Nosocomial infections caused by multidrug-resistant strains increase
morbidity and mortality in hospitalized patients, prolong hospitalization, and they have
significant negative economic impact. Currently, nosocomial infections are included in
a broader concept as healthcare-associated infections. These are caused by a wide
variety of pathogens, typically Staphylococci, Enterococci, Pseudomonas aeruginosa,
Klebsiella spp., Escherichia coli, etc. Certain fungal agents, e.g., yeasts of Candida
genus and aspergilla, are also associated with these infections. The situation is further
complicated by the development of resistance in the gram-positive cocci such as
staphylococci or enterococci to second-line antibiotics used for the treatment of gramnegative
bacteria and resistant gram-positive bacteria. Pathogenesis of mentioned
infections plays a key role in forming biofilms on artificial surfaces.
Rapid detection and identification of etiological agents of nosocomial infections and
determination of antibiotic susceptibility of pathogens are required for the optimal
therapeutic scheme. Chromatographic methods such as high performance liquid
chromatography or liquid chromatography-mass spectrometry are universal techniques
widely applied to this purpose. However, only capillary electrophoretic techniques are
able to determine both, antibiotics and microorganisms, during a single analysis.
Differences in the chemotaxonomic fingerprints of the microorganisms can be utilized
by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. In this
chapter, we would like to outline an overview of available analytical techniques capable
of rapidly identifying and estimating levels of antibiotics as well as microorganisms in
real samples with a focus on nosocomial infections.
Keywords: Antibiotics and antifungals, capillary electrophoretic techniques,
liquid chromatography, MALDI-TOF mass spectrometry, microorganisms,
Nosocomial infections.
