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ANTIBIOTIC RESISTANCE – A 21ST CENTURY THREAT
Nosirova M.M., Uspanova D.N., Reyimberganova M.M.
Students of Group 201-B, Faculty of General Medicine, Tashkent State Dental Institute
Scientific Supervisor: Kurbanova S.Y., Associate Professor, Department of Microbiology
Tashkent State Dental Institute, Uzbekistan
Keywords: microorganisms, antibiotics, antibiotic susceptibility, microbiology, bacteria.
RELEVANCE
The discovery of penicillin by Alexander Fleming in 1928 and its subsequent isolation
by Howard Florey and Ernst Chain in 1945 marked the beginning of a new era in the treatment
of infectious diseases—antibacterial therapy. However, to date, more than 20–40% of
antibacterial drugs are prescribed without adherence to the principles of rational antibiotic
therapy. These principles include strict indications for drug administration, appropriate dosing
and duration of treatment, and consideration of drug compatibility, among others.Globally,
more than 700,000 deaths per year are attributed to infectious diseases, primarily caused by
antibiotic-resistant bacterial strains. Respiratory tract infections have become among the most
frequently encountered diseases, including within the structure of hospital-acquired infections.
OBJECTIVE:
The aim of this study was to assess the prevalence and antibiotic resistance of the most
common microbial strains isolated from respiratory tract samples (nasopharyngeal swabs and
sputum) of patients with respiratory infections.
MATERIALS AND METHODS
A total of 225 microbial strains were analyzed, obtained from 69 patients (both male and
female) aged 18 to 65 years, diagnosed with respiratory diseases such as bronchitis,
pharyngitis, and tracheitis. The study focused on respiratory tract secretions, including phlegm
and nasopharyngeal swabs.
Laboratory Analysis:
The laboratory investigations were conducted at the Department of
Microbiology and Pharmacology in the “Microbiology and Immunology” laboratory of the
Research Center for Maxillofacial Surgery. The analysis included microbial isolation,
identification, and assessment of antibiotic susceptibility.
RESULTS AND DISCUSSION
A significant species diversity of detected pathogens was established, with a total of 13
identified species. Throughout the study period, infections caused by a single pathogen were
observed in 33.2% of cases, while the remaining cases were mixed infections (bacterial and
viral co-infections). The most frequently isolated pathogens were Klebsiella pneumoniae
(10.3%), Staphylococcus aureus (6.3%), and Proteus mirabilis (1.4%). The prevalence of
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Pseudomonas aeruginosa (5.5%), Staphylococcus haemolyticus (1.6%), and Enterococcus
faecalis (1.5%) was also noted.
Staphylococcus aureus is a group of Gram-positive, immobile microorganisms that do
not form spores or capsules. Methicillin-resistant Staphylococcus aureus (MRSA) strains,
which are resistant to all β-lactam antibiotics, also exhibit associated resistance to
fluoroquinolones, macrolides, aminoglycosides, lincosamides, and tetracyclines. The analysis
of isolated S. aureus strains revealed an increase in resistance to amikacin by 29.1%,
cefuroxime by 35.0%, levofloxacin by 17.5%, oxacillin by 27.8%, and erythromycin by 6.4%.
A decrease in resistance was observed for amoxicillin/clavulanic acid (by 6.9%) and
trimethoprim-sulfamethoxazole (by 12.2%).
The analysis of Klebsiella pneumoniae susceptibility to antibiotics demonstrated
resistance to amikacin in 12% of cases, meropenem in 27.3%, imipenem in 24.6%, ceftazidime
in 35.3%, amoxicillin/clavulanic acid in 21%, tigecycline in 100%, and levofloxacin in 19.2%.
Simultaneously, a reduction in resistance was observed for ampicillin (by 11.5%),
trimethoprim-sulfamethoxazole (by 0.2%), and ciprofloxacin (by 18.5%).
In patients with isolated Proteus mirabilis, resistance was recorded for amikacin (16.8%),
meropenem (2.7%), imipenem (1.5%), amoxicillin/clavulanic acid (20.6%), levofloxacin
(4.6%), ciprofloxacin (39.6%), ampicillin (15.2%), ceftazidime (12.8%), and trimethoprim-
sulfamethoxazole (10.0%).
The Gram-negative bacterium Pseudomonas aeruginosa is an obligate aerobe known for
its high resistance to multiple antimicrobial agents. Analysis of the obtained data indicated an
increase in resistance of these strains to amikacin by 52.5% (from 43.1% to 95.6%), imipenem
by 82.6% (from 9.7% to 92.3%), amoxicillin/clavulanic acid to 100%, meropenem by 71.5%
(from 23.6% to 95.1%), ertapenem to 100%, and cefotaxime by 76.4% (from 13.6% to 90.2%).
CONCLUSION
Given the global spread of resistance determinants to clinically significant antibiotics, it
is essential to integrate Klebsiella pneumoniae and Staphylococcus aureus into antibiotic
resistance surveillance systems at all levels as key indicators of overall population resistance.
In accordance with modern strategies for rational antibiotic therapy, continuous
monitoring of antimicrobial resistance, identification of resistant strains, and the widespread
implementation of accelerated laboratory diagnostics for bacterial resistance markers remain
crucial. Furthermore, to enhance the effectiveness of treatment in patients with chronic
respiratory infections, the integration of alternative therapeutic approaches—such as
physiotherapy, phytotherapy, and bacteriophage therapy—should be actively promoted in
clinical practice.
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