Bacterial and fungal pathogens in the transplantation and dialysis center. Analysis for eighteen years (1998-2015)

Abstract

Aim: to analyze the dynamics of the microflora and its sensitivity to antibiotics in patients of dialysis and transplantation center. Materials and methods: We have examined the bacteriological test results of 1282 patients with chronic kidney disease, stage 5 (renal transplant recipients and dialysis patients) in 1998-2015:1998-2003 («2003» period), 2008-2011 («2011» period) and 2012-2015 («2015» period). Biomaterial: urine, blood, wound effluent, sputum. Results: The incidence (share of all samples) of gram «-», gram «+» and fungi was 38, 56, 7% for «2003» period; 48, 69, 13% for «2011» period; 61, 54, 18% for «2015» period. The incidence of gram «-» in blood has significantly increased: 22% in «2003», 13% in «2011», and 45% in «2015», respectively. The incidence of Candida fungi is growing in sputum and urine: 15, 33, 41% and 8, 14, 18% (in 2003, 2011, 2015 respectively). The species composition of the flora has also significantly changed. In «2003» the shares of Staphylococcus spp. and Enterococcus spp. were 50 and 33%, in «2015» - 34 and 53% respectively. The shares of E. coli, Klebsiella spp., P. aeruginosa and Acinetobacter spp. were in «2003» 32, 21, 15, 11% respectively, and in «2015» - 17, 32, 9, 22%, respectively. The share of a «problem» genus of Candida: C. glabrata and C. krusei has significantly increased. Their combined share increased from 26 to 38% (2003-2015). There was a significant increase in antibiotic resistance, which is mostly pronounced in Enterococcus spp., Klebsiella spp. and Acinetobacter spp. All gram «+» bacteria in «2003» were susceptible to vancomycin and linezolid, but in «2015» 6% of Enterococcus were resistant to vancomycin. Conclusion: Bacterial profile has significantly changed. Regular analysis of the bacterial flora is necessary due to the growing antibiotic resistance.