Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.2.147-160
D. I. Gavrilenko, N. Silivontchik
This article is an overview of the data on bacterial intestinal translocation. The article reviews changes in the intestinal microbiome, the local physiological barrier, as well as the innate and adaptive immunity characteristics contributing to the liver cirrhosis development and progression. The results of published studies on the assessment of potential bacterial translocation markers (C-reactive protein, procalcitonin, lipopolysaccharide, presepsin etc.) and their use to predict infection and mortality in patients with liver cirrhosis are presented. The up-to-date methods to study the intestinal microbiome as well as some directions for future research are also described.
{"title":"Translocation of gut microbiota in liver cirrhosis: mechanisms, clinical significance, and markers","authors":"D. I. Gavrilenko, N. Silivontchik","doi":"10.36488/cmac.2021.2.147-160","DOIUrl":"https://doi.org/10.36488/cmac.2021.2.147-160","url":null,"abstract":"This article is an overview of the data on bacterial intestinal translocation. The article reviews changes in the intestinal microbiome, the local physiological barrier, as well as the innate and adaptive immunity characteristics contributing to the liver cirrhosis development and progression. The results of published studies on the assessment of potential bacterial translocation markers (C-reactive protein, procalcitonin, lipopolysaccharide, presepsin etc.) and their use to predict infection and mortality in patients with liver cirrhosis are presented. The up-to-date methods to study the intestinal microbiome as well as some directions for future research are also described.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.2.166-172
T. A. Petrovskaya, D. V. Tapalskiy
Objective. To determine the concentration of colistin, preventing the selection of colistin-resistant mutants of K. pneumoniae, and to evaluate the effect of antibiotics of different groups on the development of mutational resistance to colistin. Materials and Methods. Minimum inhibitory concentrations (MIC) of colistin were determined for 88 K. pneumoniae strains by the method of serial microdilutions in broth, and carbapenemase genes were detected. The selection of colistin-resistant subpopulations was performed on cation-adjusted MüllerHinton agar (MHA) with the addition of 16 mg/l colistin. Mutant prevention concentration (MPC) of colistin is determined on MHA containing 0, 1, 2, 4, 8, 16, 32, 64 and 128 mg/l of colistin. Also, MPCs of colistin were determined in the presence of a fixed concentration of the second antibiotic: clarithromycin (2 mg/l), azithromycin (2 mg/l), rifampicin (1 mg/l), clindamycin (0.5 mg/l), meropenem (8 mg/l), linezolid (2 mg/l), amikacin (1 mg/l), vancomycin (2 mg/l), doxycycline (2 mg/l). Results. All strains remained susceptible to colistin (colistin MIC 0.06–1.0 mg/l). Resistance to meropenem (MIC > 8 mg/l) was detected in 48 strains (54.5%), 46 of them were carbapenemase producers: KPC – 6 strains (6.8%), OXA-48 – 26 strains (29.5%), NDM – 14 strains (15.9%). Growth of colonies on MHA with 16 mg/l of colistin was found for 96.6% of the strains. The frequency of mutational resistance occurrence ranged from 6 × 10-9 to 10-6 (median: 2 × 10-7). The mutational nature of colistin resistance was confirmed for 36.4% of the strains. The MPC values of colistin were in the range of 16–256 mg/l; (MPC50 32 mg/l, MPC90 256 mg/l) and significantly (32–1024 times) exceeded the MIC values. In the presence of 1 mg/l of rifampicin, the MPC of colistin decreased 4–64 times (MPC50 4 mg/l, MPC90 4 mg/l). In the presence of 2 mg/l of doxycycline, MPC of colistin decreased 2–64 times for all strains (MPC50 8 mg/l, MPC90 16 mg/l). The presence of linezolid (2 mg/l) and vancomycin (2 mg/l) did not significantly change MPC of colistin. Meropenem at a concentration of 8 mg/l had no significant effect on colistin MPC for carbapenemase-producing K. pneumoniae strains. None of the antibiotics lowered the MPC50 of colistin to its clinically achievable serum concentrations. Conclusions. A high frequency of formation of mutational resistance to colistin in K. pneumoniae was revealed. The MPC values of colistin are outside the range of clinically achievable serum concentrations and may decrease in the presence of other antibiotics.
{"title":"Influence of different antibiotic groups on the development of mutational resistance to colistin among Klebsiella pneumoniae","authors":"T. A. Petrovskaya, D. V. Tapalskiy","doi":"10.36488/cmac.2021.2.166-172","DOIUrl":"https://doi.org/10.36488/cmac.2021.2.166-172","url":null,"abstract":"Objective. To determine the concentration of colistin, preventing the selection of colistin-resistant mutants of K. pneumoniae, and to evaluate the effect of antibiotics of different groups on the development of mutational resistance to colistin. Materials and Methods. Minimum inhibitory concentrations (MIC) of colistin were determined for 88 K. pneumoniae strains by the method of serial microdilutions in broth, and carbapenemase genes were detected. The selection of colistin-resistant subpopulations was performed on cation-adjusted MüllerHinton agar (MHA) with the addition of 16 mg/l colistin. Mutant prevention concentration (MPC) of colistin is determined on MHA containing 0, 1, 2, 4, 8, 16, 32, 64 and 128 mg/l of colistin. Also, MPCs of colistin were determined in the presence of a fixed concentration of the second antibiotic: clarithromycin (2 mg/l), azithromycin (2 mg/l), rifampicin (1 mg/l), clindamycin (0.5 mg/l), meropenem (8 mg/l), linezolid (2 mg/l), amikacin (1 mg/l), vancomycin (2 mg/l), doxycycline (2 mg/l). Results. All strains remained susceptible to colistin (colistin MIC 0.06–1.0 mg/l). Resistance to meropenem (MIC > 8 mg/l) was detected in 48 strains (54.5%), 46 of them were carbapenemase producers: KPC – 6 strains (6.8%), OXA-48 – 26 strains (29.5%), NDM – 14 strains (15.9%). Growth of colonies on MHA with 16 mg/l of colistin was found for 96.6% of the strains. The frequency of mutational resistance occurrence ranged from 6 × 10-9 to 10-6 (median: 2 × 10-7). The mutational nature of colistin resistance was confirmed for 36.4% of the strains. The MPC values of colistin were in the range of 16–256 mg/l; (MPC50 32 mg/l, MPC90 256 mg/l) and significantly (32–1024 times) exceeded the MIC values. In the presence of 1 mg/l of rifampicin, the MPC of colistin decreased 4–64 times (MPC50 4 mg/l, MPC90 4 mg/l). In the presence of 2 mg/l of doxycycline, MPC of colistin decreased 2–64 times for all strains (MPC50 8 mg/l, MPC90 16 mg/l). The presence of linezolid (2 mg/l) and vancomycin (2 mg/l) did not significantly change MPC of colistin. Meropenem at a concentration of 8 mg/l had no significant effect on colistin MPC for carbapenemase-producing K. pneumoniae strains. None of the antibiotics lowered the MPC50 of colistin to its clinically achievable serum concentrations. Conclusions. A high frequency of formation of mutational resistance to colistin in K. pneumoniae was revealed. The MPC values of colistin are outside the range of clinically achievable serum concentrations and may decrease in the presence of other antibiotics.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.2.198-204
A. Kuzmenkov, A. G. Vinogradova, I. V. Trushin, M. Edelstein, A. A. Avramenko, A. Dekhnich, R. Kozlov
Objective. To review the basic principles and functionality of the AMRmap online resource. Materials and Methods. The AMRmap platform was developed using the R programming language and various downloadable modules – packages. The current annually updated version of EUCAST clinical breakpoints was applied for determination of categories of susceptibility to antimicrobial agents. Descriptive analysis includes calculation of absolute and relative frequencies, median values, and confidence intervals using the Wilson method. Categorical variables are compared using Fisher’s exact test and Holm correction method for multiple comparisons. The algorithms are used to visualize multiple comparisons, kernel regression for trend analysis, and algorithms for finding associative rules. Results. The developed surveillance system includes modules for filtering, analyzing and visualizing antibiotic resistance data. The filters allow creating a sample of data with a specific list of parameters. A tab-based separation of analysis and visualization options ensure efficient stepwise evaluation of results. Data saving and sharing functions are also provided. Conclusions. This web-based informatics system provides a convenient way to AMR data from prospective microbiological surveillance studies in Russia. AMRmap can be accessed at https://amrmap.ru.
{"title":"AMRmap – antibiotic resistance surveillance system in Russia","authors":"A. Kuzmenkov, A. G. Vinogradova, I. V. Trushin, M. Edelstein, A. A. Avramenko, A. Dekhnich, R. Kozlov","doi":"10.36488/cmac.2021.2.198-204","DOIUrl":"https://doi.org/10.36488/cmac.2021.2.198-204","url":null,"abstract":"Objective. To review the basic principles and functionality of the AMRmap online resource. Materials and Methods. The AMRmap platform was developed using the R programming language and various downloadable modules – packages. The current annually updated version of EUCAST clinical breakpoints was applied for determination of categories of susceptibility to antimicrobial agents. Descriptive analysis includes calculation of absolute and relative frequencies, median values, and confidence intervals using the Wilson method. Categorical variables are compared using Fisher’s exact test and Holm correction method for multiple comparisons. The algorithms are used to visualize multiple comparisons, kernel regression for trend analysis, and algorithms for finding associative rules. Results. The developed surveillance system includes modules for filtering, analyzing and visualizing antibiotic resistance data. The filters allow creating a sample of data with a specific list of parameters. A tab-based separation of analysis and visualization options ensure efficient stepwise evaluation of results. Data saving and sharing functions are also provided. Conclusions. This web-based informatics system provides a convenient way to AMR data from prospective microbiological surveillance studies in Russia. AMRmap can be accessed at https://amrmap.ru.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.2.205-211
A. N. Vaganova, S. V. Borisenko, E. Nesterova, N. N. Trofimova, I. Litvinenko, Y. Petunova, W.V. Roca, V. N. Verbov
Objective. To evaluate frequency and intensity of cefazolin inoculum effect among methicillin-susceptible staphylococci isolated from patients with skin infections. Materials and Methods. A total of 80 methicillin susceptible isolates of Staphylococcus aureus were identified by cefoxitin disk-diffusion test and negative results of real-time PCR for mecA gene. Inoculum effect was measured by broth microdilution test with two inocula with concentrations of 5 × 105 CFU/mL and 5 × 107 CFU/mL. The disk-diffusion test with cefoxitin was also performed. Penicillin susceptibility was determined by disk-diffusion method. Beta-lactamase blaZ gene was identified by real-time PCR. Results. The frequency of cefazolin inoculum effect in tested isolates was 30% which is consistent with data from different countries. The MIC values for concentrated inoculum reached CLSI breakpoint for cefazolin resistance in 2.5% of isolates. The isolates with inoculum effect and those without it had the similar MIC values for cefazolin in broth microdilution test for standard inocula and similar diameters of inhibition zone in disk-diffusion test with cefazolin. Penicillin resistance was more frequent in inoculum effect-positive isolates. Beta-lactamase activity is considered as a main cause of cefazolin inoculum effect in staphylococci. The beta-lactamase blaZ gene was identified in the majority of isolates with cefazolin inoculum effect, but it was also prevalent among inoculum effect-negative isolates. Conclusions. Up to 30% of MSSA isolates from skin lesions in dermatological patients from SaintPetersburg are positive for cefazolin inoculum effect. Those isolates are usually characterized by penicillin resistance. Most of the cefazolin inoculum effect-positive isolates also carry beta-lactamase blaZ gene.
{"title":"Cefazolin inoculum effect among methicillinsusceptible Staphylococcus aureus isolated from patients with skin infections","authors":"A. N. Vaganova, S. V. Borisenko, E. Nesterova, N. N. Trofimova, I. Litvinenko, Y. Petunova, W.V. Roca, V. N. Verbov","doi":"10.36488/cmac.2021.2.205-211","DOIUrl":"https://doi.org/10.36488/cmac.2021.2.205-211","url":null,"abstract":"Objective. To evaluate frequency and intensity of cefazolin inoculum effect among methicillin-susceptible staphylococci isolated from patients with skin infections. Materials and Methods. A total of 80 methicillin susceptible isolates of Staphylococcus aureus were identified by cefoxitin disk-diffusion test and negative results of real-time PCR for mecA gene. Inoculum effect was measured by broth microdilution test with two inocula with concentrations of 5 × 105 CFU/mL and 5 × 107 CFU/mL. The disk-diffusion test with cefoxitin was also performed. Penicillin susceptibility was determined by disk-diffusion method. Beta-lactamase blaZ gene was identified by real-time PCR. Results. The frequency of cefazolin inoculum effect in tested isolates was 30% which is consistent with data from different countries. The MIC values for concentrated inoculum reached CLSI breakpoint for cefazolin resistance in 2.5% of isolates. The isolates with inoculum effect and those without it had the similar MIC values for cefazolin in broth microdilution test for standard inocula and similar diameters of inhibition zone in disk-diffusion test with cefazolin. Penicillin resistance was more frequent in inoculum effect-positive isolates. Beta-lactamase activity is considered as a main cause of cefazolin inoculum effect in staphylococci. The beta-lactamase blaZ gene was identified in the majority of isolates with cefazolin inoculum effect, but it was also prevalent among inoculum effect-negative isolates. Conclusions. Up to 30% of MSSA isolates from skin lesions in dermatological patients from SaintPetersburg are positive for cefazolin inoculum effect. Those isolates are usually characterized by penicillin resistance. Most of the cefazolin inoculum effect-positive isolates also carry beta-lactamase blaZ gene.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.4.347-358
I. B. Baranova, A. Yaremenko, A. Zubareva, S. Karpischenko, M. Popova, A.A. Kurus, G. Portnov, O. Pinegina, O. Lukina, M. V. Malyarevskaya, I.N. Kalakuckiy, M.O. Ilyukhina, N. Klimko
Abstract Currently, the relevance of the issues of diagnosis and treatment of invasive fungal diseases has increased significantly due to the pandemic of a new coronavirus infection COVID-19 and the massive use of corticosteroids for the treatment. The key success factors in the outcome of invasive fungal diseases are early diagnosis and treatment, including the applying of an adequate systemic antifungal therapy and surgical treatment. Extensive areas of mycotic lesions of the facial bones and paranasal sinuses are lifethreatening conditions due to anatomical proximity to brain structures and a high risk of dissemination of I invasive fungal diseases with a fatal outcome. The objective of this work was to study the risk factors, possible pathogenesis, diagnosis and treatment strategy of invasive fungal diseases of the orofacial region in convalescents of COVID-19. We present case-series data on six patients in the clinics of maxillofacial surgery and otorhinolaryngology of the Pavlov First Saint Petersburg State Medical University over the period of 2021–2022. Predisposing factors, clinical and radiological symptoms, features of diagnosis, therapy and surgical strategy were analyzed. The presented observations confirm the relevance and danger of complications after a COVID-19 in the form of the development of invasive fungal diseases with damage to the maxillofacial region caused by mucormycetes and Aspergillus spp., as well as importance of early diagnosis and treatment.
{"title":"Mucormycosis of the bones of the facial skull, nasal cavity and par anasal sinuses in patients with COVID19","authors":"I. B. Baranova, A. Yaremenko, A. Zubareva, S. Karpischenko, M. Popova, A.A. Kurus, G. Portnov, O. Pinegina, O. Lukina, M. V. Malyarevskaya, I.N. Kalakuckiy, M.O. Ilyukhina, N. Klimko","doi":"10.36488/cmac.2021.4.347-358","DOIUrl":"https://doi.org/10.36488/cmac.2021.4.347-358","url":null,"abstract":"Abstract Currently, the relevance of the issues of diagnosis and treatment of invasive fungal diseases has increased significantly due to the pandemic of a new coronavirus infection COVID-19 and the massive use of corticosteroids for the treatment. The key success factors in the outcome of invasive fungal diseases are early diagnosis and treatment, including the applying of an adequate systemic antifungal therapy and surgical treatment. Extensive areas of mycotic lesions of the facial bones and paranasal sinuses are lifethreatening conditions due to anatomical proximity to brain structures and a high risk of dissemination of I invasive fungal diseases with a fatal outcome. The objective of this work was to study the risk factors, possible pathogenesis, diagnosis and treatment strategy of invasive fungal diseases of the orofacial region in convalescents of COVID-19. We present case-series data on six patients in the clinics of maxillofacial surgery and otorhinolaryngology of the Pavlov First Saint Petersburg State Medical University over the period of 2021–2022. Predisposing factors, clinical and radiological symptoms, features of diagnosis, therapy and surgical strategy were analyzed. The presented observations confirm the relevance and danger of complications after a COVID-19 in the form of the development of invasive fungal diseases with damage to the maxillofacial region caused by mucormycetes and Aspergillus spp., as well as importance of early diagnosis and treatment.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.4.388-399
Sadeeva Zulfirya Z., I. Novikova, R.A. Schakirzyanova, N. M. Alyabyeva, A. Lazareva, M.S. Melkov, O. Karaseva, M. Vershinina, A. Fisenko
Objective. To assess antimicrobial susceptibility, presence of resistance genes and determine the phenotypic groups of K. pneumoniae, P. aeruginosa and A. baumannii isolated from blood and cerebrospinal fluid of children with nosocomial infections in intensive care units from 2014 to 2020. Materials and Methods. Minimum inhibitory concentrations of antibiotics were determined using the serial broth microdilution method. The identification of genes encoding the production of carbapenemases was carried out using hybridization fluorescence detection. Results. A total of 63 isolates of K. рneumoniae, 23 isolates of P. aeruginosa and 14 isolates of A. baumannii were tested in this study. K. pneumoniae was detected in 10.3%. P. aeruginosa was isolated at a frequency of 3.5%. A. baumannii accounted for 2.3%. The proportion of carbapenemresistant K. pneumoniae strains to meropenem and imipenem was 33% and 37%, respectively, of all isolates. Resistance to colistin and polymyxin in K. pneumoniae isolates was 33% and 24%, respectively. The production of carbapenemases OXA-48 was detected in 25 (89%) isolates. The presence of NDM, VIM, KPC carbapenemases was not detected. Among P. aeruginosa, 65% were resistant to meropenem, and 74% to imipenem. The highest activity against P. aeruginosa in vitro was exhibited by polymyxins. There were no strains that were insensitive to colistin. The detection rate of metallo-β-lactamases (MBL) in P. aeruginosa strains was 48%. Only VIM-type MBLs were identified. No other types of MBL have been found. A. baumannii was non-susceptible to meropenem in 64% and to imipenem in 71%. The highest in vitro activity against A. baumannii was shown by polymyxin. Rate of colistin resistance was 29%. The OXA-40 and OXA-23 genes were detected in 5 and 3 isolates, respectively. Conclusions. There were high resistance rates to most antimicrobials among K. pneumoniae, P. aeruginosa и A. baumannii isolated from blood and cerebrospinal fluid in children with nosocomial infections. The increase in carbapenem resistance rates was also observed. Carbapenem resistance was due to OXA48 carbapenemases in K. pneumoniae, VIM-type MBLs in P. aeruginosa, and OXA-40 and OXA-23 carbapenemases in A. baumannii.
{"title":"Genetic characteristics of antimicrobial resistance mechanisms in Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii isolated from blood and cerebrospinal fluid of children","authors":"Sadeeva Zulfirya Z., I. Novikova, R.A. Schakirzyanova, N. M. Alyabyeva, A. Lazareva, M.S. Melkov, O. Karaseva, M. Vershinina, A. Fisenko","doi":"10.36488/cmac.2021.4.388-399","DOIUrl":"https://doi.org/10.36488/cmac.2021.4.388-399","url":null,"abstract":"Objective. To assess antimicrobial susceptibility, presence of resistance genes and determine the phenotypic groups of K. pneumoniae, P. aeruginosa and A. baumannii isolated from blood and cerebrospinal fluid of children with nosocomial infections in intensive care units from 2014 to 2020. Materials and Methods. Minimum inhibitory concentrations of antibiotics were determined using the serial broth microdilution method. The identification of genes encoding the production of carbapenemases was carried out using hybridization fluorescence detection. Results. A total of 63 isolates of K. рneumoniae, 23 isolates of P. aeruginosa and 14 isolates of A. baumannii were tested in this study. K. pneumoniae was detected in 10.3%. P. aeruginosa was isolated at a frequency of 3.5%. A. baumannii accounted for 2.3%. The proportion of carbapenemresistant K. pneumoniae strains to meropenem and imipenem was 33% and 37%, respectively, of all isolates. Resistance to colistin and polymyxin in K. pneumoniae isolates was 33% and 24%, respectively. The production of carbapenemases OXA-48 was detected in 25 (89%) isolates. The presence of NDM, VIM, KPC carbapenemases was not detected. Among P. aeruginosa, 65% were resistant to meropenem, and 74% to imipenem. The highest activity against P. aeruginosa in vitro was exhibited by polymyxins. There were no strains that were insensitive to colistin. The detection rate of metallo-β-lactamases (MBL) in P. aeruginosa strains was 48%. Only VIM-type MBLs were identified. No other types of MBL have been found. A. baumannii was non-susceptible to meropenem in 64% and to imipenem in 71%. The highest in vitro activity against A. baumannii was shown by polymyxin. Rate of colistin resistance was 29%. The OXA-40 and OXA-23 genes were detected in 5 and 3 isolates, respectively. Conclusions. There were high resistance rates to most antimicrobials among K. pneumoniae, P. aeruginosa и A. baumannii isolated from blood and cerebrospinal fluid in children with nosocomial infections. The increase in carbapenem resistance rates was also observed. Carbapenem resistance was due to OXA48 carbapenemases in K. pneumoniae, VIM-type MBLs in P. aeruginosa, and OXA-40 and OXA-23 carbapenemases in A. baumannii.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.1.100-112
Y. Yarets, N. Shevchenko, V. Eremin, V. O. Kovalev
Objective. To assess the etiology of infections, microbial associations and antimicrobial resistance in a burn intensive care unit. Materials and Methods. A microbiological study of 1322 biological samples from 195 patients with extensive burns included 479 blood samples, 82 respiratory samples, 326 urine samples, and 435 wound samples. Antimicrobial susceptibility testing was performed, and coefficients of constancy and associativity (CA), as well as the Jaccard coefficient were calculated. Results. The etiology of infections was represented by: Pseudomonas aeruginosa – 23%, Acinetobacter baumannii – 19.1%, Enterococcus faecalis – 18.6%, Klebsiella pneumoniae – 8.2%, CoNS (coagulasenegative staphylococci) – 8.2%, Staphylococcus aureus – 7.1%, Candida albicans – 7.1%, Candida non-albicans – 3%, other species were isolated with a frequency of less than 2%. Majority of the above mentioned pathogens showed high associativity: non-fermenting rods (NFR), S. aureus, Enterobacterales, E. faecalis, Candida non-albicans formed associations in 60.0%, 88.8%, 83.0%, 83.3% and 65% of cases, respectively. The prevalence of methicillin-resistant strains of S. aureus and CoNS was 71% and 81%, respectively. CoNS showed higher resistance to fluoroquinolones and gentamicin compare to S. aureus: 42% vs 23%, 46% vs 29%, respectively (χ2 = 6.91; p = 0.086; χ2 = 6.58; p = 0.013). E. faecalis showed high resistance rates to aminoglycosides and fluoroquinolones (> 60%). All Gram-positive isolates were completely susceptible to vancomycin, linezolid, tigecycline, and teicoplanin. Resistance rates of Gram-negative bacteria (NFR, K. pneumoniae) to penicillins, cephalosporins, carbapenems (for NFR), and aminoglycosides were high (from 60% to 100%). The most active antimicrobial against NFR was colistin. Resistance of K. pneumoniae isolates to carbapenems was 23%, while other enterobacteria were highly susceptible to carbapenems. Conclusions. The implementation of the local microbiological monitoring made it possible to characterize the qualitative pathogen structure and antimicrobial resistance in our burns intensive care unit. This data will serve as the basis for improving of the infection control and antimicrobial stewardship.
{"title":"Local microbiological monitoring as a basis for determining etiological significance of conditional pathogens: data from a burn intensive care unit","authors":"Y. Yarets, N. Shevchenko, V. Eremin, V. O. Kovalev","doi":"10.36488/cmac.2021.1.100-112","DOIUrl":"https://doi.org/10.36488/cmac.2021.1.100-112","url":null,"abstract":"Objective. To assess the etiology of infections, microbial associations and antimicrobial resistance in a burn intensive care unit. Materials and Methods. A microbiological study of 1322 biological samples from 195 patients with extensive burns included 479 blood samples, 82 respiratory samples, 326 urine samples, and 435 wound samples. Antimicrobial susceptibility testing was performed, and coefficients of constancy and associativity (CA), as well as the Jaccard coefficient were calculated. Results. The etiology of infections was represented by: Pseudomonas aeruginosa – 23%, Acinetobacter baumannii – 19.1%, Enterococcus faecalis – 18.6%, Klebsiella pneumoniae – 8.2%, CoNS (coagulasenegative staphylococci) – 8.2%, Staphylococcus aureus – 7.1%, Candida albicans – 7.1%, Candida non-albicans – 3%, other species were isolated with a frequency of less than 2%. Majority of the above mentioned pathogens showed high associativity: non-fermenting rods (NFR), S. aureus, Enterobacterales, E. faecalis, Candida non-albicans formed associations in 60.0%, 88.8%, 83.0%, 83.3% and 65% of cases, respectively. The prevalence of methicillin-resistant strains of S. aureus and CoNS was 71% and 81%, respectively. CoNS showed higher resistance to fluoroquinolones and gentamicin compare to S. aureus: 42% vs 23%, 46% vs 29%, respectively (χ2 = 6.91; p = 0.086; χ2 = 6.58; p = 0.013). E. faecalis showed high resistance rates to aminoglycosides and fluoroquinolones (> 60%). All Gram-positive isolates were completely susceptible to vancomycin, linezolid, tigecycline, and teicoplanin. Resistance rates of Gram-negative bacteria (NFR, K. pneumoniae) to penicillins, cephalosporins, carbapenems (for NFR), and aminoglycosides were high (from 60% to 100%). The most active antimicrobial against NFR was colistin. Resistance of K. pneumoniae isolates to carbapenems was 23%, while other enterobacteria were highly susceptible to carbapenems. Conclusions. The implementation of the local microbiological monitoring made it possible to characterize the qualitative pathogen structure and antimicrobial resistance in our burns intensive care unit. This data will serve as the basis for improving of the infection control and antimicrobial stewardship.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.2.161-165
S. Avdeev, N. Briko, G. Galstyan, A. Dekhnich, L. Y. Drozdova, A. A. Zaitsev, R. Kozlov, T. Nikonova, S. Rachina, S. Sidorenko, A. Sinopalnikov, O. Tkacheva, S. Harit, V. Chulanov
The purpose of the meeting is to obtain an opinion on approaches and recommendations for vaccine prevention of pneumococcal infections in adults.
会议的目的是就疫苗预防成人肺炎球菌感染的方法和建议取得意见。
{"title":"Official statements of the expert meeting on pneumococcal vaccination in adults in Russia","authors":"S. Avdeev, N. Briko, G. Galstyan, A. Dekhnich, L. Y. Drozdova, A. A. Zaitsev, R. Kozlov, T. Nikonova, S. Rachina, S. Sidorenko, A. Sinopalnikov, O. Tkacheva, S. Harit, V. Chulanov","doi":"10.36488/cmac.2021.2.161-165","DOIUrl":"https://doi.org/10.36488/cmac.2021.2.161-165","url":null,"abstract":"The purpose of the meeting is to obtain an opinion on approaches and recommendations for vaccine prevention of pneumococcal infections in adults.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.3.305-313
S. Khrulnova, G. Klyasova, A. Fedorova, I. N. Frolova, B. Biderman
Objective. To study the genetic diversity of vancomycin-resistant Enterococcus faecium (VR-E. faecium) isolated from the blood culture in patients with hematological malignancies by multilocus sequence typing (MLST). Materials and Methods. VR-E. faecium isolated from the blood culture in hematological patients in 6 hospitals of 4 Russian cities (2003–2019) were evaluated. Susceptibility to vancomycin was tested by the broth microdilution method (CLSI, 2018). Vancomycin-resistance genes (vanA, vanB) were identified by polymerase chain reaction. Genotyping of VR-E. faecium was performed by MLST. Results. A total of 83 VR-E. faecium were examined. The vanA genes were detected in 71.1% (n = 59) VR-E. faecium, vanB genes – in 28.9% (n = 24). A total of 22 sequence types (STs) belonging to epidemic clonal complex CC17 were detected. The dominant sequence types were ST17 (19.3%), ST78 (18.1%), ST80 (16.9%), and comprised 54.3% VR-E. faecium. Other sequence types included 1 to 4 strains. VR-E. faecium carrying vanA, in comparison with VR-E. faecium vanB, significantly more often belonged to ST78 (23.7% vs. 4.2%, p = 0.0559, respectively) and ST80 (23.7% versus 0%, p = 0.0079, respectively) and less frequently to ST17 (6,8% versus 50%, р < 0.0001). Circulation of 9 STs including «high-risk» clones ST17 and ST78 was detected during two study periods (2003–2011 and 2012–2019). Conclusions. This study showed a genetic diversity of VR-E. faecium that was represented by 22 STs. All VR-E. faecium belonged to epidemic clonal complex CC17 and comprised «high-risk» clones ST17, ST78 and less common STs.
目标。目的研究耐万古霉素屎肠球菌(VR-E)的遗传多样性。通过多位点序列分型(MLST)从血液恶性肿瘤患者的血培养中分离出粪(faecium)。材料与方法。对俄罗斯4个城市6家医院2003-2019年血液病患者血培养分离的粪便进行了评价。采用微量肉汤稀释法检测对万古霉素的敏感性(CLSI, 2018)。聚合酶链反应法鉴定万古霉素耐药基因(vanA、vanB)。VR-E的基因分型。结果:共83例VR-E。检查粪便。71.1% (n = 59)的VR-E检测到vanA基因。粪，vanB基因-占28.9% (n = 24)。共检测到22个属于流行克隆复合体CC17的序列类型。优势序列类型为ST17(19.3%)、ST78(18.1%)、ST80 (16.9%)， VR-E占54.3%。都有效。其他序列类型为1 ~ 4株。VR-E。与VR-E相比，粪便携带vanA。faecium vanB属于ST78 (23.7% vs. 4.2%， p = 0.0559)和ST80 (23.7% vs. 0%， p = 0.0079)的频率较高，属于ST17的频率较低(6.8% vs. 50%， p < 0.0001)。在两个研究期间(2003-2011年和2012-2019年)检测到9种STs的循环，包括“高风险”克隆ST17和ST78。该研究显示了VR-E的遗传多样性。粪便，由22个STs代表。所有VR-E。粪属流行克隆复合体CC17，由“高危”克隆ST17、ST78和不常见的STs组成。
{"title":"Genetic diversity of vancomycinresistant Enterococcus faecium isolated from blood culture in patients with hematological malignancies","authors":"S. Khrulnova, G. Klyasova, A. Fedorova, I. N. Frolova, B. Biderman","doi":"10.36488/cmac.2021.3.305-313","DOIUrl":"https://doi.org/10.36488/cmac.2021.3.305-313","url":null,"abstract":"Objective. To study the genetic diversity of vancomycin-resistant Enterococcus faecium (VR-E. faecium) isolated from the blood culture in patients with hematological malignancies by multilocus sequence typing (MLST). Materials and Methods. VR-E. faecium isolated from the blood culture in hematological patients in 6 hospitals of 4 Russian cities (2003–2019) were evaluated. Susceptibility to vancomycin was tested by the broth microdilution method (CLSI, 2018). Vancomycin-resistance genes (vanA, vanB) were identified by polymerase chain reaction. Genotyping of VR-E. faecium was performed by MLST. Results. A total of 83 VR-E. faecium were examined. The vanA genes were detected in 71.1% (n = 59) VR-E. faecium, vanB genes – in 28.9% (n = 24). A total of 22 sequence types (STs) belonging to epidemic clonal complex CC17 were detected. The dominant sequence types were ST17 (19.3%), ST78 (18.1%), ST80 (16.9%), and comprised 54.3% VR-E. faecium. Other sequence types included 1 to 4 strains. VR-E. faecium carrying vanA, in comparison with VR-E. faecium vanB, significantly more often belonged to ST78 (23.7% vs. 4.2%, p = 0.0559, respectively) and ST80 (23.7% versus 0%, p = 0.0079, respectively) and less frequently to ST17 (6,8% versus 50%, р < 0.0001). Circulation of 9 STs including «high-risk» clones ST17 and ST78 was detected during two study periods (2003–2011 and 2012–2019). Conclusions. This study showed a genetic diversity of VR-E. faecium that was represented by 22 STs. All VR-E. faecium belonged to epidemic clonal complex CC17 and comprised «high-risk» clones ST17, ST78 and less common STs.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.4.359-366
Artem V. Stepin
This article presents a review of currently available data on etiology and antimicrobial resistance in surgical site infections (SSI) following cardiac surgery. Author performed analysis of the references on etiology and antimicrobial resistance in SSI after cardiac surgery from the Scopus, Medline, EMBASE, PubMed and Google Scholar over January 2010 to December 2020. The selected most cited earlier (January 1990 to December 2009) publications were also included in the analysis.
{"title":"Etiology and antimicrobial resistance in surgical site infections in cardiac surgery","authors":"Artem V. Stepin","doi":"10.36488/cmac.2021.4.359-366","DOIUrl":"https://doi.org/10.36488/cmac.2021.4.359-366","url":null,"abstract":"This article presents a review of currently available data on etiology and antimicrobial resistance in surgical site infections (SSI) following cardiac surgery. Author performed analysis of the references on etiology and antimicrobial resistance in SSI after cardiac surgery from the Scopus, Medline, EMBASE, PubMed and Google Scholar over January 2010 to December 2020. The selected most cited earlier (January 1990 to December 2009) publications were also included in the analysis.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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