The aim of the study was to evaluate the effectiveness of cefepime/sulbactam in patients with intra-abdominal infection, nosocomial pneumonia (NP) or ventilator-associated pneumonia (VAP) in actual clinical practice. Material and methods. The study was conducted in 14 Russian Clinics from October 2019 to March 2020. Study design: an open-label, prospective, non-comparative, multicenter, observational study. The study included patients who met the inclusion/exclusion criteria and signed a written informed consent. The studied antibiotic: cefepime/sulbactam (Maxictam®-AF). The primary parameter for effectiveness evaluation was the clinical effect after the conclusion of cefepime/sulbactam therapy — recovery/improvement or no effect. Results. The study included 140 patients (average age — 60.8 years) who received at least one dose of cefepime/sulbactam; 37 of them had intraabdominal infection, 72 — NP, and 31 — VAP. Most of the included patients were in the ICU department (82.1%) and their condition was severe: the average APACHE II score was 15.5 points, SOFA — 5.4 points, the Mannheim peritonitis index value in patients with intra-abdominal infection was from 14 to 35 points, with an average of 24.3 points. The majority of patients treated with cefepime/sulbactam (68.6%) had one or more risk factors for multi-resistant pathogens upon hospital or ICU admission. Cefepime/sulbactam was prescribed as the 1st or 2nd line of empirical therapy at a daily dose of 4 g (in 68.3%), 6 g (2.9%) or 8 g (28.8%); most patients were prescribed cefepime/sulbactam in monotherapy (72.3%). The average duration of therapy with cefepime/sulbactam was 9.6±3.5 days. The final assessment of treatment effectiveness was carried out in 132 patients: recovery or improvement was noted in 80.6% of patients with intra-abdominal infection, the effectiveness in NP and VAP was slightly higher — 95.6 and 89.3%. The effect was absent in 5.3% of patients, relapse or superinfection was noted in 3.0 and 1.5%. The majority of patients (81.3%) treated with cefepime/sulbactam were discharged from the hospital. No serious side effects were observed. In patients with a positive effect, age and values of APACHE II were significantly lower (59.58 years and 14.79 points) compared to those with no effect (67.95 years and 18.39 points). A multivariate analysis found that the probability of recovery of patients treated with cefepime/sulbactam did not depend on the diagnosis of infection, ICU admission, the presence of sepsis or septic shock. Conclusion. The multicenter study has established a high clinical efficacy of cefepime/sulbactam in real clinical practice in the treatment of patients with severe intraabdominal infection, nosocomial pneumonia or ventilator-associated pneumonia.

Microbiological monitoring allows epidemiologists and clinical pharmacologists to control hospital-acquired infections and make timely strategic decisions. The purpose — to determine the tendency of prevailing problem microflora and to develop a strategy of empirical antibacterial therapy for severe nosocomial infections and inflammatory processes. Material and methods. The article analyzes the main groups of pathogens of hospital infections in dynamics for the first quarter of 2018, 2019 and 2020. The relation of positive cultures to the total number of investigated samples was taken for the analysis. Antibiotic sensitivity was isolated, identified and determined using conventional mass spectrometry methods. The results. The stable sowing rate of Acinetobacter baumannii and Klebsiella pneumoniae in the intensive care and surgical departments was noted for the analyzed periods. To solve the problem of antibiotic resistance in the inpatient department, a strategy to contain it was developed.

Relevance. Conducting microbiological monitoring allows controlling hospital-acquired infections and making timely strategic decisions for epidemiologists and clinical pharmacologists. Objective of the work is to determine the tendency of prevailing problem microflora and to develop a strategy of empirical antibacterial therapy for severe nosocomial infections and inflammatory processes. Materials and methods. The article analyzes the main groups of pathogens of hospital infections in dynamics for the first quarter of 2018, 2019 and 2020. The relation of positive cultures to the total number of investigated samples was taken for the analysis. Antibiotic sensitivity was isolated, identified and determined using conventional mass spectrometry methods. The results. The stable sowing rate of Acinetobacter baumannii and Klebsiella pneumoniae in the intensive care and surgical departments was noted for the analyzed periods. To solve the issue of antibiotic resistance in the inpatient department, a strategy to contain it has been developed.

Mucormycosis is a rare fungal infection with high morbidity and mortality in immunocompromised patients. Eight cases of mucormycosis were detected in the Kazan Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan: 5 men and 3 women, aged 22 to 70. Given the presence of patient risk factors, such as diabetes mellitus, recent novel coronavirus infection, and systemic glucocorticosteroid therapy, one can assume their influence on the development of mucormycosis in these patients.

The article presents the results of the study of safety of oral anticoagulants (OACs) use in trauma patients.Venous thromboembolic complications (VTEC) after surgery are among the most common indications for prescribing direct oral anticoagulants (OACs) in elderly patients, the treatment of which can cause serious problems and is associated with age-related characteristics of the organism. The purpose — to study the safety of using oral anticoagulants (OACs) use in a trauma hospital. Material and methods. A retrospective analysis was performed of 120 medical records of inpatients receiving oral anticoagulants to prevent blood clots after reconstructive surgery for bone fractures.In the study, 2 groups were considered: group 1 (without violations of hemostasis) — 50 people, aged 54.6 ± 18.0, group 2 (with impaired hemostasis) — 70 people, aged 61.3 ± 21.5. Conclusions. There is a cause-and-effect relationship between a violation of hemostasis indicators (mainly an increase in APTT) and risk factors.