Etiology and resistance to antimicrobial agents of healthcare-associated pathogens as well as intrauterine infections in puerperas and newborns


DOI: https://dx.doi.org/10.18565/epidem.2023.13.3.88-93

Orlova O.A., Abramov Yu.E., Tutelyan A.V.

1) N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia, Moscow, Russia; 2) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 3) N.F. Gamaleya National Research Center for Epidemiology and Microbiology, Ministry of Health of Russia, Moscow, Russia; 4) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia
Objective. Identification of the leading etiologically significant healthcare-associated pathogens (HAI) in puerperal women and newborns and intrauterine infections (IUI) in newborns and assessment of their antimicrobial resistance.
Materials and methods. A retrospective epidemiological analysis of data on the etiology and resistance of HAI pathogens in puerperas and newborns and IUI to antibacterial drugs and disinfectants for 2018–2021 was carried out.
Results. Gram-positive microorganisms (Staphylococcus and Enterococcus) were identified as the leading etiological agents of HAIs in puerperas and newborns and IUI, but an increase in the proportion of E. coli was noted. In general, HAI and IUI pathogens were characterized by high sensitivity to antimicrobial drugs. Resistant microorganisms were isolated in less than 5% of cases.
Conclusion. It is necessary to improve microbiological monitoring in the system of epidemiological surveillance for HAI and IUI.

Literature


1. Айламазян Э.К. (ред.). Акушерство: учебник. 9-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2015. 704 с.


Aylamazyan E.K. (ed.). (Obstetrics: textbook). 9th ed., reprint. and add. Moscow: GEOTAR-Media, 2015. 704 p. (In Russ.).


2. Heine R.P., Puopolo K.M., Beigi R., Silverman N.S., El-Sayed Y.Y. Committee Opinion №. 712: Intrapartum Management of Intraamniotic Infection. Obstet. Gynecol. 2017; 130(2): e95-e101. DOI: 10.1097/AOG.0000000000002236


3. Rwabizi D., Rulisa S., Findlater A., Small M. Maternal near miss and mortality due to postpartum infection: a crosssectional analysis from Rwanda. BMC Pregnancy Childbirth. 2016; 16(1): 177. DOI: 10.1186/s12884–016–0951–7


4. Global Maternal and Neonatal Sepsis Initiative Working Group. Electronic address: bonetm@who.int. The Global Maternal and Neonatal Sepsis Initiative: a call for collaboration and action by 2030. Lancet Glob Health. 2017; 5(4): e390–e391. DOI: 10.1016/S2214-109X(17)30020-7


5. Black R.E., Laxminarayan R., Temmerman M., Walker N. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Vol. 2). Washington (DC): The International Bank for Reconstruction and Development. The World Bank; 2016. Chapter 3. DOI: 10.1596/978-1-4648-0348-2


6. Демографический ежегодник России 2021. Статистический сборник. М.: Росстат, 2021. 256 c.


(Demographic Yearbook of Russia 2021. Statistical collection). Moscow: Rosstat. 2021. 256 p. (In Russ.).


7. Celebi S., Hacimustafaoglu M., Ozdemir O., Ozakin C. Nosocomial Gram-positive bacterial infections in children: results of a 7-year study. Pediatr. Int. 2007; 49: 875–82. DOI: 10.1111/j.1442-200X.2007.02485.x


8. Sadowska-Krawczenko I., Jankowska A., Kurylak A. Healthcare-associated infections in a neonatal intensive care unit. Arch. Med. Sci. 2012; (8): 854–. DOI: 10.5114/aoms.2012.31412


9. Fleischmann-Struzek C., Goldfarb D.M., Schlattmann P., Schlapbach L.J., Reinhart K., Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respiratory medicine 2018; 6(3): 223–30. DOI: 10.1016/S2213-2600(18)30063-8


10. Савельев В.С., Гельфанд Б.Р. (ред.). Сепсис в начале ХXI века. Классификация, клинико-диагностическая концепция и лечение. Патологоанатомическая диагностика: Практическое руководство. М.: Литтерра, 2006. 176 с.


Savelyev V.S., Gelfand. B.R. (eds.). (Sepsis at the beginning of the XXI century. Classification, clinical and diagnostic concept and treatment. Pathoanatomic diagnostics: A practical guide). Moscow: Litterra, 2006. 176 p. (In Russ.).


11. Vain N.E., Fariña D., Va´zquez L.N. Neonatology in the emerging countries: the strategies and health-economics challenges related to prevention of neonatal and infant infections. Early Hum. Dev. 2012; 88: S53αS59. doi: 10.1016/S0378-3782(12)70016-6


12. Адамян Л.В., Кузьмин В.Н., Арсланян К.Н., Харченко Э.И. Современные способы борьбы с инфекцией в акушерстве и перинатологии (антибиотики, бактериофаги, иммуномодуляторы). Инфекционные болезни: новости, мнения, обучение 2017; (3): 37–45.


Adamyan L.V., Kuzmin V.N., Arslanyan K.N., Kharchenko E.I. (Modern methods to combat infection in obstetrics and perinatology (antibiotics, bacteriophages, immunomodulators)). Infectious diseases: News, Opinions, Training 2017; (3): 37–45. (In Russ.).


13. Иванников Н.Ю., Митичкин А.Е., Димитрова В.И., Слюсарева О.А., Хлынова С.А., Доброхотова Ю.Э. Современныеподходы в лечении послеродовых гнойно-септических заболеваний. Медицинский совет 2019; (7): 58–69. DOI: https://doi.org/10.21518/2079-701X-2019-7-58-69


Ivannikov N.Yu., Mitichkin A.E., Dimitrova V.I., Slyusareva O.A., Khlynova S.A., Dobrokhotova Yu.E. (Modern approaches to the treatment of postpartum purulent-septic diseases). Meditsinsky Sovet 2019; (7): 58–69. (In Russ.). DOI: https://doi.org/10.21518/2079-701X-2019-7-58-69


14. Смирнова С.С., Егоров И.А., Голубкова А.А. Гнойно-септические инфекции у родильниц. Часть 2. Клинико-патогенетическая характеристика нозологических форм, этиология и антибиотикорезистентность (обзор литературы). Журнал микробиологии, эпидемиологии и иммунобиологии 2022; 99(2): 244–59. DOI: https://doi.org/10.36233/0372-9311-227


Smirnova S.S., Egorov I.A., Golubkova A.A. (Purulent-septic infections in puerperas. Part 2. Clinical and pathogenetic characteristics of nosological forms, etiology and antibiotic resistance (literature review)). Journal of microbiology, epidemiology and immunobiology 2022; 99(2): 244–59. (In Russ.). DOI: https://doi.org/10.36233/0372-9311-227.


15. Орлова О.А., Абрамов Ю.Е., Акимкин В.Г. Заболеваемость инфекциями, связанными с оказанием медицинской помощи, среди родильниц и новорожденных в Российской Федерации. Медицинский алфавит 2021; 18: 7–11. https://doi.org/10.33667/2078-5631-2021-18-7-11


Orlova O.A., Abramov Yu.A., Akimkin V.G. (Incidence of healthcare-associated infections among puerperas and newborns in Russian Federation). Medical alphabet 2021; (18): 7–11. (In Russ.). https://doi.org/10.33667/2078-5631-2021-18-7-11


16. Mulani M.S., Kamble E.E., Kumkar S.N., Tawre M.S., Pardesi K.R. Emerging Strategies to Combat ESKAPE Pathogens in the Era of Antimicrobial Resistance: A Review. Frontiers in Microbiology 2019; (10): 539. doi:10.3389/fmicb.2019.00539. PMC 6452778. PMID 30988669


17. Plante L.A., Pacheco L.D., Louis J.M. SMFM Consult Series#47: Sepsis during pregnancy and the puerperium. Am. J. Obstet. Gynecol. 2019; 220(4): B2–B10. https://doi.org/10.1016/j.ajog.2019.01.216


18. Балушкина А.А., Тютюнник В.Л., Кан Н.Е., Пустотина О.А., Москалева Г.В. Новые тенденции в профилактике и лечении послеродового мастита и лактостаза. Медицинский совет 2019; (12): 136–41. DOI: https://doi.org/ 10.21518/2079-701X-2019-12-136-141


Balushkina A.A., Tyutyunnik V.L., Kan N.E., Pustotina O.A., Moskaleva G.V. (New trends in prevention and treatment of postpartum mastitis and lactostasis). Medical Council 2019; (12): 136–41. (In Russ.). DOI: https://doi.org/ 10.21518/2079-701X-2019-12-136-141


19. Панченко В.А., Смирнова С.С., Обоскалова Т.А. Оценка этиологии гнойно-септических инфекций у родильниц и частоты выявления резистентных штаммов. Актуальные вопросы современной медицинской науки и здравоохранения. Материалы VI Международной научно-практической конференции молодых ученых и студентов, посвященной году науки и технологий. (Екатеринбург, 8–9 апреля 2021 г.). В 3-х т. Екатеринбург: УГМУ, 2021; 1: 99–104.


Panchenko V.A., Smirnova S.S., Oboskalova T.A. (Evaluation of the etiology of purulent-septic infections in puerperas and the frequency of detection of resistant strains. Topical issues of modern medical science and healthcare. Materials of the VI International Scientific and Practical Conference of Young Scientists and Students dedicated to the Year of Science and Technology (Yekaterinburg, April 8–9, 2021)). In 3 vol. Yekaterinburg, 2021; 1: 99–104. (In Russ.).


20. Hall J., Adams N.H., Bartlett L., Seale A.C., Lamagni T., Bianchi-Jassir F. et al. Maternal disease with group B Streptococcus and serotype distribution worldwide: systematic review and meta-analyses. Clin. Infect. Dis. 2017; 65(Suppl. 2): S112–24. https://doi.org/10.1093/cid/cix660


21. Nguyen M., Bendi V.S., Guduru M., Olson E., Vivekanandan R., Foral P.A. et al. Postpartum invasive group a infection: case report and mini-review. Cureus. 2018; 10(8): e3184. https://doi.org/10.7759/cureus.3184


22. Dong Y., Basmaci R., Titomanlio L., Sun B.J.C. Neonatal sepsis: within and beyond China. Chin. Med. J. (Engl.). 2020; 133(18): 2219–28. doi: 10.1097/CM9.0000000000000935


23. Cruz A.T., Lane R.D., Balamuth F., Aronson P.L., Ashby D.W., Neuman M.I. et al. Updates on pediatric sepsis. J. Am. Coll. Emerg. Physicians Open. 2020; 1(5): 981–93. doi: 10.1002/emp2.1217


24. Куликов А.В., Шифман Е.М., Проценко Д.Н., Овезов А.М., Роненсон А.М., Распопин Ю.С. и др. Септический шок в акушерстве: клинические рекомендации общероссийской общественной организации «Федерация анестезиологов и реаниматологов». Вестник интенсивной терапии имени А.И. Салтанова 2023; (2): 7–44. https://doi.org/10.21320/1818-474X-2023-2-7-44


Kulikov A.V., Shifman E.M., Protsenko D.N., Ovezov A.M., Ronenson A.M., Raspopin Yu.S. et. al. (Septic shock in obstetrics: guidelines of the All-Russian public organization «Federation of Anesthesiologists and Reanimatologists»). Annals of Critical Care 2023; (2): 7–44. (In Russ.). https://doi.org/10.21320/1818-474X-2023-2-7-44


25. Яковлева С.В., Брико Н.И., Сидоренко С.В., Проценко Д.Н. (ред.). Программа СКАТ (Стратегия Контроля Антимикробной Терапии) при оказании стационарной медицинской помощи: Российские клинические рекомендации. М.: Перо, 2018. 56 с.


Yakovlev S.V., Briko N.I., Sidorenko S.V., Protsenko D.N. (eds.). (The SCAT program (Antimicrobial Therapy Control Strategy) in the provision of inpatient medical care: Russian clinical recommendations). Moscow: Pero, 2018. 156 p. (In Russ.).


26. Demirdağ T.B., Koç E., Tezer H., Oğuz S., Satar M., Sağlam Ö. et al. The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study. Pediatr. Neonatol. 2021; 62(2): 208–17. DOI: 10.1016/j.pedneo.2021.01.001


27. Тарасова А.В., Шляпников М.Е., Кузнецова Л.В., Неганова О.Б. Микробный спектр и антибиотикочувствительность микроорганизмов в посеве из цервикального канала при сочетанных инфекционно-воспалительных заболеваниях матки и венозной системы таза в послеродовом периоде. Вестник медицинского института «РЕАВИЗ»: реабилитация, врач и здоровье 2019; 6(42): 68–73.


Tarasova A.V., Shlyapnikov M.E., Kuznetsova L.V., Neganova O.B. (Microbial spectrum and antibiotic sensitivity of microorganisms in culture from the cervical canal in combined infectious and inflammatory diseases of the uterus and pelvic venous system in the postpartum period). Bulletin of the medical Institute «REAVIZ»: rehabilitation, doctor and health 2019; 6(42): 68–73. (In Russ.).


28. Наумкина Е.В., Пахалкова Е.В., Пядочкина Т.В., Абросимова О.А. Микробиологический мониторинг в отделениях перинатального центра. Мать и дитя в Кузбассе 2018; 1(72): 23–7.


Naumkina E.V., Pakhalkova E.V., Piadochkina Т.V., Abrosimova O.A. (Мicrobiological monitoring in the departments of the perinatal center). Mother and Baby in Kuzbass 2018; 1(72): 23–7. (In Russ.).


About the Autors


Oksana A. Orlova, МD, Epidemiologist, Head, Department of Epidemiology, N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia; Leading Researcher, Laboratory of Healthcare-Associated Infections, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Senior Researcher, Laboratory of Opportunistic Infections, N.F. Gamaleya National Research Center for Epidemiology and Microbiology, Ministry of Health of Russia, Moscow, Russia; oksana_orlova@bk.ru; http://orcid.org/0000-0002-6701-1252
Yuri E. Abramov, Postgraduate Student, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; abramoffye@gmail.com; http://orcid.org/ 0000-0002-1972-4581
Professor Aleksey V. Tutelyan, Сorresponting Member of the Russian Academy of Sciences, МD, 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, Ministry of Health of Russia (Sechenov University), Moscow, Russia; bio-tav@yandex.ru; http://orcid.org/ 0000-0002-2706-6689


Similar Articles


Бионика Медиа