zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2023-20-2-04zdor-2546Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEВирусно-бактериальная пневмония при COVID-19: клинико-лабораторная характеристика пациентов и спектр бактериальных возбудителейViral-bacterial pneumonia in COVID-19: clinical and laboratory characteristics of patients and a spectrum of bacterial pathogenshttps://orcid.org/0000-0002-0368-0473ЛевченкоК. В.LevchenkoK. V.

Левченко Кристина Владимировна, ассистент кафедры фтизиопульмонологии с курсом ФПКиП

Гомель

Kristina V. Levchenko, Assistant Lecturer at the Department of Phthisiopulmonology with the course of FPDR

Gomel

kristy_levchenko@mail.ruhttps://orcid.org/0000-0003-2701-2207БондаренкоВ. Н.BondarenkoV. N.

Бондаренко Василий Николаевич, к.м.н., доцент, доцент кафедры фтизиопульмонологии с курсом  ФПКиП

Гомель

Vasily N. Bondarenko, PhD (Med), Associate Professor, Associate Professor at the Department of Phthisiopulmonology with the course of FPDR

Gomel

basyleus@rambler.ruhttps://orcid.org/0000-0002-0449-5026МицураВ. М.MitsuraV. M.

Мицура Виктор Михайлович, д.м.н., доцент,  заместитель директора по научной работе;

профессор кафедры инфекционных болезней

Гомель

Viktаr M. Mitsura, MD, Deputy Director for Scientific  Work;

Professor at the Department of Infectious Diseases

Gomel

mitsura_victor@tut.byhttps://orcid.org/0000-0002-9484-7848ТапальскийД. В.TapalskiD. V.

Тапальский Дмитрий Викторович, д.м.н., доцент, заведующий кафедрой микробиологии, вирусологии и  иммунологии

Гомель

Dmitry V. Tapalski, Doctor of Medical Sciences, Associate Professor, Head of the Department of  Microbiology, Virology and Immunology

Gomel

tapalskiy@gmail.comГомельский государственный медицинский университетБеларусьGomel State Medical UniversityBelarusРеспубликанский научно-практический центр радиационной медицины и экологии человека; Гомельский государственный медицинский университетБеларусьRepublican Scientific and Practical Center for Radiation Medicine and Human Ecology: Gomel State Medical UniversityBelarus2023100720232022734Copyright © Левченко К.В., Бондаренко В.Н., Мицура В.М., Тапальский Д.В., 20232023Левченко К.В., Бондаренко В.Н., Мицура В.М., Тапальский Д.В.Levchenko K.V., Bondarenko V.N., Mitsura V.M., Tapalski D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/2546

Цель исследования. Изучить клинико-лабораторные данные пациентов с вирусно-бактериальной пневмонией, вызванной SARS-CoV-2, оценить спектр бактериальных возбудителей и их чувствительность к антибактериальным лекарственным средствам.Материалы и методы. Проведен анализ 50 случаев вирусно-бактериальной пневмонии, ассоциированной с инфекцией COVID-19. Изучены гендерно-возрастная структура пациентов, клинико-лабораторные данные, степень тяжести заболевания, сопутствующие заболевания. Микробиологическое исследование мокроты и промывных вод бронхов (ПВБ) выполняли бактериологическим методом с использованием автоматического микробиологического анализатора. Проводилась идентификация выделенных культур и определение их чувствительности к антибактериальным лекарственным средствам.Результаты. Средний возраст пациентов в изучаемой группе составил 71,1 ± 14,8 года. У 90 % пациентов отмечались сопутствующие заболевания, чаще сердечно-сосудистой системы. Присоединение вторичной бактериальной инфекции диагностировалось на 13,0 ± 5,0 день от начала заболевания и характеризовалось двусторонним поражением легких. Наиболее частыми этиологическими факторами бактериальной пневмонии явились микроорганизмы семейства Enterobacteriaceae — 37 %, Staphylococcus aureus — 23 % и Acinetobacter baumannii — 13 %. Выделенные штаммы характеризовались лекарственной устойчивостью к аминопенициллинам, цефалоспоринам, фторхинолонам, аминогликозидам и карбапенемам.Заключение. Высокий уровень устойчивости возбудителей бактериальной пневмонии, выделенных от пациентов на фоне инфекции SARS-CoV-2, к антибактериальным лекарственным средствам требует более широкого использования препаратов резерва и внедрения других стратегий лечения.

Objective. To study the clinical and laboratory data of patients with viral-bacterial pneumonia caused by SARS-CoV-2, to evaluate the spectrum of bacterial causative agents and their sensitivity to antibacterial drugs.Materials and methods. 50 cases of viral-bacterial pneumonia associated with the COVID-19 infection were analyzed. The gender-age structure of patients, clinical and laboratory data, degree of disease severity and concomitant diseases were studied. Microbiological examination of sputum and bronchoalveolar lavage (BAL) was performed by bacteriological method using an automatic microbiological analyzer. Identification of the selected cultures and the determination of their sensitivity to antibacterial drugs were provided.Results. The average age of the patients in the studied group was 71,1 ± 14,8 years. 90% of patients had concomitant diseases, mainly of cardiovascular system. The secondary bacterial infection was diagnosed on 13,0 ± 5,0 day from the disease onset and was characterized by bilateral lung lesions. The most common etiological factors of bacterial pneumonia were the microorganisms of the Enterobacteriaceae family — 37%, Staphylococcus aureus — 23% and Acinetobacter baumannii — 13%. The isolated strains were characterized by drug resistance to aminopenicillins, cephalosporins, fluoroquinolones, aminoglycosides and carbapenems.Conclusion. The high level of resistance of bacterial pneumonia causative agents isolated from patients with SARS-CoV-2 infection to antimicrobial drugs requires wider use of reserve drugs and implementation of other treatment strategies.

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