Analysis of the spectrum of microflora and antibiotic resistance of the main pathogens in the pathology of ENT organs

Relevance. Among all purulent-inflammatory diseases, pathology of the upper respiratory tract and ear accounts for up to 15% of patients. Microorganisms play the greatest role in the occurrence of diseases of these organs. However, in recent years, the prevalence of antibiotic-resistant bacterial strains has increased sharply, which is one of the important public health problems of the 21st century according to WHO. Goal. To study and analyze the spectrum of various microorganisms in purulent-inflammatory diseases of ENT organs and to assess their antibiotic resistance to the most commonly used groups of drugs. Methods. Study of scientific, special and public literature; analysis of microbiological monitoring of the main biomaterial (ear discharge; upper respiratory tract discharge) of the ENT-1 department BUZ VO VOKB No. 1 for the period 2014-2019. Results. During the time period from 2014 to 2019, with purulent-inflammatory ear diseases, the following dynamics of the microflora spectrum is observed: the leading position is occupied by the Pseudomonas aeruginosa (an increase from 12.24% to 33.89%), the share of diseases caused by Staphylococcus aureus decreases (from 32 , 65% to 10.17%), the dynamics of saprophytic staphylococcus fluctuates slightly (from 18.37% to 18.64%). In case of purulent-inflammatory diseases of the upper respiratory tract, the following can be noted: Staphylococcus aureus retains 1 position, but the percentage of diseases caused by this pathogen decreases from 41.94% to 20.96%. Streptococcus viridans and Staphуlococcus saprophyticus, which until 2016 were at 2 and 3 positions, respectively, however, in 2019 Staphуlococcus epidermidis decreases (from 10.81% to 9.97%), while Klebsiella increases (from 9.80% to 10, 99%), although diseases associated with the pathogen - Klebsiella are relatively stable.Investigating the level of resistance of the leading flora to antibacterial drugs, it turned out that the highest resistance of Staphуlococcus aureus is observed to ampicillin (35-42%); Streptococcus viridans - to oxacillin (17-23%); Staphylococcus saprophyticus - to erythromycin (47-49%); Pseudomonas aeruginosa - to ceftazidime (6-15%); Staphуlococcus epidermidis - to ampicillin (27-50%); Klebsiella pneumoniae - to fosfomycin (20%). Therefore, treatment with the listed drugs in relation to these pathogens will be the least effective. Conclusion. Assessment of the antibiotic resistance of microflora at the present stage will allow the otorhinolaryngologist to choose the most appropriate antibacterial drugs. Monitoring the dynamics of the spectrum of microflora in inflammatory diseases caused by certain bacteria will make it possible to correctly predict the effectiveness of the treatment, reduce the number of complications in purulent-inflammatory diseases of the upper respiratory tract and ear, and reduce the transition of an acute inflammatory process into a chronic one.