Fomina M.V., Mikhailova E.A., Kuznetsova N.P., Morozovа A.I., Kirgizova S.B., Aznabaeva L.M., Zherebyatyeva O.О., Safarova D.R.
MEDICAL-ECOLOGICAL ASPECTS OF RESISTANCE MICROFLORA IN CHILDREN WITH ACUTE INFLAMMATORY DISEASES OF THE UPPER RESPIRATORY TRACT ^{[№ 12 ' 2017]}
Inflammatory diseases of the upper respiratory tract bacterial nature of the disease, which most often otolaryngologists in modern conditions are becoming increasingly epidemiological, economic and social significance. The trend in recent years has been the changing epidemiology of causative agents of this disease, the properties of the pathogens, resistance to drugs. Along with this, there are regional differences of indicators of resistance of microorganisms, which complicates the selection of antimicrobial agents in starting empirical therapy of acute rhinosinusitis in children. A monitoring study of the species composition of microflora of nasal cavity showed that, along with the leading (80.3 %) etiologically significant representatives of pathogenic flora — gram-positive cocci (mainly Staphylococcus аureus and Staphylococcus haemolyticus), the microflora was represented by gram-negative rods bacteria of the genus Klebsiella (Klebsiella pneumonicae) — 1.6 %. Among non-fermenting gram-negative bacteria in 0.8 % of cases were allocated to members of the genus Pseudomonas. According to the study, the selected isolates of Staphylococcus haemolyticus were not sensitive to ampicillin/sulbactam in 75 % of cases, ceftazidime — 73.3 %, the highest activity possessed antimicrobial agents ceftriaxone (87.5 %) and azithromycin (89.1 % of cases). In turn, Staphylococcus аureus in 54.5 % of cases were sensitive to ceftazidime, 45.4 % to oxacillin. Observed high sensitivity of the pathogen to erythromycin (100 %), gentamycin (100 %), ofloxacin and ceftriaxone — 90.9 % of cases. The results obtained, taking into account regional differences in the indicators of resistance of microorganisms and their sensitivity to antibiotics, can be used in starting the empirical therapy of acute rhinosinusitis in children.