High resistance of pneumococcus to gentamine, cephalexin, oxacillin is noted . In many patients, pneumococcus retains sensitivity to penicillin, erythromycin, linkocomycin, cefazolin, cefotaxime. Hemophilus bacillus maintains minimal resistance to lincomycin, erythromycin, amoxicillin, oxacillin, cefazolin, cefoxime; significant resistance to gentamicin, penicillin. Staphylococcus aureus retains a high resistance to methicillin, penicillin, lincomycin, and carbenicillin. Among gram-negative microorganisms, there is high resistance to gentamicin, penicillin, amoxicillin. There is a high sensitivity to ciprofloxacin, cefoxime. Most gram-negative and gram-positive pathogens were sensitive to meropenem, fortum, cefepime, methicillin.
In the Far Eastern region, in the etiological structure of pathogens of community-acquired pneumonia in elderly patients (not suffering from lymphoproliferative diseases), along with pneumococcus and hemophilus bacilli, aerobic gram-negative bacteria (20%) and golden staphylococcus (8.5%) occupy a special place; Gram-negative microflora is the leading etiological factor in the development of NP (75.5%). The literary flora plays an important role in the occurrence of pneumonia in CLL patients, most of whom are elderly. In accordance with the occurrence of pneumonia in the hospital or outside the hospital, the suspected causative agent, the clinical and pathogenetic situation and the presence of underlying diseases, an empirical treatment algorithm for pneumonia in patients with CLL isin the period until the causative agent is detected and its sensitivity to antibiotics is determined, as well as for those situations when it is impossible to establish the etiological diagnosis of pneumonia It is possible .
In 54 patients with CLL complicated by pneumonia, a fatal outcome was noted. In 30 of them, during the histological study, an inflammatory focus was identified in the sites of lung lymphoid infiltration. Pneumonia, which was of a barbaric nature, was located mainly in the posterior sections of the lungs. In a macroscopic study, one or several lung lobes were enlarged. The tissue of the affected lung was sealed in gray, pink-gray or red. Large areas of airless tissue with hemorrhages were detected. The cut surface was grainy or smooth. In all cases, there was exudative pleurisy. Histological examination of lymphocytic infiltration in the bronchioles and alveolar passages revealed a loose exudate consisting of a serous or hemorrhagic fluid,fibrin and neutrophils. Due to the characteristics of CLL, the number of neutrophils in the exudate was reduced.