Русский
Monitoring the pathogens (Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Stenotrophomonas maltophilia) of healthcare-associated infections in a hospital
DOI: https://dx.doi.org/10.18565/epidem.2019.9.2.68-74
Markelova N.N., Semenov E.F., Tutelyan A.V.
1) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 2) Russian Research Center of Roentgenoradiology, Ministry of Health of Russia, Moscow, Russia; 3) Penza State University, Penza, Russia; 4) I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia; 5) Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia, Moscow, Russia
Materials and methods. A total of 633 gram-negative bacterial isolates were studied. The bacteria were identified using biochemical tests and mass spectrometry; antibiotic resistance genes were determined by a polymerase chain reaction assay; antibiotic susceptibility was defined by diffusion methods.
Results. The leading pathogens P. aeruginosa (n = 193), K. pneumoniae (n = 180), A. baumannii (n = 177), and S. maltophilia (n = 83) were identified in the bacterial profile of hospital. They showed a 2.8-fold preponderance in the intensive care units versus surgical units; the studied biomaterial displayed a predominance of monocultures in 79.1% of cases; there was an uneven distribution of the pathogens in seasonal dynamics, their varying incidence according to gender, and non-specific colonization of patients (p < 0.05). Stable morphological types of antibiotic-resistant isolates were detected in A. baumannii (19.8%) and P. aeruginosa (19.7%).
Conclusion. Local monitoring the leading pathogens of healthcare-associated infections makes it possible to obtain reliable data on their colonization of inpatients, on the characteristics of their distribution in seasonal and annual dynamics, and increased antibiotic resistance, which contributes to their timely consideration in a package of preventive and anti-epidemic measures implemented in a healthcare facility and promotes the maintenance of the efficiency of its used antimicrobial agents.
Literature
1. Mehrad B., Clark N.M., Zhanel G.G., Lynch J.P. Antimicrobial resistance in hospital-acquired gram-negative bacterial infections. Chest 2015; 147(5): 1413–21. 2. Cerceo E., Deitelzweig S.B., Sherman B.M., Amin A.N. Multidrug-resistant gram-negative bacterial infections in the hospital setting: overview, implications for clinical practice, and emerging treatment options. Microbial. Drug. Resistance 2016; 22(5): 412–31. 3. Brooke J.S., Di Bonaventura G., Berg G., Martinez J. L. A multidisciplinary look at Stenotrophomonas maltophilia: An emerging multi-drug-resistant global opportunistic pathogen. Frontiers in Microbiology 2017; (8): 1511–21. 4. Kaye K.S., Pogue J.M. Infections caused by resistant gram negative bacteria: epidemiology and management. J. Human Pharmacology and Drug Therapy 2015; 35(10): 949–62. 5. Трухачева Н.В. Математическая статистика в медико-биологических исследованиях с применением пакета Statistica. М.: ГЭОТАР-Медиа, 2013. 379 с.Truhachyova N.V. [Mathematical statistics in biomedical research with the use of Statistica]. Moscow: GEOTAR-Media, 2013. 379 p. (In Russ.). 6. Pitout J.D., Nordmann P., Poirel L. Carbapenemase-producing Klebsiella pneumoniae: a key pathogen set for global nosocomial dominance. Antimicrobial Agents and Chemotherapy 2015; 59(10): 5873–84. 7. Sader H.S., Farrell D.J., Flamm R.K., Jones R.N. Antimicrobial susceptibility of Gram-negative organisms isolated from patients hospitalised with pneumonia in US and European hospitals: results from the SENTRY Antimicrobial Surveillance Program, 2009–2012. Int. J. Antimicrob. Agents 2014; 43(4): 328–34. 8. Adler A., Friedman N.D., Marchaim D. Multidrug-resistant gram-negative bacilli: infection control implications. Infect. Dis. Clin. 2016; 30(4): 967–97. 9. Gonzalez-Villoria A.M., Valverde-Garduno V. Antibiotic-resistant Acinetobacter baumannii increasing success remains a challenge as a nosocomial pathogen. J. Pathog. 2016; 2016(7318075): 1–10.
About the Autors
Natalia N. Markelova, Cand. Biol. Sci., Senior Researcher, Laboratory of Healthcare-associated Infections, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Bacteriologist, Clinical Diagnostic Laboratory, Russian Scientific Center of Roentgenoradiology, Ministry of Health of Russia, Moscow, Russia; e-mail: nataljamarkelova@yandex.ru
Elena F. Semenova, Cand. Biol. Sci., Senior Researcher, Professor, Department of General and Clinical Pharmacolog, Medical Institute, Penza State University, Penza, Russia; е-mail: sef1957@mail.ru
Prof. Alexey V. Tutelyan, MD, Corresponding Member of the Russian Academy of Sciences; Head, Laboratory of Healthcare-associated Infections, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Professor, Department of Epidemiology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; Head, Department of Molecular Immunology, Infectology and Pharmacotherapy Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia, Moscow, Russia; е-mail: bio-tav@yandex.ru; ORCID: http://orcid.org/0000-0002-2706-6689
Similar Articles
