Candida auris—a fungus (yeast) that can cause hospital outbreaks was first recognized in 2009. The authors report data on 38 cases of C. auris bloodstream infections in multidisciplinary hospitals situated in two distantly located regions of Russia, considering predisposing factors, antifungal susceptibility of isolates, treatment, and outcomes. Interhospital transfers of patients and labor migration contributed to the spread of C. auris. The South Asian lineage of the studied strains was indicated by K143R substitution in ERG11 gene and phylogenetic analysis of internal transcribed spacer and D1-D2 domain. All isolates from C. auris candidemia cases were susceptible to echinocandins. High-level resistance to fluconazole and resistance to amphotericin B were present in the majority of strains. The overall all-cause mortality rate in C. auris bloodstream infections was 55.3% and the 30-day all-cause mortality rate 39.5%. The attributable mortality was 0%. Eradication of C. auris from blood was associated with the favourable outcomes in patients. It was achieved irrespective of whether antifungal preparations within or outside the susceptibility range were administered. Further international surveillance and studies providing consensus guidelines for the management of C. auris infections are needed.

Klebsiella pneumoniae microorganisms belong to a group of the most prevalent clinically significant pathogens with a high level of antibacterial resistance (ESKAPE). The speed of formation of antibiotics-resistance by K. pneumoniae strains has sharply increased and reached pandemic scale. One of the main clinically significant mechanisms of antimicrobial resistance is (3-lactamase production, the groups being active depending on the region, country' and hospital. Currently, a significant part of nosocomial K. pneumoniae is resistant to penicillins, 11I-IV generation cephalosporins. The growth of resistance of klebsiellae to carbapenems is a serious threat to the healthcare system. First ofall, KPC-, OXA-, NDM-, VIM-, IMP-producing Widespread of carbapenem-resistant klebsiellae gives evidence on the necessity of international collaboration within the framework of antibiotics resistance control. An increase of frequency of obtained resistance of K. pneumoniae to non-(3-lactame antibiotics (fluoroquinolones, aminoglycosides) is noted. Isolates of K. pneumoniae resistant to tygecyclin, colistin are registered. In general, the problem of antibiotics resistance of causative agents of human diseases including K. pneumoniae continues to intensify. This is a serious threat to world public health that requires action in all sectors of the state.

The aim of the work was to establish the significance of complex bacteriological research in the diagnostics of acute appendicitis and to determine an optimal material for the research based on the findings. We examined 19patients with acute phlegmonous or acute gangrenous appendicitis (males, aged 18–60years). We performed bacteriological research of abdominal exudate (n=19) and biopsy specimen (n=19) of appendix wall taken before opening the lumen of the intestine. Both abdominal exudate and appendix wall specimen were taken at the same time. Aerobic and anaerobic microorganisms were detected and identified, antimicrobial susceptibility was tested. In total, we detected 25 strains of aerobic and 13 strains of anaerobic microorganisms. It has been established that a bioptate was most informative for testing (68.4 %); the parallel study of an abdominal exudate gave positive results in 21.1 % of cases. In the structure of clinically significant microflora dominated E.coli (43.3%), then went nonfermentative gram-negative bacteria (13.3%) and Bacteroidesspp. (16.7%). We marked growing resistance of detected strains of gram-negative bacteria to some antibiotics. For instance, 62 % of detected E.c oli strains were resistant to ampicillin, 25 % – to ciprofloxacin. 92 % of strains were resistant to cefepime, 93 % – to ceftriaxone, 77 % – to Amoxiclav, 67 % – to gentamicin, 90 % – to tobramycin. From one bioptate a strain of E. coli ESBL was separated. The study of intraoperative bioptate of appendix wall increases effectiveness of microbiological diagnostics in com-parison with the abdominal exudate research.

Objective: to determine antimicrobial resistance of Enterococcus faecium and Enterococcus faecalis isolated from blood culture of hematological patients during different study periods.Materials and methods. Antimicrobial susceptibility of Enterococcus spp., collected as part of the multicenter study was tested by the broth microdilution method (USA Clinical and Laboratory Standards Institute (CLSI), 2018), to daptomycin by Etest (bioMeriéux, France). High-level gentamicin resistance (HLGR) and high-level streptomycin resistance (HLSR) was performed by the agar dilution method (CLSI (Oxoid, UK), 2018).Results. The susceptibility of 366 E. faecium (157 in 2002-2009 and 209 in 2010-2017) and 86 E. faecalis (44 in 20022009 and 42 in 2010-2017) was studied. In the second study period (2010-2017) the rise of vancomycin-resistant E. faecium (VREF) increased from 8.3 % to 23.4 % (p = 0.0001), and two linezolid-resistant (LREF) were identified. All VREF and LREF remained susceptible to daptomycin and tigecycline. The rate of susceptible to tetracycline E. faecium remained the same (73.9 and 74.6 %), and an increase in susceptibility to chloramphenicol (74.5 and 82.3 %) was observed. Susceptibility of E. faecium to tetracycline was detected with almost the same rate and in a part of isolates, the increase of susceptibility to chloramphenicol was registered during the analyzed periods. The rise of E. faecium susceptible to HLGR and HLSR has increased significantly in 2010-2017 compared to 2002-2009. Erythromycin, levofloxacin, ampicillin and penicillin had the least activity against E. faecium (less than 5 %).All E. faecalis were susceptible to tigecycline, linezolid, and teicoplanin. Only one of E. faecalis had intermediate resistance to vancomycin. High susceptibility to ampicillin in E. faecalis remained unchanged (97.7 and 97.6 %, respectively). In the second period of the study the rise of susceptible E. faecalis decreased significantly to penicillin (from 97.7 % to 76.2 %), to levofloxacin (from 59.1 % to 31 %), to HLSR (from 52.3 % до 31 %), and to HLGR (from 47.7 % to 26.2 %), remained unchanged to chloramphenicol (52.3 % and 50 %) and was minimal to erythromycin and tetracycline.Conclusion. The study demonstrated higher rates of antibiotic resistance among E. faecium, which consisted of an increase in VREF and the appearance of linezolid-resistant strains. High susceptibility to ampicillin remained in E. faecalis, but there was an increase in resistance to penicillin and aminoglycosides.