Pub Date : 2023-01-01DOI: 10.36488/cmac.2023.2.116-122
Vladimir V. Gostev, O.S. Sulian, P.A. Pavlova, E.V. Nesterova, O.S. Kalinogorskaya, P.S. Chulkova, N.N. Trofimova, V.A. Ageevets, I.V. Ageevets, Sergey V. Sidorenko
Objective. To characterize the genomes of oxacillin-susceptible mecA-positive Staphylococcus aureus ST59 isolated in St. Petersburg. Materials and Methods. Nine oxacillin-susceptible mecA-positive of S. aureus isolates (OS-MRSA) of ST59 were included in the study. The isolates were obtained from children who showed no clinical signs of staphylococcal infections during nasal screening of S. aureus in St. Petersburg in 2018–2019. One isolate was obtained from an adult patient with skin and soft tissue infection (SSTI). The susceptibility to antibiotics and whole genome sequencing were performed. The analysis included 242 genomes of S. aureus ST59 from open access databases. Results. By employing the broth serial dilution and VITEK, the isolates’ phenotypic susceptibility to oxacillin was determined. The cefoxitin inhibition zones ranged from 17 to 22 mm. All isolates showed a penicillinclavulanate MIC ≤ 0.5 µg/mL. Isolates obtained from carriers belonged to the ST59-t1950-SCCmec Vb (seb+) genotype whereas the isolate obtained from SSTI belonged to the ST59-t437-SCCmec Vb (seb/ lukF/lukS+) genotype. Nucleotide position -33 (C/T) of mecA promoter and mutations in PBP2a (S225R + E246G) were present in all isolates. Based on phylogenetic analysis and Bayesian clustering the ST59 genomes were divided into four clusters and all Russian genomes belonged to the East Asian ST59 sublineage. The PVL toxin was present in the genomes of the first cluster of the East Asian ST59 sublineage. Pairwise comparisons of nucleotide substitutions among the genomes of Russian isolates showed a high similarity: median 13, interquartile range 8–18. All ST59 clusters were characterized by the presence of enterotoxin B, as well as mutations in PBP2a (S225R and E246G) and the promoter regions of the mecA gene (-7 G/A or -33 C/T). The genomes of the Russian isolates differed from the globally spread ST59 by specific mutations at the following loci (relative to the reference genome of S. aureus M013TW): lactose catabolism regulator RS03495 (N168D), ribosomal protein L28 (V47A), putative glyoxalase RS07825 (V42A), and the hypothetical protein RS13235 (K32E). Conclusions. Russian MRSA-ST59 isolates belong to the East Asian sublineage and are characterized by the presence of the enterotoxin B gene. Oxacillin susceptibility and borderline resistance to cefoxitin are specific characteristics of MRSA-ST59. OS-MRSA phenotypes have a risk of improper sensitivity testing leading to ineffective antibiotic treatment. Detection of mecA gene is the most accurate method for differentiating between MSSA and MRSA.
{"title":"Genomic characterization of oxacillin-susceptible mecA-positive Staphylococcus aureus ST59","authors":"Vladimir V. Gostev, O.S. Sulian, P.A. Pavlova, E.V. Nesterova, O.S. Kalinogorskaya, P.S. Chulkova, N.N. Trofimova, V.A. Ageevets, I.V. Ageevets, Sergey V. Sidorenko","doi":"10.36488/cmac.2023.2.116-122","DOIUrl":"https://doi.org/10.36488/cmac.2023.2.116-122","url":null,"abstract":"Objective. To characterize the genomes of oxacillin-susceptible mecA-positive Staphylococcus aureus ST59 isolated in St. Petersburg. Materials and Methods. Nine oxacillin-susceptible mecA-positive of S. aureus isolates (OS-MRSA) of ST59 were included in the study. The isolates were obtained from children who showed no clinical signs of staphylococcal infections during nasal screening of S. aureus in St. Petersburg in 2018–2019. One isolate was obtained from an adult patient with skin and soft tissue infection (SSTI). The susceptibility to antibiotics and whole genome sequencing were performed. The analysis included 242 genomes of S. aureus ST59 from open access databases. Results. By employing the broth serial dilution and VITEK, the isolates’ phenotypic susceptibility to oxacillin was determined. The cefoxitin inhibition zones ranged from 17 to 22 mm. All isolates showed a penicillinclavulanate MIC ≤ 0.5 µg/mL. Isolates obtained from carriers belonged to the ST59-t1950-SCCmec Vb (seb+) genotype whereas the isolate obtained from SSTI belonged to the ST59-t437-SCCmec Vb (seb/ lukF/lukS+) genotype. Nucleotide position -33 (C/T) of mecA promoter and mutations in PBP2a (S225R + E246G) were present in all isolates. Based on phylogenetic analysis and Bayesian clustering the ST59 genomes were divided into four clusters and all Russian genomes belonged to the East Asian ST59 sublineage. The PVL toxin was present in the genomes of the first cluster of the East Asian ST59 sublineage. Pairwise comparisons of nucleotide substitutions among the genomes of Russian isolates showed a high similarity: median 13, interquartile range 8–18. All ST59 clusters were characterized by the presence of enterotoxin B, as well as mutations in PBP2a (S225R and E246G) and the promoter regions of the mecA gene (-7 G/A or -33 C/T). The genomes of the Russian isolates differed from the globally spread ST59 by specific mutations at the following loci (relative to the reference genome of S. aureus M013TW): lactose catabolism regulator RS03495 (N168D), ribosomal protein L28 (V47A), putative glyoxalase RS07825 (V42A), and the hypothetical protein RS13235 (K32E). Conclusions. Russian MRSA-ST59 isolates belong to the East Asian sublineage and are characterized by the presence of the enterotoxin B gene. Oxacillin susceptibility and borderline resistance to cefoxitin are specific characteristics of MRSA-ST59. OS-MRSA phenotypes have a risk of improper sensitivity testing leading to ineffective antibiotic treatment. Detection of mecA gene is the most accurate method for differentiating between MSSA and MRSA.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495908","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 : 2023-01-01DOI: 10.36488/cmac.2023.1.41-55
O. Stetsiouk, T. Kovalenko, I. Andreeva, Y. Belkova
Despite the presence of more than 100 different antibacterials in the therapeutic arsenal, beta-lactam antibiotics, in general, and the third-generation cephalosporins, in particular, remain the main option for the treatment of the most of infections in inpatients. At the same time, the widespread and oftentimes inappropriate use of the third-generation cephalosporins in Russian hospitals lead to the emergence and spread of antimicroabial resistance. The review covers the problems of antibiotic resistance to cephalosporins due to the production of beta-lactamases, the role of beta-lactamase inhibitors in overcoming this type of resistance, options for combinations of cephalosporins with beta-lactamase inhibitors, in vitro activity of cefotaxime/sulbactam and cefepime/sulbactam, the results of clinical studies, and the role of the above combinations in the treatment of infections in the hospital.
{"title":"The known-unknown: third- and fourth-generation cephalosporins combined with sulbactam","authors":"O. Stetsiouk, T. Kovalenko, I. Andreeva, Y. Belkova","doi":"10.36488/cmac.2023.1.41-55","DOIUrl":"https://doi.org/10.36488/cmac.2023.1.41-55","url":null,"abstract":"Despite the presence of more than 100 different antibacterials in the therapeutic arsenal, beta-lactam antibiotics, in general, and the third-generation cephalosporins, in particular, remain the main option for the treatment of the most of infections in inpatients. At the same time, the widespread and oftentimes inappropriate use of the third-generation cephalosporins in Russian hospitals lead to the emergence and spread of antimicroabial resistance. The review covers the problems of antibiotic resistance to cephalosporins due to the production of beta-lactamases, the role of beta-lactamase inhibitors in overcoming this type of resistance, options for combinations of cephalosporins with beta-lactamase inhibitors, in vitro activity of cefotaxime/sulbactam and cefepime/sulbactam, the results of clinical studies, and the role of the above combinations in the treatment of infections in the hospital.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624682","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}
The purpose of systematic review was to assess the incidence of blood-borne infections in oncohematological patients in the period from 1980 to 2020 in different countries of the world, including in main oncohematological clinical groups of patients, assessment of the dynamics of the prevalence of blood-borne infections in the high-risk group after implementation of blood transfusion safety measures. An analysis of the data of the systematic review showed a high incidence of patients with oncohematological diseases in the period from 1980 to 2020: HCV – 8.2%, HBV (total markers) – 14.7% (HBsAg – 10.8%), HIV – 0.4 %. Middle levels of HCV and HBV infection in patients in the period from 2009 to 2017 exceeded the infection levels of the population in 2015 by 3.9 and 1.6 times, respectively. The prevalence of HIV was 1.16 times lower. According to the data of individual countries, the incidence of HCV among oncohematological patients is 1.3-118 times higher than the population, HBV – 0.4-73.5 times. The prevalence of HBsAg among children with oncohematological diseases was 18.3% and exceeded the same level among adult patients (7.1%) by 2.6 times. The prevalence of HBsAg among children with oncohematological diseases before 2000 was 14.8% and exceeded the prevalence of HBsAg among the child population before 2000 by 3 times, after 2000 – 20.5% and exceeded that among the child population by 16 times. The introduction of screening of blood donors has significantly reduced the incidence of patients at risk. Prior to the introduction of screening, the level of HCV infection among oncohematological patients was 35.7%, after the introduction of screening it was 5.2%, which is 7 times less. The level of HBV infection in the pre-screening period was 41.3%, after the introduction of screening – 5.9%, which is also 7 times less. During the course of treatment of oncohematological diseases or after its completion, the infection of patients with HCV is 7.7 times higher, HBV – 4.2 times higher, compared with infection at the stage of diagnosis or start of treatment. The level of HCV and HBV infection in patients with hematological malignancies exceeded that in patients with solid tumors by 1.8 times, both in the case of HCV and HBV. The conducted analysis emphasizes the urgency of the problem of nosocomial transmission of blood-borne infections, which is actively realized among patients at risk.
{"title":"Systematic review of seroprevalence of markers of hepatitis B, C and HIV among oncohematological patients","authors":"A.V. Satsuk, G.G. Solopova, A.A. Ploskireva, V.G. Akimkin","doi":"10.36488/cmac.2023.2.131-141","DOIUrl":"https://doi.org/10.36488/cmac.2023.2.131-141","url":null,"abstract":"The purpose of systematic review was to assess the incidence of blood-borne infections in oncohematological patients in the period from 1980 to 2020 in different countries of the world, including in main oncohematological clinical groups of patients, assessment of the dynamics of the prevalence of blood-borne infections in the high-risk group after implementation of blood transfusion safety measures. An analysis of the data of the systematic review showed a high incidence of patients with oncohematological diseases in the period from 1980 to 2020: HCV – 8.2%, HBV (total markers) – 14.7% (HBsAg – 10.8%), HIV – 0.4 %. Middle levels of HCV and HBV infection in patients in the period from 2009 to 2017 exceeded the infection levels of the population in 2015 by 3.9 and 1.6 times, respectively. The prevalence of HIV was 1.16 times lower. According to the data of individual countries, the incidence of HCV among oncohematological patients is 1.3-118 times higher than the population, HBV – 0.4-73.5 times. The prevalence of HBsAg among children with oncohematological diseases was 18.3% and exceeded the same level among adult patients (7.1%) by 2.6 times. The prevalence of HBsAg among children with oncohematological diseases before 2000 was 14.8% and exceeded the prevalence of HBsAg among the child population before 2000 by 3 times, after 2000 – 20.5% and exceeded that among the child population by 16 times. The introduction of screening of blood donors has significantly reduced the incidence of patients at risk. Prior to the introduction of screening, the level of HCV infection among oncohematological patients was 35.7%, after the introduction of screening it was 5.2%, which is 7 times less. The level of HBV infection in the pre-screening period was 41.3%, after the introduction of screening – 5.9%, which is also 7 times less. During the course of treatment of oncohematological diseases or after its completion, the infection of patients with HCV is 7.7 times higher, HBV – 4.2 times higher, compared with infection at the stage of diagnosis or start of treatment. The level of HCV and HBV infection in patients with hematological malignancies exceeded that in patients with solid tumors by 1.8 times, both in the case of HCV and HBV. The conducted analysis emphasizes the urgency of the problem of nosocomial transmission of blood-borne infections, which is actively realized among patients at risk.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495891","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 : 2023-01-01DOI: 10.36488/cmac.2023.1.68-76
A. G. Vinogradova, A. Kuzmenkov, I. V. Trushin, M. Edelstein, M. Sukhorukova, A.A. Starostenkov
Objective. To review the key principles and functionality of AMRexpert online platform. Materials and Methods. The information part of the platform is comprised of rules based on the EUCAST recommendations and various standards for interpreting the results of antimicrobial susceptibility testing (EUCAST, CLSI versions 2020-2022). The technical part of the platform was developed using C# programming language, Angular and Bootstrap frameworks. AST results of Serratia marcescens, Pseudomonas aeruginosa, Staphylococcus saprophyticus, Enterococcus faecium specific isolates were analyzed for practical testing of the platform using EUCAST v.12.0, 2022 interpretation criteria. Results. The developed platform for the evaluation of microbiological reports includes a wide list of expert rules, various standards for the interpretation of the AST results. Consistent data input, the ability to switch forms between several microorganisms, and the presentation of evaluation results in the form of blocks allows all necessary information to be structured. Practical use of the platform is available for various infectious pathogens. Fast and efficient interaction between users is provided by different options for sharing and saving the results. Conclusions. The web-based application evaluates microbiological reports in a comprehensive approach, with the ability to apply the results later to prescribe antimicrobial therapy. The platform for the interpretation, verification and validation of the AST results – AMRexpert can be accessed at https://amrexpert.ru.
{"title":"AMRexpert – online platform for interpretation, verification and validation of antimicrobial susceptibility testing","authors":"A. G. Vinogradova, A. Kuzmenkov, I. V. Trushin, M. Edelstein, M. Sukhorukova, A.A. Starostenkov","doi":"10.36488/cmac.2023.1.68-76","DOIUrl":"https://doi.org/10.36488/cmac.2023.1.68-76","url":null,"abstract":"Objective. To review the key principles and functionality of AMRexpert online platform. Materials and Methods. The information part of the platform is comprised of rules based on the EUCAST recommendations and various standards for interpreting the results of antimicrobial susceptibility testing (EUCAST, CLSI versions 2020-2022). The technical part of the platform was developed using C# programming language, Angular and Bootstrap frameworks. AST results of Serratia marcescens, Pseudomonas aeruginosa, Staphylococcus saprophyticus, Enterococcus faecium specific isolates were analyzed for practical testing of the platform using EUCAST v.12.0, 2022 interpretation criteria. Results. The developed platform for the evaluation of microbiological reports includes a wide list of expert rules, various standards for the interpretation of the AST results. Consistent data input, the ability to switch forms between several microorganisms, and the presentation of evaluation results in the form of blocks allows all necessary information to be structured. Practical use of the platform is available for various infectious pathogens. Fast and efficient interaction between users is provided by different options for sharing and saving the results. Conclusions. The web-based application evaluates microbiological reports in a comprehensive approach, with the ability to apply the results later to prescribe antimicrobial therapy. The platform for the interpretation, verification and validation of the AST results – AMRexpert can be accessed at https://amrexpert.ru.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624737","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 : 2023-01-01DOI: 10.36488/cmac.2023.1.77-82
E. M. Gordina, S. Bozhkova, D. Labutin, D. Goncharuk, E. N. Tkach
Objective. To study the antibacterial activity of lysostaphin against staphylococci various species, as well as its effect on the viability of Vero cells. Materials and Methods. Lysostaphin was obtained by genetic engineering. Purification of the protein was carried out on SP-sepharose, the purity was determined by electrophoresis in PAGE by Lamley. The susceptibility to lysostaphin of 9 species 175 strains of staphylococci was studied. Identification was performed by MALDI-TOF MS, antibiotic susceptibility by EUCAST (v. 11.0). The MIC of lysostaphin was studied by the method of serial dilutions with concentrations between 0.015 and 512 mg/l. For 72 hours, the viability of Vero cells with lysostaphin at concentrations of 0.5-32.0 mg/l was determined by the MTT method with counting of living cells according to their growth curve. The results were analyzed by ANOVA followed by Dunnett’s test. Results. A kinetic study of S. aureus growth in the presence of revealed an inhibitory effect of endopeptidase (MIC 0.06 mg/l). Lysostaphin was characterized by pronounced activity against clinical methicillinsensitive S. aureus. The MIC ranged between 0.03 and 0.5 mg/l and the MIC50/90 was 0.125⁄0.5 mg/l. For methicillin-resistant S. aureus MIC50/90 0.25⁄0.5 mg/l. The MIC50 for MRSE was 2 times higher than for MSSE – 1 mg/l. The maximum MIC value was determined against isolates of S. warneri and S. hominis – 64 mg/l, the lowest for S. saprophyticus – 0.5 mg/l. MIC50 of lysostaphin against MRSA was 4 times lower than that of vancomycin, MIC90 was 3 times lower. Differences in viable cells depending on the concentration of lysostaphin were not found. Conclusions. Significant activity of lysostaphin against staphylococci was revealed, which is several times higher than vancomycin against MRSA. Lysostaphin was also effective against methicillin-resistant S. aureus. The high anti-staphylococcal activity and cytocompatibility of lysostaphin are promising for its further study in the prevention and treatment of staphylococcal orthopedic infections.
{"title":"Anti-staphylococcal activity and cytocompatibility of lysostaphin","authors":"E. M. Gordina, S. Bozhkova, D. Labutin, D. Goncharuk, E. N. Tkach","doi":"10.36488/cmac.2023.1.77-82","DOIUrl":"https://doi.org/10.36488/cmac.2023.1.77-82","url":null,"abstract":"Objective. To study the antibacterial activity of lysostaphin against staphylococci various species, as well as its effect on the viability of Vero cells. Materials and Methods. Lysostaphin was obtained by genetic engineering. Purification of the protein was carried out on SP-sepharose, the purity was determined by electrophoresis in PAGE by Lamley. The susceptibility to lysostaphin of 9 species 175 strains of staphylococci was studied. Identification was performed by MALDI-TOF MS, antibiotic susceptibility by EUCAST (v. 11.0). The MIC of lysostaphin was studied by the method of serial dilutions with concentrations between 0.015 and 512 mg/l. For 72 hours, the viability of Vero cells with lysostaphin at concentrations of 0.5-32.0 mg/l was determined by the MTT method with counting of living cells according to their growth curve. The results were analyzed by ANOVA followed by Dunnett’s test. Results. A kinetic study of S. aureus growth in the presence of revealed an inhibitory effect of endopeptidase (MIC 0.06 mg/l). Lysostaphin was characterized by pronounced activity against clinical methicillinsensitive S. aureus. The MIC ranged between 0.03 and 0.5 mg/l and the MIC50/90 was 0.125⁄0.5 mg/l. For methicillin-resistant S. aureus MIC50/90 0.25⁄0.5 mg/l. The MIC50 for MRSE was 2 times higher than for MSSE – 1 mg/l. The maximum MIC value was determined against isolates of S. warneri and S. hominis – 64 mg/l, the lowest for S. saprophyticus – 0.5 mg/l. MIC50 of lysostaphin against MRSA was 4 times lower than that of vancomycin, MIC90 was 3 times lower. Differences in viable cells depending on the concentration of lysostaphin were not found. Conclusions. Significant activity of lysostaphin against staphylococci was revealed, which is several times higher than vancomycin against MRSA. Lysostaphin was also effective against methicillin-resistant S. aureus. The high anti-staphylococcal activity and cytocompatibility of lysostaphin are promising for its further study in the prevention and treatment of staphylococcal orthopedic infections.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624778","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 : 2023-01-01DOI: 10.36488/cmac.2023.1.106-112
N. Ovsyannikov, O. Bilevich, V. G. Berezhnoy, E. V. Romanovskaya, I.N. Zyatkov, O.P. Minkovich, D.I. Eshtokin
Pulmonary aspergillosis has always been considered as a disease that occurs in patients with certain risk factors for its development. The COVID-19 pandemic has shown that fungal complications are common in patients without aspergillosis risk factors. Thus, invasive aspergillosis is a common complication of COVID-19. There are rare reports of aspergilloma that developed after a severe coronavirus infection in individuals who did not previously have cavitary lesions in the lungs. Development of aspergilloma as an expected long-term complication after COVID-19 may be due to damage of lung structure caused by coronavirus infection, oxygen therapy and mechanical ventilation. This article describes a case report of aspergilloma in a patient with confirmed severe COVID-19 and background chronic diseases without risk factors for fungal infection. A review of publications on the development of aspergilloma in patients following COVID-19 is also presented.
{"title":"Pulmonary aspergilloma after previous COVID-19: a case report\u0000and a literature review","authors":"N. Ovsyannikov, O. Bilevich, V. G. Berezhnoy, E. V. Romanovskaya, I.N. Zyatkov, O.P. Minkovich, D.I. Eshtokin","doi":"10.36488/cmac.2023.1.106-112","DOIUrl":"https://doi.org/10.36488/cmac.2023.1.106-112","url":null,"abstract":"Pulmonary aspergillosis has always been considered as a disease that occurs in patients with certain risk factors for its development. The COVID-19 pandemic has shown that fungal complications are common in patients without aspergillosis risk factors. Thus, invasive aspergillosis is a common complication of COVID-19. There are rare reports of aspergilloma that developed after a severe coronavirus infection in individuals who did not previously have cavitary lesions in the lungs. Development of aspergilloma as an expected long-term complication after COVID-19 may be due to damage of lung structure caused by coronavirus infection, oxygen therapy and mechanical ventilation. This article describes a case report of aspergilloma in a patient with confirmed severe COVID-19 and background chronic diseases without risk factors for fungal infection. A review of publications on the development of aspergilloma in patients following COVID-19 is also presented.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69625042","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 : 2023-01-01DOI: 10.36488/cmac.2023.2.179-186
Alina G. Vinogradova, Alexey Yu. Kuzmenkov, Ivan V. Trushin, Marina V. Sukhorukova, Roman S. Kozlov
Objective. To analyse aggregated AST results for key microorganisms collected through the 2022 reports of chief specialists in clinical microbiology and antimicrobial resistance. Materials and Methods. The study included an analysis of the interpretation criteria used in the laboratories and an evaluation of the AST reports. Data were obtained from the clinical microbiology and antimicrobial resistance annual reporting system. Reports were analyzed using EUCAST guidelines for expected resistance phenotypes and expected susceptible phenotypes. Data processing and analysis were realized using the «R» programming language. The 95% CI for the percentages of inaccuracies/errors distributed by federal districts was calculated using the Wilson method. Results. A combination of several interpretation standards was used in 27.78% of laboratories, MUK 4.2.1890-04 was noted as one of the options in 57.6% of laboratories. Irrelevant standards of interpretation with a lag of 1 year or more were used in a significant number of cases. The highest percentage of errors/ inaccuracies by the type «expected resistance» was observed for A. baumannii – 14,06% (N = 9163), E. faecium – 8,05% (N = 3451) and S. pneumoniae – 6,18% (N = 2779). «Susceptibility categorization in the absence of interpretive breakpoints» was highest for S. aureus – 13.24% (N = 19784) and S. pneumoniae – 8.76% (N = 3942). Rare phenotype was determined in the highest percentage in relation to S. pneumoniae and antimicrobials: vancomycin – 54.04% and linezolid – 64.6%. Conclusions. The study revealed a significant number of errors/inaccuracies in the data reported. The use of irrelevant interpretation criteria, the exclusion of situations with rare phenotypes and expected resistance, may contribute to a significant increase in the likelihood of inappropriate antibacterial prescribing.
{"title":"Systemic analysis of the AST results in medical organizations of the Russian Federation","authors":"Alina G. Vinogradova, Alexey Yu. Kuzmenkov, Ivan V. Trushin, Marina V. Sukhorukova, Roman S. Kozlov","doi":"10.36488/cmac.2023.2.179-186","DOIUrl":"https://doi.org/10.36488/cmac.2023.2.179-186","url":null,"abstract":"Objective. To analyse aggregated AST results for key microorganisms collected through the 2022 reports of chief specialists in clinical microbiology and antimicrobial resistance. Materials and Methods. The study included an analysis of the interpretation criteria used in the laboratories and an evaluation of the AST reports. Data were obtained from the clinical microbiology and antimicrobial resistance annual reporting system. Reports were analyzed using EUCAST guidelines for expected resistance phenotypes and expected susceptible phenotypes. Data processing and analysis were realized using the «R» programming language. The 95% CI for the percentages of inaccuracies/errors distributed by federal districts was calculated using the Wilson method. Results. A combination of several interpretation standards was used in 27.78% of laboratories, MUK 4.2.1890-04 was noted as one of the options in 57.6% of laboratories. Irrelevant standards of interpretation with a lag of 1 year or more were used in a significant number of cases. The highest percentage of errors/ inaccuracies by the type «expected resistance» was observed for A. baumannii – 14,06% (N = 9163), E. faecium – 8,05% (N = 3451) and S. pneumoniae – 6,18% (N = 2779). «Susceptibility categorization in the absence of interpretive breakpoints» was highest for S. aureus – 13.24% (N = 19784) and S. pneumoniae – 8.76% (N = 3942). Rare phenotype was determined in the highest percentage in relation to S. pneumoniae and antimicrobials: vancomycin – 54.04% and linezolid – 64.6%. Conclusions. The study revealed a significant number of errors/inaccuracies in the data reported. The use of irrelevant interpretation criteria, the exclusion of situations with rare phenotypes and expected resistance, may contribute to a significant increase in the likelihood of inappropriate antibacterial prescribing.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135494982","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}
The species Treponema pallidum includes 4 subspecies. According to the bioinformatic analysis, the syphilis pathogen T. pallidum subsp. pallidum was probably separated from the causative agents of yaws, bejel, and pinta more than 800 years ago. Its entry into Europe with its subsequent epidemic at the end of the 15th century remains a matter of debate. The rapid spread in the European countries and the increase in the incidence of the disease were most likely due to the significant genomic rearrangements, which increased the infectivity and virulence of the microorganism, as well as the sociocultural factors of that era. Currently, T. pallidum subsp. pallidum divides into 2 phylogenetic lines – SS14 and Nichols. The SS14 line is widespread and dominant in almost all countries; however, it is significantly inferior to the Nichols line in genetic diversity. Despite these facts, Nichols strains continue to be used in scientific laboratories as reference strains, which is obviously a disadvantage in research planning. While penicillin sensitivity remains, there is a significant spread of resistance of syphilis pathogen to macrolides, especially among SS14 isolates. Further studies of genetic variability as well as the structure of T. pallidum subsp. pallidum outer membrane proteins can bring modern medicine closer to the creating a vaccine against syphilis.
{"title":"Phylogeny and antibiotic resistance of Treponema pallidum subsp. pallidum","authors":"Nikita Yu. Nosov, O.A. Obraztsova, G.L. Katunin, K.I. Plakhova, V.S. Solomka","doi":"10.36488/cmac.2023.2.123-129","DOIUrl":"https://doi.org/10.36488/cmac.2023.2.123-129","url":null,"abstract":"The species Treponema pallidum includes 4 subspecies. According to the bioinformatic analysis, the syphilis pathogen T. pallidum subsp. pallidum was probably separated from the causative agents of yaws, bejel, and pinta more than 800 years ago. Its entry into Europe with its subsequent epidemic at the end of the 15th century remains a matter of debate. The rapid spread in the European countries and the increase in the incidence of the disease were most likely due to the significant genomic rearrangements, which increased the infectivity and virulence of the microorganism, as well as the sociocultural factors of that era. Currently, T. pallidum subsp. pallidum divides into 2 phylogenetic lines – SS14 and Nichols. The SS14 line is widespread and dominant in almost all countries; however, it is significantly inferior to the Nichols line in genetic diversity. Despite these facts, Nichols strains continue to be used in scientific laboratories as reference strains, which is obviously a disadvantage in research planning. While penicillin sensitivity remains, there is a significant spread of resistance of syphilis pathogen to macrolides, especially among SS14 isolates. Further studies of genetic variability as well as the structure of T. pallidum subsp. pallidum outer membrane proteins can bring modern medicine closer to the creating a vaccine against syphilis.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495917","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 : 2023-01-01DOI: 10.36488/cmac.2023.1.100-105
M.Yu. Zhilinskiy, N. Mukhina, I. Komarova, S. Rachina, N. A. Cherkasova, A.B. Borisov, L. Fedina, S. M. Nasrulloeva
A rare clinical case of native aortic valve infective endocarditis (IE) caused by Klebsiella pneumoniae in a 56-year old man without known risk factors predisposing to the development of IE is presented. Diagnosis of IE in this patient was a challenge due to the lack of recent interventions that could be considered as a source of bacteremia, scarce clinical manifestation and absence of typical complications. Aortic valve vegetation was detected by transesophageal echocardiography. K. pneumoniae isolate was susceptible to all antibiotics tested. Antibacterial therapy (cefepime 6 g/day IV for 2 weeks in the hospital followed by ceftriaxone 4 g/day IM and cefixime 400 mg/day PO, a total of 4 weeks as an outpatient) resulted in a complete resolution of IE signs and symptoms, laboratory abnormalities as well as vegetation size decrease. Surgical treatment was not required in this patient.
{"title":"Infective endocarditis caused by Klebsiella pneumoniae in a patient with non ST elevation myocardial infarction","authors":"M.Yu. Zhilinskiy, N. Mukhina, I. Komarova, S. Rachina, N. A. Cherkasova, A.B. Borisov, L. Fedina, S. M. Nasrulloeva","doi":"10.36488/cmac.2023.1.100-105","DOIUrl":"https://doi.org/10.36488/cmac.2023.1.100-105","url":null,"abstract":"A rare clinical case of native aortic valve infective endocarditis (IE) caused by Klebsiella pneumoniae in a 56-year old man without known risk factors predisposing to the development of IE is presented. Diagnosis of IE in this patient was a challenge due to the lack of recent interventions that could be considered as a source of bacteremia, scarce clinical manifestation and absence of typical complications. Aortic valve vegetation was detected by transesophageal echocardiography. K. pneumoniae isolate was susceptible to all antibiotics tested. Antibacterial therapy (cefepime 6 g/day IV for 2 weeks in the hospital followed by ceftriaxone 4 g/day IM and cefixime 400 mg/day PO, a total of 4 weeks as an outpatient) resulted in a complete resolution of IE signs and symptoms, laboratory abnormalities as well as vegetation size decrease. Surgical treatment was not required in this patient.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624998","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 : 2023-01-01DOI: 10.36488/cmac.2023.1.19-25
D. Popov, N. Zubareva, A. Parshakov
One of the urgent problems of modern health care is the growing resistance of microorganisms to antibiotics, including carbapenems, which until recently were considered as the drugs of choice in the treatment of life-threatening infections. Enzymatic inactivation of antibiotics, including through the production of carbapenemase, is the main mechanism of resistance in Gram-negative bacteria. The treatment of these infections presents significant difficulties due to the extremely limited arsenal of effective drugs. Aztreonam is currently the first and only monocyclic beta-lactam antibiotic, monobactam, which is used in clinical practice for the treatment of infections caused by gram-negative bacteria. The data obtained in vitro and clinical observations are presented. These results justify the use of the drug in infections caused by a number of «problem» Gram-negative pathogens, including those resistant to carbapenems. Aztreonam has a high potential and should be used to treat patients with nosocomial infections – the focus of its use is Gram-negative bacteria-producers of metallo-beta-lactamases.
{"title":"Aztreonam: clinical and pharmacological characteristics at the present stage","authors":"D. Popov, N. Zubareva, A. Parshakov","doi":"10.36488/cmac.2023.1.19-25","DOIUrl":"https://doi.org/10.36488/cmac.2023.1.19-25","url":null,"abstract":"One of the urgent problems of modern health care is the growing resistance of microorganisms to antibiotics, including carbapenems, which until recently were considered as the drugs of choice in the treatment of life-threatening infections. Enzymatic inactivation of antibiotics, including through the production of carbapenemase, is the main mechanism of resistance in Gram-negative bacteria. The treatment of these infections presents significant difficulties due to the extremely limited arsenal of effective drugs. Aztreonam is currently the first and only monocyclic beta-lactam antibiotic, monobactam, which is used in clinical practice for the treatment of infections caused by gram-negative bacteria. The data obtained in vitro and clinical observations are presented. These results justify the use of the drug in infections caused by a number of «problem» Gram-negative pathogens, including those resistant to carbapenems. Aztreonam has a high potential and should be used to treat patients with nosocomial infections – the focus of its use is Gram-negative bacteria-producers of metallo-beta-lactamases.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69625067","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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