elderly age, stay in intensive care units, use of an artificial ventilation, irrational use of antibiotics are risk factors for COVID-19 complications with a high mortality rate. The irrational use of antibacterial drugs exacerbates the problem of antibiotic resistance, which is currently increasing in the world.
The purpose of this study was to conduct a retrospective analysis of the obtained microbiological monitoring data, taking into account the strategy of antibacterial therapy in older age groups.
Materials and methods. A total of 6,137 microorganisms from 1,283 biomaterial samples from 927 people aged 19 to 96 years were studied. Of these, 59% are women (545 people), 41% are men (382 people). Selection of biomaterial of the lower respiratory tract (LRT) for microbiological diagnostics in patients, it was performed upon admission to the hospital and repeatedly in the presence of convincing signs of bacterial infection (increased procalcitonin more than 0,5 ng/ml, leukocytosis more than (10-12) x109/L, the appearance of purulent sputum). The following methods were used in the study along with the bacteriological one. PCR diagnostics of the SARS-CoV-2 virus, real-time (CFX96 Real-Time System amplifier, BioRad; kits for isolation and identification of the SARS-CoV-2 virus by Vector Best, an automatic nucleic acid isolation station Vector Best).
Results. As a result of a retrospective analysis of the data obtained, the dominant flora of the discharge of the lower respiratory tract was determined in persons younger than 59 and older than 60 years. The comparison of the microbial landscape of the intensive care unit and intensive care unit with other departments of the hospital was carried out. The analysis of strategies for the use of antibacterial drugs, as well as a comparison of the structure of pathogens with multidrug resistance in elderly and senile people was performed.
Conclusions. The results of the study confirm that the use of antibacterial drugs for coronavirus infection is necessary only if there are convincing signs of bacterial infection. This is especially true for people over 60 years of age, as a group at high risk of an adverse outcome.
Keywords elderly and senile age, COVID-19, microbiota, antibacterial therapy
Bibliographic reference:
Yu.V. Evnevich, E.P. Davydova, S.A. Rukavishnikova, A.S. Pushkin, M.A. Evnevich, L.V. Borisova, O.N. Titiva, FEATURES OF THE MICROBIAL LANDSCAPE OF RESPIRATORY TRACT SECRETIONS WITH COVID-19 TAKING INTO ACCOUNT THE STRATEGIES OF ANTIBACTERIAL THERAPY IN ELDERLY AND SENILE PERSONS // Scientific journal «Current problems of health care and medical statistics». - 2022. - №4;
URL: http://healthproblem.ru/magazines?textEn=856 (date of access: 04.12.2024).
URL: http://healthproblem.ru/magazines?textEn=856 (date of access: 04.12.2024).
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