scholarly journals IN INTRA-ABDOMINAL INFECTIONS AND PERITONITIS

2021 ◽  
pp. 90-96
Author(s):  
A. V. Kotov ◽  
V. I. Desyaterik ◽  
S. P. Mikhno
Keyword(s):  
Absolute Number ◽  
Multidrug Resistant ◽  
E Coli ◽  
The Past ◽  
Rational Therapy ◽  
Acinetobacter Spp ◽  
The Difference ◽  
Abdominal Infections ◽  
Staphylococcus Spp ◽  
Klebsiella Spp

Summary. Purpose of the reserche. To study changes in microflora and sensitivity of isolated strains to antibiotics using bacteriological research methods for intra-abdominal infections and peritonitis to determine their resistance when planning antibiotic therapy. Results and discussion. The paper presents data from a retrospective analysis of the results of studies of microflora and its resistance in intra-abdominal infections (IAI) and peritonitis for 2 periods: I period — from january 2007 to december 2008, II period — from january 2018 to december 2019. The difference between period II and I was in the increase in the number of individual pathogenic strains of microorganisms. Thus, the number of Klebsiella spp. increased from 13.8 % to 23.8 %, which in absolute number of their total number amounted to a 73.5 %, ranking second in the overall structure among pathogens sown in IAI and peritonitis. The number of strains of Staphylococcus spp., Enterobacter spp., Acinetobacter spp. has also increased by 2.4–5.8 % respectively. Among the strains Klebsiella spp., E. coli and Staphylococcus spp. the number of poly- and multi-polyresistant forms has increased. Thus, the number of such forms among Klebsiella spp. increased from 19.2 to 44.5 %, Staphylococcus spp. — from 43.8 to 67.1 % and E. coli from 18.2 to 23.5 %, respectively. Conclusions. Over the past 10 years, with IAI and peritonitis, the most significant changes were revealed on the part of pathogenic strains of Klebsiella spp., Staphylococcus spp. and Acinetobacter spp. Multidrug resistant strains were predominantly susceptible to carbapenems, semisynthetic ureidopenicillins, aminoglycosides, glycopeptides, oxazalidinones, phosphonoic acid derivatives. In the context of changes in the microbial landscape observed over the past decade, an increase in the number of poly- and multi-resistant forms of pathogenic microorganisms in IAI and peritonitis, the choice of antibiotics for rational therapy should be based solely on bacterioscopy and antibiograms.

scholarly journals High Level of Multidrug-Resistant Gram-Negative Pathogens Causing Burn Wound Infections in Hospitalized Children in Dar es Salaam, Tanzania

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Fatima Kabanangi ◽  
Agricola Joachim ◽  
Emmanuel James Nkuwi ◽  
Joel Manyahi ◽  
Sabrina Moyo ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Pediatric Patients ◽  
Multidrug Resistant ◽  
Dar Es Salaam ◽  
Wound Infections ◽  
Burn Wound ◽  
Gram Negative ◽  
E Coli ◽  
Acinetobacter Spp ◽  
Klebsiella Spp

Background. Bacterial infection remains the most common cause of morbidity and mortality in pediatric patients with burn wounds. The increase in infection and multidrug-resistant (MDR) pathogens necessitates a periodic review of antimicrobial susceptibility patterns in the burn units. The study aimed to determine the magnitude of multidrug-resistant Gram-negative (MDRGN) bacteria in children with burn wound infections and describe the resistance patterns in the tertiary and regional hospitals in Dar es Salaam, Tanzania. Materials and Methods. The study was a hospital-based cross-sectional study design conducted between May 2017 and February 2018. Bacterial isolates from 103 wound swabs of pediatric patients with burn wounds were identified using conventional methods and API 20E. The antimicrobial susceptibility pattern was determined by the Kirby–Bauer disc diffusion method. Data were analyzed using Statistical Package for Social Science (SPSS) version 23.0. Results. A total of 136 pathogenic Gram-negative organisms were isolated from burn wound infections in pediatric patients. The most isolated Gram-negative bacterium was Pseudomonas aeruginosa (39.0%), followed by Acinetobacter spp. (28.7%) and Klebsiella spp. (16.2%). MDRGN strains made up 80.1% of all Gram-negative isolates. All (100%) Klebsiella spp. and E. coli were MDR, while 69.2% and 79.2% of Acinetobacter spp. and P. aeruginosa, respectively, displayed MDR strains. We observed high levels of resistance to commonly prescribed antibiotics. Among P. aeruginosa isolates, highest resistance (81.8%) was seen toward meropenem and piperacillin, 79.5% of Acinetobacter spp. showed resistance to aztreonam, while 93–100% of Klebsiella spp and E. coli displayed resistance to amoxyclavulanic acid, ceftriaxone, and ceftazidime. The proportion of extended-spectrum beta-lactamase producers among Enterobacteriaceae was 78.6%. There was a significant higher rate of infection with MDRGN organisms in pediatric patients with a higher percentage of total burn surface area (TBSA) than patients with lower TBSA ( p  = 0.016). Conclusions. P. aeruginosa, Acinetobacter spp., and Klebsiella spp. are the common Gram-negative pathogens causing burn wound infections in hospitalized pediatric patients in our setting. A high proportion of these organisms were multidrug resistant. The findings appeal for regular antimicrobial resistance surveillance in burn wound infection to inform empirical therapy.

The Characterization of Antibiotic Resistance of Bacterial Isolates from Intensive Care Unit Patient Samples in a University Affiliated Hospital in Romania

2019 ◽  
Vol 70 (5) ◽  
pp. 1778-1783
Author(s):  
Andreea-Loredana Golli ◽  
Floarea Mimi Nitu ◽  
Maria Balasoiu ◽  
Marina Alina Lungu ◽  
Cristiana Cerasella Dragomirescu ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Bacterial Pathogens ◽  
Resistance Rate ◽  
Resistance Pattern ◽  
Bacterial Isolates ◽  
E Coli ◽  
Acinetobacter Spp ◽  
Almost All ◽  
Klebsiella Spp

To determine the resistance pattern of bacterial pathogens involved in infections of the patients aged between 18-64 years, admitted in a ICU from a 1518-bed university-affiliated hospital. A retrospective study of bacterial pathogens was carried out on 351 patients aged between 18-64 years admitted to the ICU, from January to December 2017. In this study there were analysed 469 samples from 351 patients (18-64 years). A total of 566 bacterial isolates were obtained, of which 120 strains of Klebsiella spp. (35.39%%), followed by Nonfermenting Gram negative bacilli, other than Pseudomonas and Acinetobacter (NFB) (75- 22.12%), Acinetobacter spp. (53 - 15.63%), Pseudomonas aeruginosa and Proteus (51 - 15.04%), and Escherichia coli (49 - 14.45%). The most common isolates were from respiratory tract (394 isolates � 69.61%). High rates of MDR were found for Pseudomonas aeruginosa (64.70%), MRSA (62.65%) and Klebsiella spp. (53.33%), while almost all of the isolated NFB strains were MDR (97.33%). There was statistic difference between the drug resistance rate of Klebsiella and E. coli strains to ceftazidime and ceftriaxone (p[0.001), cefuroxime (p[0.01) and to cefepime (p[0.01). The study revealed an alarming pattern of antibiotic resistance in the majority of ICU isolates.

scholarly journals Molecular Characterization of Isolated Multidrug-Resistant Bacteria from Tertiary Care Hospitals of Ahmedabad: A Comparison Study Between Previous to COVID-19 and Current Scenario

2021 ◽  
Author(s):  
Anurag D. Zaveri ◽  
Dilip N. Zaveri ◽  
Lakshmi Bhaskaran
Keyword(s):  
Molecular Characterization ◽  
Tertiary Care ◽  
Future Generation ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
E Coli ◽  
Pseudomonas Spp ◽  
Bacillus Spp ◽  
Current Scenario ◽  
Klebsiella Spp

Hospital Acquired Infections (HAIs) are a significant concern for healthcare setups, as it increases the overall cost of treatment, patients stay in hospitals, making them susceptible to secondary and tertiary infections and, sometimes, mortality1. To prevent or control HAIs, evaluating the organisms isolated from the critically maintained areas is considered of epitome importance and everlasting practice in the healthcare industry. Identifying such organisms and screening them for antibiotic resistance is mandatory, but it also helps professionals understand colonization trends. Sensitive areas of healthcare setups were screened monthly from years 2017 to 2020. A total of 4400 samples of hospital hygiene, e.g., intravenous drip stands, ventilator surface, anesthetist’s trolley, patient’s bed, instrument trolley, etcetera, were collected. Isolated organisms were cultured and screened using the CLSI technique. E. coli, Pseudomonas spp., and Klebsiella spp. were found in both previous to COVID current samples. Multidrug-resistant organisms were subjected to molecular characterization to detect the presence of carbapenem genes. Evaluation data of both pre-and during Coronavirus Disease or COVID-19 were compared. The prevalence of pathogenic (Klebsiella spp., E. coli, and Pseudomonas spp.) and non-pathogenic (Staphylococcus aureus and Bacillus spp.) strains in healthcare setups decreased drastically (Klebsiella spp. from 80% to 20%, E.coli from 90% to 10% and Pseudomonas spp. from 80% to 20%). It is possible only because of the awareness in non-specialists and healthcare workers due to the unforeseen critical situation proving to be a blessing for the future generation.

​Detection of Carbapenemase Genes (bla-NDM, bla-KPC, bla-OXA-48) in Escherichia coli and Klebsiella species, Isolated from Milk Samples of Bovine in Eastern Plain Zone of Uttar Pradesh

2021 ◽  
Author(s):  
Vibha Yadav ◽  
Rajesh Kumar Joshi ◽  
Namita Joshi ◽  
Amit Kumar ◽  
Satyavrat Singh
Keyword(s):  
Bovine Milk ◽  
Uttar Pradesh ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Pcr Analysis ◽  
Rrna Gene ◽  
Klebsiella Species ◽  
E Coli ◽  
Species Specific ◽  
Klebsiella Spp

Background: Among enterobacteria E. coli and Klebsiella spp. are of great concern in health care settings, as these bacteria sometimes may contaminate the milk due to unhygienic practices and poor udder condition which have been associated with various illnesses. Therefore, this study aimed to detect the carbapenem resistant E. coli and Klebsiella spp. of bovine milk origin with regard to the risk of human transfer via the food chain in community. Methods: Total 240 samples were collected from Ayodhya and Sultanpur districts of Eastern Plain Zone of Uttar Pradesh (India). Confirmation of E. coli and Klebsiella spp. isolates was done by using species specific uidA and 16S rRNA gene, respectively. Then, carbapenemase positive E. coli and Klebsiella spp. were confirmend by DDST, MBL E-strip test and PCR analysis by targeting (bla-NDM, bla-OXA-48 and bla-KPC). Antibiogram of all carbapenemase positive isolates was performed against 20 antibiotics of 12 different classes. Result: In the present study, total 74(30.83%) isolates were identified including 55(22.92%) E. coli and 19(7.92%) Klebsiella spp. by PCR, out of which 12(16.21%) isolates were confirmed as carbapenemase producers comprising 7(12.72%) E. coli and 5(26.31%) Klebsiella spp by DDST and E-strip. All carbapenemase positive E. coli were found 100% sensitive to polymyxin-B and chloramphenicol, while all Klebsiella spp. were 100% sensitive to amikacin and polymyxin-B. Resistance against imipenem, meropenem, cefotaxime, cefpodoxime, ceftazidime, ceftriazone, aztreonam and ampicillin ranged between 80.0%-100%. All carbapenemase positive isolates were found multidrug resistant. Carbapenemase genes bla-NDM and bla-KPC were detected in E. coli while bla-OXA-48 and bla-KPC were detected in Klebsiella spp.

scholarly journals Detection of extended-spectrum beta-lactamase-producing E. coli and Klebsiella spp. in effluents of different hospitals sewage in Biratnagar, Nepal

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Sanjay Mahato ◽  
Ajay Mahato ◽  
Elina Pokharel ◽  
Ankita Tamrakar
Keyword(s):  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Amoxicillin Clavulanate ◽  
Baseline Information ◽  
Klebsiella Spp

Abstract Objective This study was aimed to determine prevalence and resistance pattern like multidrug resistant (MDR) or ESBL nature of E. coli and Klebsiella spp. from various sewage drain samples with an idea to deliver baseline information that could be utilized for defining guidelines for the treatment of hospital sewages. Results Of 10 sewage samples analyzed, 7 (70%) contained E. coli while 6 (60%) contained Klebsiella. Except one sample, all positive samples contained both E. coli and Klebsiella spp. E. coli isolates were resistant to ampicillin, amoxicillin, cefoxitin, cefuroxime, and cefpodoxime; while 85.7% were resistant to amoxicillin/clavulanate, ceftazidime, cefotaxime and ceftriaxone. 71.4%, 57.1%, 42.9%, and 28.6% were resistant to aztreonam, trimethoprim/sulfamethoxazole, nitrofurantoin, and gentamicin. Most were sensitive to chloramphenicol, ofloxacin, ciprofloxacin, and azithromycin. 85.7% and 57.1% of E. coli were MDR and ESBL isolates, respectively. Klebsiella were resistant to ampicillin, amoxicillin, and amoxicillin/clavulanate. 83.4% of Klebsiella were resistant to cefoxitin. 66.7% of strains were resistant to cefuroxime, ceftazidime, cefotaxime, ceftriaxone, and cefpodoxime. Klebsiella showed 50% resistant to aztreonam and trimethoprim/sulfamethoxazole, while 33.3% were resistant to chloramphenicol, nitrofurantoin, ofloxacin, and ciprofloxacin. Klebsiella were sensitive to azithromycin and gentamicin. 66.7% and 33.3% of Klebsiella were MDR and ESBL isolates, respectively.

scholarly journals Prevalence of bovine mastitis pathogens and antibioresistance of Escherichia coli isolates

2017 ◽  
Vol 55 (2) ◽  
pp. 113
Author(s):  
A. ZDRAGAS (Α. ΖΔΡΑΓΚΑΣ) ◽  
P. TSAKOS (Π. ΤΣΑΚΟΣ) ◽  
K. ANATOLIOTIS (Κ. ΑΝΑΤΟΛΙΩΤΗΣ)
Keyword(s):  
Escherichia Coli ◽  
Bovine Mastitis ◽  
Clinical Mastitis ◽  
Resistance Rate ◽  
Northern Greece ◽  
E Coli ◽  
Milk Samples ◽  
Staphylococcus Spp ◽  
Klebsiella Spp ◽  
Mastitis Pathogens

Nine hundred and fifty two milk samples from clinical bovine mastitis cases, originated from 269 farms in Northern Greece, were tested. Escherichia coli was isolated in 49.3% of samples. Furthermore, Staphylococcus spp, Corynebacterium spp, Streptococcus spp, Pseudomonas spp, Proteus spp, Klebsiella spp or a combination of the above bacteria were isolated. The bacteriological result from 4.3% of samples was negative. No correlation between clinical mastitis cases and seasonal variation was observed. Resistance of E. coli isolates to tetracycline was 82-96%, to enrofloxacin 10-30%, to gentamicin 58-80%, to cephalosporins 47-75%, to sulfamethoxazole-trimethoprime 46-81%, to ampicillin 71-92% and to neomycin 83-97%. The highest resistance rate and the appearance of multi-resistant isolates of E. coli (6%), to 8 antibacterials, were recorded during the last year of the survey.

scholarly journals Microbial Profile of Various Catheter Tips among Hospitalized Patients

2018 ◽  
Vol 5 ◽  
pp. 32-38
Author(s):  
Pushpa Man Shrestha ◽  
Nisha Thapa ◽  
Navraj Dahal ◽  
Nabaraj Adhikari ◽  
Upendra Thapa Shrestha
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Descriptive Analysis ◽  
Multidrug Resistant ◽  
Antimicrobial Susceptibility Testing ◽  
Resistance Pattern ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Klebsiella Spp

Objectives: This study aimed to identify the microbiological profile of various catheter tips, and multidrug resistance pattern of extended spectrum β-lactamase (ESBL) producing E. coli and Klebsiella spp. isolates. Methods: A descriptive analysis of 263 catheter tip specimens processed for culture and antimicrobial susceptibility testing was carried out in B&B Hospital, Lalitpur. Five different types of catheter tips were analyzed for microbiological growth and antimicrobial susceptibility testing. Results: Among catheter tips, the highest percentage of microbial growth was observed in tracheostomy tip. Monomicrobial growth was recorded in 82.9% catheter tips and polymicrobial growth was observed in 17.1% tip samples. Of 180 isolates, gram negative rods (76.6%) followed by yeast (19.4%) and gram-positive cocci (3.9%) were isolated. Gram negative Acinetobacter spp. (25%) and Pseudomonas spp. (23.3%) and gram-positive Enterococcus spp. (2.2%) were the most frequently isolated bacteria. However, carbapenam was the most effective antibiotic for both groups. Conclusion: Of the total isolates tested, 61.4% were found to be multidrug resistant (MDR). Among gram negative rods, 22.2% E. coli and 27.3% Klebsiella spp. were confirmed as ESBL producer. It is recommended to apply standard protocol during insertion and removal of catheter which may help in managing nosocomial infection associated with catheters.

scholarly journals Value of polymerase chain reaction in etiological diagnostic of infectiove endocarditis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E O Kotova ◽  
E A Domonova ◽  
A S Pisaryuk ◽  
O Y Silveystrova ◽  
Y L Karaulova ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Microbiological Method ◽  
Chain Reaction ◽  
E Coli ◽  
Enterococcus Spp ◽  
Acinetobacter Spp ◽  
Pcr Method ◽  
Polymerase Chain ◽  
Staphylococcus Spp ◽  
Culture Negative

Abstract Introduction Identification of a causative agent in patients with infective endocarditis (IE) is crucial for diagnostic and prescribing etiotropic therapy which defines positive outcome of a disease. High rate of a culture negative IE and inaccurate results of traditional microbiological methods raise a concern. So the methods of etiological diagnostics in IE are in need of development, particularly introduction of polymerase chain reaction (PCR) method might be helpful. Aim Modernisation of the algorithm of IE etiological diagnostic by introducing PCR Materials and methods The study included 85 cases of IE [first episode of IE (n=79), recurrence/relapse (n=6)] verified by DUKE criteria 2009, 2015, hospitalized in Moscow primary hospital from 2012 to 2017. All patient had venous blood investigated both with microbiological method and with broadrange and specific PCR. Following microorganisms' DNA were assessed by PCR: Staphylococcus spp. (MRCoNS, S. aureus and others), Streptococcus spp. (S. agalactiae, S. pyogenes and others), Enterococcus spp. (E. faecium, E. faecalis and others), Enterobacteriaceae, Klebsiella spp. (K. pneumoniae and others), E. coli, Proteus spp., A. baumanii, P. aeruginosa, Fungi (C. albicans, C. glabrata, Aspergillus spp. and others). Results Median age was 55.48 years (95% confidence interval (CI) 51.16–59.8), males 67.9%. History of cardiovascular diseases was in 54 (68.35%), diabetes mellitus in 18 (22.78%), hepatitis B and/or C in 31 (39.2%), intravenous drug dependency in 27 (34.18%), chronic kidney disease in 38 (48.1%), median Charlson comorbidity index was 5.44 (95% CI 4.52–6.37). Left-side IE was in 50 (63.29%), right-side IE – in 23 (29.12%), left-right-side IE in 6 (7.59%). Secondary IE was in 53 patients (62.3%). Embolic events were diagnosed in 27 cases (34.18%), in-hospital mortality – in 22 (27.8%). Microbiological method identified etiological agent in 55 of 85 cases (61.2%), featuring Staphylococcus aureus (n=23), Staphylococcus CoNS (n=6), Escherichia coli (n=1), Acinetobacter spp. (n=2), Streptococcus spp. (n=2), Enterococcus spp. (n=8), Klebsiella pneumoniae (n=2), Gemella haemolysans (n=2), several causative agents (n=6). Additional PCR testing identified etiology in 14 of 33 (42.2%) featuring Staphylococcus spp. (n=6), Enterococcus spp. (n=3), Streptococcus spp. (n=1), Aspergillus sp. (n=1) Pasteurella multocida (n=1), Enterococcus spp. + Staphylococcus spp. (n=1), Staphylococcus spp.+ A. baumanii + E. coli (n=1). PCR method identified 6 fals-positive results of microbilogical investigation [S. epidermidis (n=2), G. haemolysans, Acinetobacter spp., E. faecalis, K. pneumoniae], that are most probably due to preanalytical sample contamination Conclusions Introduction of PCR into the algorithm of IE etiological diagnostic increased validity of laboratory findings on 23.5%. True culture negative IE was present in 19 of 85 patients. Rate of mortality and complications in IE remains high. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Peoples' Friendship University of Russia (RUDN), Moscow, Russia

scholarly journals Prevalence and Antibiogram Profiling of Rotten Fruits from Different Areas of Dhaka City, Bangladesh

2020 ◽  
pp. 1-9
Author(s):  
Mahmuda Akhter Akhi ◽  
Avijit Banik ◽  
Oshin Ghurnee ◽  
Nantu Chandra Das ◽  
Showmitro Nondi ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Vibrio Parahaemolyticus ◽  
Pathogenic Microorganisms ◽  
Dhaka City ◽  
Salmonella Spp ◽  
Street Vendors ◽  
E Coli ◽  
Daily Diet ◽  
Acinetobacter Spp ◽  
Klebsiella Spp

Fruits are highly nutritious, sources of vitamins, minerals, fibers etc. and these are part of our daily diet. However, during cultivation, harvesting, transportation, handling fruits get contaminated with pathogenic microorganisms which leads to severe problems to community. Owning to this point, in current research, bacteriological analysis was performed on Sofeda, Pineapple, Grape, Banana, Apple, Orange, Guava, papaya, Jujube and Starfruit. Total 50 samples were randomly collected from market and street vendors of Dhaka city. Higher numbers of rotten fruits were present in wholesale markets. 35 strains were isolated which included Salmonella spp., Acinetobacter spp., Klebsiella spp., Vibrio cholerae, Vibrio parahaemolyticus, Staphylocoous aureus and E. coli. They were identified using biochemical test and antibiogram for selective isolates. In case of drug resistance of isolates, majority exhibited resistance against Erythromycin, Vancomycin and Amoxycillin and showing sensitivity against Ciprofloxacin and Ceftriaxone. It was observed in the current study that 100% isolates were resistant against Erythromycin, followed by Amoxycillin 90.63% and vancomycin 86.25%, where only 35.27% isolates were resistant against Ciprofloxacin. In case of sensitivity 64.73% isolates were sensitive against Ciprofloxacin followed by Ceftriaxone 66.25%. 

scholarly journals Nosocomial post-cesarean endometritis: a rationalized strategy of antibacterial therapy

2018 ◽  
Vol 12 (2) ◽  
pp. 12-20
Author(s):  
N. A. Korobkov ◽  
N. N. Volkov ◽  
E. R. Tsoy ◽  
S. М. Mikaelyan
Keyword(s):  
Antibacterial Therapy ◽  
Antibacterial Agents ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
E Coli ◽  
Number Of Patients ◽  
Previously Treated ◽  
New Mother ◽  
Clinically Significant ◽  
Klebsiella Spp

The number of patients with nosocomial post-cesarean endometritis is steadily growing. Aim: to study the etiology of nosocomial post-cesarean endometritis and to propose a rationalized antimicrobial therapy. Material and methods. Sixty six puerperas with post-cesarean endometritis were examined. The spectrum of microflora and its resistance to antimicrobial agents were determined using an automatic microbiological analyzer based on mass spectrometry. Results. Enterococci, E. coli, staphylococci and streptococci were the most clinically significant pathogens found in the examined patients with post-cesarean endometritis. The microflora spectrum in the endometrium reflected the previous «antibacterial history»; this association must be taken into account when developing antibacterial therapy. Conclusion. If the new mother was previously treated with antibacterial agents, it is recommended to use a combination of the reserve antibiotics in order to block the entire spectrum of possible multidrug-resistant pathogens. In cases of the resistant Gram-positive microflora (MRSE, MRSA, E. faecium), it is advisable to prescribe vancomycin. For the resistant Gram-negative microflora (Enterobacter spp., Citrobacter spp., E. coli-ESBL+ and Klebsiella spp.-ESBL+), vancomycin should be combined with carbapenems.

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