The treatment of nosocomial pneumonia, caused by P. аeruginosa, in patients with hematologic malignancies is quite complicated and requires the data on local sensitivity of the microorganisms to antibacterial agents. In our study the frequency and antibiotic resistance of P. аeruginosa in patients with nosocomial pneumonia and concomitant severe disorders of the immune system due to the hematologic malignancies had been determined to develop rational strategies and tactics of empirical antimicrobial therapy. We have evaluated 209 patients with hospital-acquired pneumonia admitted to the Community Institution “Dnipropetrovsk City Clinical Hospital N 4” in 2011–2013. The diagnosis of hematologic malignancies and pneumonia had been established in accordance with approved morphological criteria. Microbiological examination of sputum and bronchoalveolar lavage fluid was performed by studying native smears with determination of the main morphological types and by using dense differential nutrient media. Determination of sensitivity of the selected bacterial isolates to antimicrobial agents was performed using disco-diffusion method in compliance with modern standards. It was determined, that gram-negative strains of P. aeruginosа were identified almost in one-third of the patients with hospital-acquired pneumonia and concomitant hematologic malignancies. The different sensitivity of P. aeruginosa, demonstrates the urgent need for a differentiated prescription of antibiotics. The principles of empirical antimicrobial therapy should take into account the data on a high local sensitivity of P. aeruginosa to colistin, amikacin, meropenem, and cefipime, while selecting the optimal treatment of nosocomial pneumonia in patients with impaired immunity due to hematologic malignancies.
