Species composition and antibiotic resistance of the conjunctival microflora of premature newborns during natural delivery

   Relevance. The quality of neonatal care for premature infants is improving, but the incidence of retinopathy of prematurity remains high. The results of treatment with angiogenesis inhibitors depend on the drug and antibacterial prophylaxis. The incidence of endophthalmitis after injections is 0.028 % — 0.029 %. Antibiotic prophylaxis should not be unjustified because of the risk of bacterial resistance. There is little data on the microflora of newborns, especially premature infants, in the scientific literature.

   Objective. To identify the main representatives of the conjunctival cavity microflora and its antibiotic resistance in premature infants born vaginally.

   Materials and methods. The material was collected using the eSwab system. Subsequent identification of microorganisms and determination of sensitivity to antibacterial drugs were carried out using the disk diffusion method, the double disk method, and the D-test. The results were calculated using the ADAGIO analyzer. The results were processed using IBM SPSS Statistics v27.

   Results. The conjunctival material was obtained from 22 premature newborns (44 eyes) born vaginally. The gestational age was 31–35 weeks, and the birth weight was 1385–2150 grams. 33 microbial cultures were isolated: S. epidermidis — 84.8 %; S. aureus — 9.1 %, Kl. pneumoniae — 3.0 %, E. faecalis — 3.0 %. The sterile cultures were 25.0 %. The total microflora had resistance in 42.4 % to aminoglycosides, 36.4 % to fluoroquinolones, 63.6 % to macrolides, 9.1 % to lincosamides and 60.6 % to cephalosporins. The MRS phenotype was detected in 70.97 %. MLS-B phenotype was detected in 9.68 %. Extended spectrum beta-lactamase (ESBL) 3.03 %.

   Conclusions. The most common representative of the microflora is S. epidermidis, which has high resistance to fluoroquinolones, aminoglycosides, macrolides, and cephalosporins.

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