Pub Date : 2022-01-01DOI: 10.36488/cmac.2022.1.52-60
I. Edelstein, N. Rudneva, A. Romanov, L. M. Zubareva, A. Kuzmenkov, E. Kolesnikova, I. V. Trushin, I. V. Borisov, L. Sukhanova, A.M. Akhmedova, O.P. Novikova, R. Kozlov
Objective. To determine spectrum and prevalence of genetic determinants of resistance to macrolides in Mycoplasma genitalium in a Russian patient population. Materials and Methods. A total of 873 M. genitalium-positive samples from five geographical regions of Russia were investigated over the period of 2009–2019 using the previously developed protocol of real-time polymerase chain reaction (allows detecting any nucleotide substitutions in the 23S rRNA gene of M. genitalium at positions 2058, 2059, and 2611). The results were confirmed using Sanger sequencing. Results. The most frequent mutations associated with resistance to macrolides in M. genitalium were the following: A2058G (60.5%) and A2059G (30.2%). The relatively rare mutations were A2058T (7%) and C2611T (2.3%). In the studied period, there was no trend to increase in frequency of mutations associated with resistance to macrolides. The study results are presented as an open project on the AMRcloud platform (https://amrcloud.net/ru/project/demares/). Conclusions. Our data emphasize a need to introduce regular screening of M. genitalium-positive samples for the presence of macrolide resistance-associated mutations into clinical practice.
{"title":"Monitoring of macrolide resistanceassociated mutations in Mycoplasma genitalium in Russia","authors":"I. Edelstein, N. Rudneva, A. Romanov, L. M. Zubareva, A. Kuzmenkov, E. Kolesnikova, I. V. Trushin, I. V. Borisov, L. Sukhanova, A.M. Akhmedova, O.P. Novikova, R. Kozlov","doi":"10.36488/cmac.2022.1.52-60","DOIUrl":"https://doi.org/10.36488/cmac.2022.1.52-60","url":null,"abstract":"Objective. To determine spectrum and prevalence of genetic determinants of resistance to macrolides in Mycoplasma genitalium in a Russian patient population. Materials and Methods. A total of 873 M. genitalium-positive samples from five geographical regions of Russia were investigated over the period of 2009–2019 using the previously developed protocol of real-time polymerase chain reaction (allows detecting any nucleotide substitutions in the 23S rRNA gene of M. genitalium at positions 2058, 2059, and 2611). The results were confirmed using Sanger sequencing. Results. The most frequent mutations associated with resistance to macrolides in M. genitalium were the following: A2058G (60.5%) and A2059G (30.2%). The relatively rare mutations were A2058T (7%) and C2611T (2.3%). In the studied period, there was no trend to increase in frequency of mutations associated with resistance to macrolides. The study results are presented as an open project on the AMRcloud platform (https://amrcloud.net/ru/project/demares/). Conclusions. Our data emphasize a need to introduce regular screening of M. genitalium-positive samples for the presence of macrolide resistance-associated mutations into clinical practice.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623817","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 : 2022-01-01DOI: 10.36488/cmac.2022.1.77-82
Y. Cherkasova, E. Kremleva, Yu. S. Shchetinina, A. Sgibnev
Objective. To assess effect of topical use of solution containing ferrous ions on efficacy of metronidazole therapy in women with recurrent urogenital trichomoniasis. Materials and Methods. The study enrolled 55 women aged of 20–30 years with recurrent trichomoniasis after failures of multiple standard of care regimens. All patients received oral (tablets) and intravaginal (1% gel) metronidazole therapy. Participants in the experimental group (29 women) received intravaginal therapy with a solution of ferrous ions at concentration which was determined as effective for potentiating metronidazole in a previous study. In the control group, saline solution was used. Biological samples for laboratory tests were collected prior to treatment and on treatment days 4, 8 and 22. Treatment efficacy was assessed by laboratory results (detection of T. vaginalis, leukocyte-epithelial index). Results. Concomitant use of solutions containing ferrous ions at concentration 8.96 mmol/L can increase frequency of successful treatment outcomes in recurrent trichomoniasis. T. vaginalis was detected at the end of therapy in 10.3% of patients from the experimental group and 69.2% of patients from the control group. Conclusions. The concomitant use of metronidazole and solution containing ferrous ions makes it possible to increase the efficacy of therapy for Trichomonas infection. The results of the study allow us to consider topical use of iron-containing drugs to increase metronidazole treatment efficacy in recurrent trichomoniasis.
{"title":"Effect of topical use of solution containing ferrous ions on treatment efficacy in women with recurrent urogenital trichomoniasis","authors":"Y. Cherkasova, E. Kremleva, Yu. S. Shchetinina, A. Sgibnev","doi":"10.36488/cmac.2022.1.77-82","DOIUrl":"https://doi.org/10.36488/cmac.2022.1.77-82","url":null,"abstract":"Objective. To assess effect of topical use of solution containing ferrous ions on efficacy of metronidazole therapy in women with recurrent urogenital trichomoniasis. Materials and Methods. The study enrolled 55 women aged of 20–30 years with recurrent trichomoniasis after failures of multiple standard of care regimens. All patients received oral (tablets) and intravaginal (1% gel) metronidazole therapy. Participants in the experimental group (29 women) received intravaginal therapy with a solution of ferrous ions at concentration which was determined as effective for potentiating metronidazole in a previous study. In the control group, saline solution was used. Biological samples for laboratory tests were collected prior to treatment and on treatment days 4, 8 and 22. Treatment efficacy was assessed by laboratory results (detection of T. vaginalis, leukocyte-epithelial index). Results. Concomitant use of solutions containing ferrous ions at concentration 8.96 mmol/L can increase frequency of successful treatment outcomes in recurrent trichomoniasis. T. vaginalis was detected at the end of therapy in 10.3% of patients from the experimental group and 69.2% of patients from the control group. Conclusions. The concomitant use of metronidazole and solution containing ferrous ions makes it possible to increase the efficacy of therapy for Trichomonas infection. The results of the study allow us to consider topical use of iron-containing drugs to increase metronidazole treatment efficacy in recurrent trichomoniasis.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623876","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 : 2022-01-01DOI: 10.36488/cmac.2022.4.383-387
N. Barantsevich, E. Barantsevich
Objective. To compare the efficacy of ceftazidime-avibactam and aztreonam combination therapy with “standard” therapy in patients with hematological malignancies and sepsis, caused by carbapenemresistant K. pneumoniae. Materials and Methods. In this open, single center prospective-retrospective, cohort study, during 2019–2022, we analyze medical documentation of 81 hospitalized patients with hematologic malignancies and K. pneumoniae sepsis. K. pneumoniae was identified by MALDI-TOF mass-spectrometry; antimicrobial susceptibility testing was performed in accordance with current versions of EUCAST guidelines. Patients with sepsis, caused by carbapenem-resistant K. pneumoniae isolates (n = 53), received either ceftazidimeavibactam plus aztreonam combined therapy (1st group, n = 26), or “standard” antimicrobial therapy (2nd group, n = 27). Results. K. pneumoniae sepsis was diagnosed in 81 patient with hematologic malignancies during 3 years study period. In 53 (65.4%) cases sepsis was caused by carbapenem-resistant K. pneumoniae isolates. Mortality in patients that received combination therapy with ceftazidime-avibactam and aztreonam was significantly lower (34.6%), than in patients that received other antimicrobial therapy (63.0%), p = 0.039. When ceftazidime-avibactam plus aztreonam therapy was started ≥7 days after the onset of infection the mortality rates in both groups were similar (p > 0.05). Conclusions. The incidence of carbapenem-resistance in K. pneumoniae sepsis in hematologic malignancies was 65.4% in the present study. Early administration of ceftazidime-avibactam and aztreonam combined therapy was associated with lower mortality (34.6%) comparing alternative antibiotic regimens (63.0%).
{"title":"Antimicrobial therapy of sepsis caused by carbapenem-resistant Klebsiella pneumoniae in patients with hematological malignancies","authors":"N. Barantsevich, E. Barantsevich","doi":"10.36488/cmac.2022.4.383-387","DOIUrl":"https://doi.org/10.36488/cmac.2022.4.383-387","url":null,"abstract":"Objective. To compare the efficacy of ceftazidime-avibactam and aztreonam combination therapy with “standard” therapy in patients with hematological malignancies and sepsis, caused by carbapenemresistant K. pneumoniae. Materials and Methods. In this open, single center prospective-retrospective, cohort study, during 2019–2022, we analyze medical documentation of 81 hospitalized patients with hematologic malignancies and K. pneumoniae sepsis. K. pneumoniae was identified by MALDI-TOF mass-spectrometry; antimicrobial susceptibility testing was performed in accordance with current versions of EUCAST guidelines. Patients with sepsis, caused by carbapenem-resistant K. pneumoniae isolates (n = 53), received either ceftazidimeavibactam plus aztreonam combined therapy (1st group, n = 26), or “standard” antimicrobial therapy (2nd group, n = 27). Results. K. pneumoniae sepsis was diagnosed in 81 patient with hematologic malignancies during 3 years study period. In 53 (65.4%) cases sepsis was caused by carbapenem-resistant K. pneumoniae isolates. Mortality in patients that received combination therapy with ceftazidime-avibactam and aztreonam was significantly lower (34.6%), than in patients that received other antimicrobial therapy (63.0%), p = 0.039. When ceftazidime-avibactam plus aztreonam therapy was started ≥7 days after the onset of infection the mortality rates in both groups were similar (p > 0.05). Conclusions. The incidence of carbapenem-resistance in K. pneumoniae sepsis in hematologic malignancies was 65.4% in the present study. Early administration of ceftazidime-avibactam and aztreonam combined therapy was associated with lower mortality (34.6%) comparing alternative antibiotic regimens (63.0%).","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624208","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 : 2022-01-01DOI: 10.36488/cmac.2022.3.248-253
I. Pozdnyakova-Filatova, A. A. Zagoskin, M. Zakharova, M. Nagornykh
Objective. To determine whether the genes whose products are annotated as «MBL-fold metallohydrolase superfamily» are related to the proteins of the metallo-β-lactamase group. Materials and Methods. Sequences of the 7 genes annotated as «MBL-fold metallohydrolase superfamily» were analyzed using the following resources: ClustalW, IQ-TREE, iTOL. Selection of the oligonucleotides for real-time PCR was performed using the Primer-BLAST resource. The level of gene expression was assessed using real-time PCR. MIC and MBC measuring was performed using cefepime and meropenem. The double-disc method with EDTA was used to determine the presence of MBL in the strain. Results. Analysis of the nucleotide sequences of the studied genes revealed that all of them were not included in the clade containing sequences of metallo-β-lactamase. In the exponential growth phase, mRNAs corresponding to the studied proteins were found. Determination of MIC and MBC revealed a low level of resistance to antibiotics of the β-lactamase group. The phenotypic test was negative for MBL in P. putida strain BS3701. Conclusions. The investigated genes and corresponding proteins are not related to metallo-β-lactamases. They are not involved in the resistance of P. putida BS3701 to antibiotics of the metallo-β-lactamase group.
{"title":"Analysis of the genes encoding the MBL-fold metallohydrolase superfamily proteins of the Pseudomonas putida BS3701 petroleum component-degrading strain","authors":"I. Pozdnyakova-Filatova, A. A. Zagoskin, M. Zakharova, M. Nagornykh","doi":"10.36488/cmac.2022.3.248-253","DOIUrl":"https://doi.org/10.36488/cmac.2022.3.248-253","url":null,"abstract":"Objective. To determine whether the genes whose products are annotated as «MBL-fold metallohydrolase superfamily» are related to the proteins of the metallo-β-lactamase group. Materials and Methods. Sequences of the 7 genes annotated as «MBL-fold metallohydrolase superfamily» were analyzed using the following resources: ClustalW, IQ-TREE, iTOL. Selection of the oligonucleotides for real-time PCR was performed using the Primer-BLAST resource. The level of gene expression was assessed using real-time PCR. MIC and MBC measuring was performed using cefepime and meropenem. The double-disc method with EDTA was used to determine the presence of MBL in the strain. Results. Analysis of the nucleotide sequences of the studied genes revealed that all of them were not included in the clade containing sequences of metallo-β-lactamase. In the exponential growth phase, mRNAs corresponding to the studied proteins were found. Determination of MIC and MBC revealed a low level of resistance to antibiotics of the β-lactamase group. The phenotypic test was negative for MBL in P. putida strain BS3701. Conclusions. The investigated genes and corresponding proteins are not related to metallo-β-lactamases. They are not involved in the resistance of P. putida BS3701 to antibiotics of the metallo-β-lactamase group.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624263","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 : 2022-01-01DOI: 10.36488/cmac.2022.4.308-313
E. A. Ortenberg
This paper provides a review of the largest studies (over the period of 2017 to 2022) on the use of fecal microbiota transplantation (FMT) for the treatment of patients with recurrent *Clostridioides difficile*associated diarrhea (CDAD), including pseudomembranous colitis. A focus was made on methods of preparation and administration of fecal microbiota product. The recent systematic reviews and metaanalyses consistently consider TFM as an effective treatment option for recurrent CDAD. The different methods of fecal microbiota preparation and administration (fresh, frozen, lyophilized) show similar efficacy but differ by convenience of use.
{"title":"Fecal microbiota transplantation as a treatment option for patients with recurrent Clostridioides difficile-associated diarrhea","authors":"E. A. Ortenberg","doi":"10.36488/cmac.2022.4.308-313","DOIUrl":"https://doi.org/10.36488/cmac.2022.4.308-313","url":null,"abstract":"This paper provides a review of the largest studies (over the period of 2017 to 2022) on the use of fecal microbiota transplantation (FMT) for the treatment of patients with recurrent *Clostridioides difficile*associated diarrhea (CDAD), including pseudomembranous colitis. A focus was made on methods of preparation and administration of fecal microbiota product. The recent systematic reviews and metaanalyses consistently consider TFM as an effective treatment option for recurrent CDAD. The different methods of fecal microbiota preparation and administration (fresh, frozen, lyophilized) show similar efficacy but differ by convenience of use.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624549","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 : 2022-01-01DOI: 10.36488/cmac.2022.3.202-212
Vasilii D. Fedotov, A. V. Zhestkov, A. Lyamin, M. I. Zaslavskaya, I. Dobrotina, A. Tulichev
Chronic obstructive pulmonary disease (COPD) is a serious problem for global health. Infectious agents play a main role in the development of COPD exacerbations. Bacterial colonization of the lower respiratory tract is common in patients with stable COPD. The role of microbiota and host immune response to potential pathogens is not well studied. Microbiota composition disorders in respiratory tract are found in patients with COPD and associated with maladaptive changes in the immune system of the lungs and increased level of inflammation. This review investigates role of microbiota in the pathogenesis of COPD and its impact on the course of the disease. Some important issues such as pneumococcal vaccination and antimicrobial resistance of respiratory pathogens are also discussed.
{"title":"Microbiota in the pathogenesis of COPD and its impact on the course of the disease","authors":"Vasilii D. Fedotov, A. V. Zhestkov, A. Lyamin, M. I. Zaslavskaya, I. Dobrotina, A. Tulichev","doi":"10.36488/cmac.2022.3.202-212","DOIUrl":"https://doi.org/10.36488/cmac.2022.3.202-212","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is a serious problem for global health. Infectious agents play a main role in the development of COPD exacerbations. Bacterial colonization of the lower respiratory tract is common in patients with stable COPD. The role of microbiota and host immune response to potential pathogens is not well studied. Microbiota composition disorders in respiratory tract are found in patients with COPD and associated with maladaptive changes in the immune system of the lungs and increased level of inflammation. This review investigates role of microbiota in the pathogenesis of COPD and its impact on the course of the disease. Some important issues such as pneumococcal vaccination and antimicrobial resistance of respiratory pathogens are also discussed.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624629","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 : 2022-01-01DOI: 10.36488/cmac.2022.3.213-218
P. V. Tkachev, A. E. Goncharov, A. Dmitriev
Temperate bacteriophages are of interest as carriers and vectors of pathogenicity factors that determine an epidemic potential of opportunistic bacteria as well as biotechnology objects. This review describes studies of temperate bacteriophages infecting bacteria of the genus Enterococcus, including strains associated with the development of nosocomial infections. Genetic features of moderate enterococcal phages as well as their potential for practical application in medicine are considered.
{"title":"Temperate enterococcal bacteriophages: genetic features and practical application","authors":"P. V. Tkachev, A. E. Goncharov, A. Dmitriev","doi":"10.36488/cmac.2022.3.213-218","DOIUrl":"https://doi.org/10.36488/cmac.2022.3.213-218","url":null,"abstract":"Temperate bacteriophages are of interest as carriers and vectors of pathogenicity factors that determine an epidemic potential of opportunistic bacteria as well as biotechnology objects. This review describes studies of temperate bacteriophages infecting bacteria of the genus Enterococcus, including strains associated with the development of nosocomial infections. Genetic features of moderate enterococcal phages as well as their potential for practical application in medicine are considered.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624175","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 : 2022-01-01DOI: 10.36488/cmac.2022.4.388-394
A. Taube, T. V. Alexandrova, O. A. Demidova, M. Zhuravleva, E. A. Stepanov, R. Alyautdin
Objective. To analyze new strategies for the treatment of community-acquired pneumonia (CAP) by age and assess treatment efficacy by age category based on real world data. Materials and Methods. A total of 612 patients (medical charts) with CAP treated in 3 hospitals during the 2017–2019 were included in the retrospective pharmacoepidemiological study. A retrospective analysis of antimicrobial therapy (AMT) administration in the treatment of CAP was performed. Results. Duration of hospital stay in CAP patients of young age was 10% shorter than in patients of any other age category. The least frequency (19.6%) of antibiotic combination administration as initial empiric therapy was found in patients of young age. There were no significant differences in frequency of initial AMT administration between age groups. Ceftriaxone, cefepime and cefoperazone were the most common antimicrobials used as monotherapy in all age groups. Ceftriaxone with azithromycin combination was the most common (42%) initial combination therapy in all age groups. The highest number (27) of various antibiotic combinations was administered to old patients, and the lowest number (16) – to young patients. Efficacy of initial AMT was similar between elderly and old patients. Overall efficacy of initial AMT in patients with non-severe CAP and severe CAP was 54% and 50%, respectively. Analysis of antimicrobial treatment of CAP in real practice and its compliance with the current clinical guidelines showed cephalosporin plus macrolide to be a predominant antibiotic combination (83%). Conclusions. Antibiotic combination administration was found to be common in patients with non-severe CAP, whereas initial monotherapy was administered to severe CAP patients. Antibiotic prescription pattern in patient of young age was different from that in any other age groups. CAP had a less severe course in young patients as evidenced by shorter duration of hospital stay, more frequent monotherapy administration and higher efficacy of initial AMT compared to other age categories. There were no prescriptions of the recommended fifth generation cephalosporin (ceftaroline fosamil).
{"title":"Analysis of antibiotic prescriptions in patients with community-acquired pneumonia in clinical practice","authors":"A. Taube, T. V. Alexandrova, O. A. Demidova, M. Zhuravleva, E. A. Stepanov, R. Alyautdin","doi":"10.36488/cmac.2022.4.388-394","DOIUrl":"https://doi.org/10.36488/cmac.2022.4.388-394","url":null,"abstract":"Objective. To analyze new strategies for the treatment of community-acquired pneumonia (CAP) by age and assess treatment efficacy by age category based on real world data. Materials and Methods. A total of 612 patients (medical charts) with CAP treated in 3 hospitals during the 2017–2019 were included in the retrospective pharmacoepidemiological study. A retrospective analysis of antimicrobial therapy (AMT) administration in the treatment of CAP was performed. Results. Duration of hospital stay in CAP patients of young age was 10% shorter than in patients of any other age category. The least frequency (19.6%) of antibiotic combination administration as initial empiric therapy was found in patients of young age. There were no significant differences in frequency of initial AMT administration between age groups. Ceftriaxone, cefepime and cefoperazone were the most common antimicrobials used as monotherapy in all age groups. Ceftriaxone with azithromycin combination was the most common (42%) initial combination therapy in all age groups. The highest number (27) of various antibiotic combinations was administered to old patients, and the lowest number (16) – to young patients. Efficacy of initial AMT was similar between elderly and old patients. Overall efficacy of initial AMT in patients with non-severe CAP and severe CAP was 54% and 50%, respectively. Analysis of antimicrobial treatment of CAP in real practice and its compliance with the current clinical guidelines showed cephalosporin plus macrolide to be a predominant antibiotic combination (83%). Conclusions. Antibiotic combination administration was found to be common in patients with non-severe CAP, whereas initial monotherapy was administered to severe CAP patients. Antibiotic prescription pattern in patient of young age was different from that in any other age groups. CAP had a less severe course in young patients as evidenced by shorter duration of hospital stay, more frequent monotherapy administration and higher efficacy of initial AMT compared to other age categories. There were no prescriptions of the recommended fifth generation cephalosporin (ceftaroline fosamil).","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624219","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 : 2022-01-01DOI: 10.36488/cmac.2022.3.236-247
A. S. Pavlova, A. Egorova, N.E. Krutova, S. Saenko, Y. Mikhaylova, A. N. Guseva, I. Chebotar, A. Podkolzin, K. Kuleshov, V. Akimkin
Objective. To analyze frequency and identify genetic determinants of resistance of non-typhoid Salmonella (NTS) producing extended-spectrum β-lactamase (ESBL) isolated in the Russian Federation over the period 2016 to 2020. Materials and Methods. Salmonella isolates, suspected to ESBL production, were collected by the All-Russia Reference Center of Salmonellosis during the national Salmonellosis surveillance program. Phenotypic resistance was determined by the broth microdilution method using G-I and G-II Mikrolatest®SensiLaTest MIC plates and by the double-disk synergy test. Whole genome sequencing was performed on the NextSeq platform (Illumina, USA), with subsequent de novo genome assembly (SPAdes 3.15.4), identification of plasmid types (MOB-suite v3.0.0), and identification of resistance genes (AMRFinderPlus v3.10.40). Results. Out of 1792 NTS isolates, 22 strains contained bla-genes of molecular classes A and D (blaTEM, blaCTX-M, blaSHV, blaOXA), one strain – AmpC (blaCMY-2) and three strains – combination ESBL of class A and AmpC (blaTEM, blaCMY-2, blaDHA). The frequency of occurrence of ESBL-producing Salmonella is 1.3%, AmpC – 0.2%. Additionally, strains were resistant to other non-β-lactam antibiotics. Six different types of plasmids were identified (IncI, IncFIB, IncC, IncHI2A, IncL/M and IncX1) in studied isolates. It was possible for 17 strains to identify location of resistance genes in plasmids of a certain type. Conclusions. The frequency of occurrence of Salmonella strains producing ESBL and AmpC was 1.45%, which were found in sporadic cases of human diseases, as well as food and environmental objects were sources of isolation. The fact of detection of such strains among various NTC serotypes and a wide range of sources of isolation confirms the relevance of monitoring antimicrobial resistance of Salmonella strains in the future.
{"title":"The prevalence and characterization of ESBL-producing strains of Salmonella enterica circulating in the territory of the Russian Federation (2016–2020)","authors":"A. S. Pavlova, A. Egorova, N.E. Krutova, S. Saenko, Y. Mikhaylova, A. N. Guseva, I. Chebotar, A. Podkolzin, K. Kuleshov, V. Akimkin","doi":"10.36488/cmac.2022.3.236-247","DOIUrl":"https://doi.org/10.36488/cmac.2022.3.236-247","url":null,"abstract":"Objective. To analyze frequency and identify genetic determinants of resistance of non-typhoid Salmonella (NTS) producing extended-spectrum β-lactamase (ESBL) isolated in the Russian Federation over the period 2016 to 2020. Materials and Methods. Salmonella isolates, suspected to ESBL production, were collected by the All-Russia Reference Center of Salmonellosis during the national Salmonellosis surveillance program. Phenotypic resistance was determined by the broth microdilution method using G-I and G-II Mikrolatest®SensiLaTest MIC plates and by the double-disk synergy test. Whole genome sequencing was performed on the NextSeq platform (Illumina, USA), with subsequent de novo genome assembly (SPAdes 3.15.4), identification of plasmid types (MOB-suite v3.0.0), and identification of resistance genes (AMRFinderPlus v3.10.40). Results. Out of 1792 NTS isolates, 22 strains contained bla-genes of molecular classes A and D (blaTEM, blaCTX-M, blaSHV, blaOXA), one strain – AmpC (blaCMY-2) and three strains – combination ESBL of class A and AmpC (blaTEM, blaCMY-2, blaDHA). The frequency of occurrence of ESBL-producing Salmonella is 1.3%, AmpC – 0.2%. Additionally, strains were resistant to other non-β-lactam antibiotics. Six different types of plasmids were identified (IncI, IncFIB, IncC, IncHI2A, IncL/M and IncX1) in studied isolates. It was possible for 17 strains to identify location of resistance genes in plasmids of a certain type. Conclusions. The frequency of occurrence of Salmonella strains producing ESBL and AmpC was 1.45%, which were found in sporadic cases of human diseases, as well as food and environmental objects were sources of isolation. The fact of detection of such strains among various NTC serotypes and a wide range of sources of isolation confirms the relevance of monitoring antimicrobial resistance of Salmonella strains in the future.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624242","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 : 2022-01-01DOI: 10.36488/cmac.2022.3.268-272
N. Gordinskaya, E. V. Boriskina, D. Kryazhev
Objective. To study in vitro antimicrobial resistance and prevalence of the most clinically important carbapenemases genes in Klebsiella pneumoniae clinical isolates in Nizhny Novgorod. Materials and Methods. A total of 238 K. pneumoniae clinical isolates from upper and lower respiratory tracts, abdominal cavity, urogenital tract, and wound discharge were tested in this study. Species identification was done using WalkAway 96 analyzer (Siemens, Germany) with POS Combo Type 20 tablets (Beckman Coulter, USA) and Multiscan FC spectrophotometer (Thermo Scientific, Finland) with Microlatest tablets (PLIVA-Lachema, Czech Republic). Antimicrobial resistance was determined by discdiffusion method and using microbiological analyzer WalkAway 96 (Siemens, Germany). Minimal inhibitory concentrations for colistin were determined using the “MIC Colistin” kit (Erba Mannheim, Czech Republic). Detection of carbapenemases genes (KPC, OXA-48 group, IMP, VIM and NDM) was performed by RT-PCR using CFX-96 machine (Bio-Rad, USA) and commercial kits «MDR KPC/OXA-48-FL» and «MDR MBL-FL» (AmpliSens, Russia). Results. More than 90% of K. pneumoniae isolates in Nizhny Novgorod were resistant to III–V generation cephalosporins, 53.8% – to gentamicin, 71.2% – to ciprofloxacin, 81.2% – to co-trimoxazole, 88.1% – to ertapenem, 37.1% – to doripenem, 21.6% – to imipenem, 34.3% – to meropenem, 3.2% – to colistin. Genes of КРС-like carbapenemases were detected in 13.1% of isolates, OХA-48 – in 21.6%. Metallobeta-lactamases were not identified among tested isolates. Conclusions. Currently, there are no antimicrobials that active against all K. pneumoniae isolates in Nizhny Novgorod. Carbapenems and polymyxins remain active against more than 50% of isolates.
{"title":"Phenotypic and genetic characteristics of antimicrobial resistance of Klebsiella pneumoniae clinical isolates in hospitals of Nizhny Novgorod","authors":"N. Gordinskaya, E. V. Boriskina, D. Kryazhev","doi":"10.36488/cmac.2022.3.268-272","DOIUrl":"https://doi.org/10.36488/cmac.2022.3.268-272","url":null,"abstract":"Objective. To study in vitro antimicrobial resistance and prevalence of the most clinically important carbapenemases genes in Klebsiella pneumoniae clinical isolates in Nizhny Novgorod. Materials and Methods. A total of 238 K. pneumoniae clinical isolates from upper and lower respiratory tracts, abdominal cavity, urogenital tract, and wound discharge were tested in this study. Species identification was done using WalkAway 96 analyzer (Siemens, Germany) with POS Combo Type 20 tablets (Beckman Coulter, USA) and Multiscan FC spectrophotometer (Thermo Scientific, Finland) with Microlatest tablets (PLIVA-Lachema, Czech Republic). Antimicrobial resistance was determined by discdiffusion method and using microbiological analyzer WalkAway 96 (Siemens, Germany). Minimal inhibitory concentrations for colistin were determined using the “MIC Colistin” kit (Erba Mannheim, Czech Republic). Detection of carbapenemases genes (KPC, OXA-48 group, IMP, VIM and NDM) was performed by RT-PCR using CFX-96 machine (Bio-Rad, USA) and commercial kits «MDR KPC/OXA-48-FL» and «MDR MBL-FL» (AmpliSens, Russia). Results. More than 90% of K. pneumoniae isolates in Nizhny Novgorod were resistant to III–V generation cephalosporins, 53.8% – to gentamicin, 71.2% – to ciprofloxacin, 81.2% – to co-trimoxazole, 88.1% – to ertapenem, 37.1% – to doripenem, 21.6% – to imipenem, 34.3% – to meropenem, 3.2% – to colistin. Genes of КРС-like carbapenemases were detected in 13.1% of isolates, OХA-48 – in 21.6%. Metallobeta-lactamases were not identified among tested isolates. Conclusions. Currently, there are no antimicrobials that active against all K. pneumoniae isolates in Nizhny Novgorod. Carbapenems and polymyxins remain active against more than 50% of isolates.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624392","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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