Dynamics of Antibiotic Resistance in Maxillofacial Surgery in Vitebsk Region in 2020–2024

The aim of the study was to analyze the dynamics of antibiotic resistance among major pathogens causing maxillofacial infections from 2020 to 2024.

Materials and methods. The study was based on the analysis of microbiological cultures from patients treated in the Dental Purulent-Surgical Unit at Vitebsk Regional Clinical Hospital between 2020 and 2024. Antibiotic susceptibility was determined using broth microdilution and disk diffusion methods, as well as the Biomérieux ATB Expression and BD Phoenix test systems. To evaluate the efficacy of antibacterial agents, the minimum inhibitory concentration (MIC₉₀) of antibiotics was compared between planktonic bacteria and those within biofilms (BF).

Results. K. pneumoniae exhibited a critical increase in resistance to carbapenems, reaching 50% in 2022, which alters approaches to empirical therapy with β-lactam antibiotics. The following changes were observed among Gram-positive pathogens: S. aureus showed a marked increase in resistance to amikacin and erythromycin. Coagulase-negative staphylococci showed an increase in the proportion of methicillin-resistant strains to 43.64% by 2024. An increase in resistance to third-generation cephalosporins was observed among α-hemolytic streptococci (cefotaxime: 31.58% in 2024). Vancomycin and linezolid remained fully active (100%) against all Gram-positive pathogens tested. Biofilm formation significantly increases antibiotic resistance, with MIC₉₀ values 4to 128-fold higher than those for planktonic bacteria.

Conclusion. These findings indicate the need to reconsider empirical therapy, favoring antibiotic combinations with anti-biofilm properties, and to enhance microbiological surveillance.

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