Abstract:
The relevance of this study lies in examining the dominant opportunistic microbiota among critically ill children
in the Pediatric Intensive Care Unit (PICU) of a tertiary care hospital during wartime in Ukraine. This is crucial for
understanding the impact of antimicrobial resistance on the treatment of infections. The aim of the study was to
identify the spectrum of dominant opportunistic microorganisms in patients admitted to the Pediatric Intensive Care
Unit, which operated from a shelter facility during 2023, and to assess the antibiotic susceptibility of leading pathogens. Microbiological analysis was conducted on biological material obtained from 25 critically ill children diagnosed
with various conditions, including acute bronchitis, pneumonia, acute hematogenous osteomyelitis, closed traumatic brain injury, mechanical asphyxia, severe carbon monoxide poisoning, polytrauma, and epilepsy. Samples were
collected on the day of admission to the Pediatric Intensive Care Unit and subsequently every three days until discharge or transfer. Key findings revealed that the dominant pathogens included Staphylococcus aureus (25%), Candida albicans (24.1%), Enterobacter aerogenes (17.6%), Pseudomonas aeruginosa (16.7%), and Klebsiella pneumoniae
(6.9%). These microorganisms exhibited high levels of antibiotic resistance, complicating infection treatment. Clinical
isolates of Enterobacter aerogenes and Enterobacter cloacae showed resistance to meropenem (97.4%), while Klebsiella oxytoca and K. pneumoniae were resistant to commonly used antibiotics. Analysis of S. aureus susceptibility
indicated 100% sensitivity to linezolid, but high resistance to amoxicillin and trimethoprim (74%). The study highlights the urgent need for rational antibiotic use, careful selection and combination of existing drugs for improved
therapeutic outcomes, and enhanced strategies for infection control and prevention to ensure effective treatment of
infections in critically ill pediatric patients.
