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A retrospective analysis of the medical data of 12 patients with COVID-19 was performed. For the diagnosis of invasive aspergillosis the international criteria ECMM/ISHAM 2020 were used. We analyzed the scientific literature data on the diagnosis and treatment of invasive aspergillosis in patients with COVID-19.Results. Among the 12 examined patients with a severe course of COVID-19, invasive aspergillosis was diagnosed in 5 patients. Four patients (80%) were treated in the ICU. Steroids or interleukin-6 inhibitors were used in 80% patients. Severe lymphocytopenia was in 80% patients, neutropenia 20%. A fever refractory to antibiotic therapy was noted in 80% patients, an increase in respiratory failure – 60%, acute respiratory distress syndrome – 60%. All patients showed negative dynamics of changes in the chest CT scan. Invasive aspergillosis was confirmed with a positive test for galactomannan in bronchoalveolar lavage and / or serum in 100% of cases. All patients received antifungal therapy with voriconazole and/or caspofungin. The overall 12-week survival rate was 80%.Conclusion. In ICU patients with severe COVID-19 and progressive pulmonary symptoms invasive aspergillosis should be excluded. Examination of substrates from the lower respiratory tract (BAL, tracheal aspirate, or nonbronchoscopic lavage) is necessary. Laboratory examination should include microscopy, culture and test for galactomannan. Voriconazole and isavuconazole are drugs of choice for the treatment of invasive aspergillosis in patients with COVID-19.

Relevance. Staphylococci are one of the most common pathogens in the etiological structure of nosocomial infections. Methicillinresistant staphylococci are resistant to the main groups of antibiotics and are one of bacteria that pose the greatest threat to human health according to the World Health Organization. The introduction of modern molecular biological methods in the monitoring of methicillin-resistant staphylococci is necessary for the rapid and accurate identification of microorganisms, monitoring the epidemiological situation and studying the need for anti-epidemic measures. Aims. Аnalysis of the results of monitoring methicillinresistant staphylococcus strains using molecular biological methods in a multidisciplinary hospital in Moscow for one year. Materials and methods. Single-center observational study with a one-year follow-up period (December 2016 to December 2017). The research included a molecular-biological analysis of biological material from 240 patients with signs of infection and washings samples (n=250) from the objects of the hospital environment. The whole genome sequencing was carried out for 24 samples, isolated from patients with different forms of staphylococcal infection and washings from a hospital environment. DNA detection of methicillin-resistant strains was performed using the «AmpliSens®MRSA-screen-titer-FL» reagent kit. Sequencing was performed on an Illumina HiSeq1500 instrument using the IlluminaHiSeq PE RapidClusterKit v2 and IlluminaHiSeqRapid SBS Kit v2. Results. DNA of methicillin-resistant staphylococci were detected in 6.3% of blood samples from patients with signs of infection and in 42.4% of washings from the objects of the hospital environment. The results of PCR of washing samples showed that DNA of methicillin-resistant coagulase-negative staphylococci were detected much more often than MRSA (p DNA of methicillin-resistant staphylococci were detected more often in the intensive care and intensive care units compared with the hematology and surgical departments (p The examine samples of Staphylococcus aureus belonged to 6 different sequence types (ST-5, ST-7, ST-8, ST-22, ST-30 and ST-5555) and 8 spatypes (t008, t021, t091, t1062, t12437, t1544, t223, t4573). As a result of monitoring, an isolate with a new allelic profile was found. Today it has been assigned the number ST5555. The predominant type of staphylococcal mec cassette was the type IV SCCmec cassette. Conclusion. Due to the widespread distribution of methicillin-resistant strains and the identification of epidemiologically significant genetic lines of staphylococci, it is necessary to conduct regular monitoring, take measures to limit the spread of such strains and introduce modern molecular biological methods for quick and accurate identification.

AIM: to reduce antibiotic resistance of infectious agents in colorectal surgery using optimal antibiotic therapy. PATIENTS AND METHODS: single-center interventional study with retrospective control has been done. Start point of intervention was January 2017, when it was provided direct administrative control of perioperative antibiotic prophylaxis protocols and empirical antibiotic therapy. The study included 200 patients after colorectal surgery in 2016-2017. Patients divided in two groups: in 2016 y – control (A), in 2017 – interventional one (B). RESULTS: significant decrease was detected in total antibiotic use from 16.1 to 12.2 defined daily dose (DDD) and in duration of antibiotic prophylaxis from 5.5 to 1.9 days (p

The purpose of the study is to assess the possibility of managing the antibiotic resistance level and consumption of antimicrobial agents in a hospital based on the analysis of the drug resistance index. Material and methods. The antibiotic consumption planning system was employed at the multidisciplinary surgical hospital based on the unified Registry of microorganisms (ROM). ROM included data on 25.581 strains obtained from patients with infections admitted to the intensive care units (ICU) and specialized departments. Protocols of empiric antimicrobial therapy and perioperative antibiotic prevention were developed. The ROMbased system allowed automated calculation of drug resistance indices for nosocomial microor ganisms. Data obtained during the preintervention period (2012) and intervention period, (2014—2015) were compared. Results. Decreases in the drug resistance indices for Pseudomonas aeruginosa from 0.721 in 2012 to 0.596 in 2015, Acinetobacter baumannii from 0.96 in 2012 to 0.889 in 2015, Klebsiella pneumoniae from 0.728 in 2012 to 0.595 in 2015 were achieved due to reduction of antimicrobial resistance, reduced consumption of III—IV generation cephalosporins and antipseudomonal carbapenems, and more frequent use of ertapenem for treatment of infections caused by Klebsiella pneumoniae. There was an increase in the drug resistance index of Escherichia coli from 0.325 in 2012 to 0.382 in 2015 due to increased consumption of protected penicillins and first generation cephalosporins for prevention in abdominal surgery and urology and increased pathogen resistance to these antibiotics. Conclusion. A development of a unified hospital ROM and application of the drug resistance index for math ematical modeling of the pathogens resistance level allows to perform timely monitoring of changes in antibiotic resistance of nosocomial microorganisms in ICU setting and other hospital departments and proper managinge the antibiotics prescription.