Antibiotic resistance is a global problem that threatens the treatment of many infectious diseases. Regional studies and monitoring of antibiotic resistance are of great importance for effective antibiotic therapy.
OBJECTIVE
To study the species composition and antimicrobial susceptibility phenotypes of the upper respiratory tract (URT) microbiota in children with COVID-19 hospitalized in Ryazan.
MATERIALS AND METHODS
Retrospective laboratory monitoring of the URT microbiota and antimicrobial susceptibility testing was conducted in 164 children with COVID-19 aged 2 months to 17 years who were treated in a specialized hospital in Ryazan in 2020—2021.
RESULTS
The predominant microorganisms colonizing the URT mucosa in children with COVID-19 were Streptococcus pneumoniae (38.7%) and Staphylococcus aureus (32.9%). Resistance determinants were detected in 45.6% of S. aureus strains and in 80.6% of S. pneumoniae isolates. The main mechanisms of S. pneumoniae antibiotic resistance were mutations in the penicillin-binding protein gene (66.7%) and the M-phenotype (9.3%). In S. aureus isolates, the production of class A2a plasmid penicillinases was determined both in isolation (74%) and in combination with MLSb phenotype (18.6%) and M-phenotype (7.4%). For S. pneumoniae, activity of aminopenicillins (75.8%), inhibitor-protected penicillins (75.8%), rifampicin (100%), clindamycin (94%), and sulfamethoxazole+trimethoprim (86.4%) was demonstrated, and for S. aureus, active were inhibitor-protected penicillins (100%), most cephalosporins (100%), macrolides (81%), clindamycin (88.3%), rifampicin, and sulfamethoxazole+trimethoprim (98% each).
CONCLUSION
In children with COVID-19, the species structure of the upper respiratory tract microbiota was dominated by gram-positive microorganisms (75.7%), mostly belonging to the genera Streptococcus (42.2%) and Staphylococcus (32.9%). In 47.4% of dominant microorganisms, determinants of antibiotic resistance were detected. Observed susceptibility phenotypes allow the use of β-lactam antibiotics for empirical therapy of bacterial co-infections in COVID-19 in children, not excluding the utility of a personalized approach.
