Pub Date : 2022-01-01DOI: 10.36488/cmac.2022.3.283-288
E. M. Gordina, S. Bozhkova, L. N. Smirnova
Objective. To study effects of bacteriophages on biofilm formation and formed biofilm by S. aureus isolated from patients with orthopedic infection. Materials and Methods. A total of 50 clinical strains of S. aureus were tested. Species identification was performed by MALDI-TOF MS, antibiotic susceptibility – in accordance with the EUCAST v21. Isolates susceptibility to bacteriophages «Sextafag» (Microgen, Russia) was determined by MPA medium. The antibacterial activity of phages against S. aureus ATCC 29213 and S. aureus ATCC 43300 was evaluated by growth kinetic curves. Biofilms of bacteriophage-sensitive S. aureus strains were formed according to the protocol described by O’Toole. Isolates were divided into categories in accordance with the Stepanovic criteria. The effects of bacteriophages on the formation of S. aureus biofilm were studied by co-incubation of phages and bacteria followed by calculation of the percentage inhibition relative to the control without the introduction of the phages. The effect of phages on 24-hour biofilms formed by staphylococci was also evaluated in comparison with the control. Results. Out of 50 clinical S. aureus strains studied, 43 isolates (86%) were susceptible to phages, including 22 MSSA and 21 MRSA. All phage-susceptible cultures were characterized by biofilm-forming ability of varying degree: 28% – weak biofilm producer, 35% – moderate, 37% – strong. Inhibition of biofilm formation was determined in all tested MRSA strains, while in 73% of isolates the index of biofilm formation inhibition was more than 80%, which exceeded this indicator for MSSA by 2.5 times. In turn, the destruction of the formed biofilm under the action of the bacteriophage was 72% for all S. aureus. In 57% of MSSA strains, the decrease in biofilm biomass in comparison with the control was more than 80%, while this indicator was 2 times higher than for MRSA. Conclusions. The results demonstrated a high in vitro efficacy of bacteriophages against biofilm formation in S. aureus.
{"title":"Effects of bacteriophages on biofilms formed by Staphylococcus aureus isolated from patients with orthopedic infection","authors":"E. M. Gordina, S. Bozhkova, L. N. Smirnova","doi":"10.36488/cmac.2022.3.283-288","DOIUrl":"https://doi.org/10.36488/cmac.2022.3.283-288","url":null,"abstract":"Objective. To study effects of bacteriophages on biofilm formation and formed biofilm by S. aureus isolated from patients with orthopedic infection. Materials and Methods. A total of 50 clinical strains of S. aureus were tested. Species identification was performed by MALDI-TOF MS, antibiotic susceptibility – in accordance with the EUCAST v21. Isolates susceptibility to bacteriophages «Sextafag» (Microgen, Russia) was determined by MPA medium. The antibacterial activity of phages against S. aureus ATCC 29213 and S. aureus ATCC 43300 was evaluated by growth kinetic curves. Biofilms of bacteriophage-sensitive S. aureus strains were formed according to the protocol described by O’Toole. Isolates were divided into categories in accordance with the Stepanovic criteria. The effects of bacteriophages on the formation of S. aureus biofilm were studied by co-incubation of phages and bacteria followed by calculation of the percentage inhibition relative to the control without the introduction of the phages. The effect of phages on 24-hour biofilms formed by staphylococci was also evaluated in comparison with the control. Results. Out of 50 clinical S. aureus strains studied, 43 isolates (86%) were susceptible to phages, including 22 MSSA and 21 MRSA. All phage-susceptible cultures were characterized by biofilm-forming ability of varying degree: 28% – weak biofilm producer, 35% – moderate, 37% – strong. Inhibition of biofilm formation was determined in all tested MRSA strains, while in 73% of isolates the index of biofilm formation inhibition was more than 80%, which exceeded this indicator for MSSA by 2.5 times. In turn, the destruction of the formed biofilm under the action of the bacteriophage was 72% for all S. aureus. In 57% of MSSA strains, the decrease in biofilm biomass in comparison with the control was more than 80%, while this indicator was 2 times higher than for MRSA. Conclusions. The results demonstrated a high in vitro efficacy of bacteriophages against biofilm formation in S. aureus.","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":"69624452","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.2022.1.67-76
O. O. Ivoylov, A. G. Kochetov, K.A. Tirskikh
Objective. To analyze the structure and magnitude of the labor costs of various categories of personnel of the microbiological laboratory in their workplaces in order to standardize labor and calculate the labor intensity of the studies performed. Materials and Methods. The assessment of the labor costs of the personnel of the microbiological laboratory was carried out by time-and-motion study in the workplaces of a microbiologist (bacteriologist), a medical laboratory technician (MLT), a microbiological media preparation technician. The author’s «The method for researching the labor costs of staff of medical laboratory» was applied. Results. The lists and duration of standard manipulations of the labor process of the analyzed workplaces are determined, their classification by labor components was performed, on the basis of which the values of fixed and variable labor costs of the personnel and the labor intensity of microbiological studies were calculated. Workload modeling was performed for all categories of personnel depending on the change in the number of bacteriological tests performed. It is shown that at the moment the total annual labor costs of a microbiologist make up 34% of the full-time budget, a MLT – 61%, and a media preparation technician – 31%. The workload ratio at the workplaces «microbiologist / MLT / media preparation technician» with the existing number of tests corresponds to 1.0/1.7⁄0.9. The full workload on the one rate, according to currently existing regulatory documents, can be achieved with a microbiologist – with a volume of 16.3 K, with a MLT – 10.5 K, and with a media preparation technician – 36.4 K tests in year. Conclusions. Systematized data on the structure and magnitude of labor costs of the microbiological laboratory personnel workplaces were obtained. The high labor intensity of bacteriological tests and its variability depending on their types and volumes are demonstrated. The proposed approach allows not only to analyze the actual labor costs of different categories of microbiological laboratory personnel, but also makes it possible to effectively model the workload, take into account the actual overload of a laboratory specialist, and predict the need for staff units depending on the volume and quantitative ratio of the range of tests performed.
{"title":"A modern approach to timeandmotion study of microbiological laboratory workplaces","authors":"O. O. Ivoylov, A. G. Kochetov, K.A. Tirskikh","doi":"10.36488/cmac.2022.1.67-76","DOIUrl":"https://doi.org/10.36488/cmac.2022.1.67-76","url":null,"abstract":"Objective. To analyze the structure and magnitude of the labor costs of various categories of personnel of the microbiological laboratory in their workplaces in order to standardize labor and calculate the labor intensity of the studies performed. Materials and Methods. The assessment of the labor costs of the personnel of the microbiological laboratory was carried out by time-and-motion study in the workplaces of a microbiologist (bacteriologist), a medical laboratory technician (MLT), a microbiological media preparation technician. The author’s «The method for researching the labor costs of staff of medical laboratory» was applied. Results. The lists and duration of standard manipulations of the labor process of the analyzed workplaces are determined, their classification by labor components was performed, on the basis of which the values of fixed and variable labor costs of the personnel and the labor intensity of microbiological studies were calculated. Workload modeling was performed for all categories of personnel depending on the change in the number of bacteriological tests performed. It is shown that at the moment the total annual labor costs of a microbiologist make up 34% of the full-time budget, a MLT – 61%, and a media preparation technician – 31%. The workload ratio at the workplaces «microbiologist / MLT / media preparation technician» with the existing number of tests corresponds to 1.0/1.7⁄0.9. The full workload on the one rate, according to currently existing regulatory documents, can be achieved with a microbiologist – with a volume of 16.3 K, with a MLT – 10.5 K, and with a media preparation technician – 36.4 K tests in year. Conclusions. Systematized data on the structure and magnitude of labor costs of the microbiological laboratory personnel workplaces were obtained. The high labor intensity of bacteriological tests and its variability depending on their types and volumes are demonstrated. The proposed approach allows not only to analyze the actual labor costs of different categories of microbiological laboratory personnel, but also makes it possible to effectively model the workload, take into account the actual overload of a laboratory specialist, and predict the need for staff units depending on the volume and quantitative ratio of the range of tests performed.","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":"69623833","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.2022.3.261-266
S. S. Andreev, E. V. Ryazantseva, N. Maltseva, Z. Mutovina, D. Fomina, M. Lysenko
Objective. To present a case of successful treatment of a secondary bacterial infection caused by nondiphtheritic corynebacterium in a patient with severe COVID-19 and known beta-lactam intolerance. Materials and Methods. A clinical case of infective endocarditis (IE) caused by Corynebacterium amycolatum in a 74-year-old patient hospitalized with severe COVID-19 is presented. Comorbidity (secondary immune deficiency due to active malignancy, chemotherapy courses; previous heart disease) and the need for immunosuppressive therapy were triggers for infection caused by a rare Gram-positive bacterium which is usually considered as clinically non-significant. The choice of empiric antimicrobial treatment was limited by the patient’s history of beta-lactam intolerance. Results. A multidisciplinary approach to medical care of the patient and alertness to secondary infections helped to diagnose IE in a timely manner and to choose effective antimicrobial therapy. Combination therapy with vancomycin and amikacin helped to make blood flow free from infection. The further switch to oral doxycycline in outpatient settings resulted in the patient recovery from the infection. Conclusions. Under conditions of limited choice of drug therapy, it is critical to have access to modern microbiological diagnostics which make it possible to diagnose rare pathogens. A dialogue between treating physician and clinical pharmacologist helps to choose an empirical and targeted antimicrobial therapy with the best efficacy-safety ratio. There is a need to be alert to secondary infections, including those of atypical locations and courses and caused by rare or opportunistic pathogens.
{"title":"Corynebacterium amycolatum infective endocarditis in a patient with severe COVID-19: a case report","authors":"S. S. Andreev, E. V. Ryazantseva, N. Maltseva, Z. Mutovina, D. Fomina, M. Lysenko","doi":"10.36488/cmac.2022.3.261-266","DOIUrl":"https://doi.org/10.36488/cmac.2022.3.261-266","url":null,"abstract":"Objective. To present a case of successful treatment of a secondary bacterial infection caused by nondiphtheritic corynebacterium in a patient with severe COVID-19 and known beta-lactam intolerance. Materials and Methods. A clinical case of infective endocarditis (IE) caused by Corynebacterium amycolatum in a 74-year-old patient hospitalized with severe COVID-19 is presented. Comorbidity (secondary immune deficiency due to active malignancy, chemotherapy courses; previous heart disease) and the need for immunosuppressive therapy were triggers for infection caused by a rare Gram-positive bacterium which is usually considered as clinically non-significant. The choice of empiric antimicrobial treatment was limited by the patient’s history of beta-lactam intolerance. Results. A multidisciplinary approach to medical care of the patient and alertness to secondary infections helped to diagnose IE in a timely manner and to choose effective antimicrobial therapy. Combination therapy with vancomycin and amikacin helped to make blood flow free from infection. The further switch to oral doxycycline in outpatient settings resulted in the patient recovery from the infection. Conclusions. Under conditions of limited choice of drug therapy, it is critical to have access to modern microbiological diagnostics which make it possible to diagnose rare pathogens. A dialogue between treating physician and clinical pharmacologist helps to choose an empirical and targeted antimicrobial therapy with the best efficacy-safety ratio. There is a need to be alert to secondary infections, including those of atypical locations and courses and caused by rare or opportunistic pathogens.","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":"69624330","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.2022.1.14-22
Y. Dinikina, E. Shagdileeva, S. Khostelidi, O. Shadrivova, Y. Avdeenko, A. G. Volkova, M. Popova, L. S. Zubarovskaya, T. Bogomolova, S. Ignatyeva, A. Kolbin, M. Belogurova, E. Boychenko, N. Klimko
Objective. To study risk factors, etiology, clinical signs and treatment outcomes of invasive aspergillosis (IA) and mucormycosis combination (IAM) in children. Materials and Methods. A retrospective review of Saint-Petersburg register (1998–2021) of patients with IA was done and children with IAM were included. EORTC/MSGERG 2019 criteria were used for diagnosing and treatment results evaluation of invasive mycosis. We presented a clinical case of IAM in a child with acute lymphoblastic leukemia relapse. Results. A total of 12 children with IAM were included. They accounted 8% of all pediatric patients with invasive aspergillosis (n = 152). IAM was diagnosed in children with hematological malignancies and solid tumors from 4 to 16 years (median age – 11.5 years), mostly in girls (83%). Main risk factors of IAM were prolonged lymphopenia (75%, median 22 days) and neutropenia (67%, median 30 days) due to chemotherapy, systemic corticosteroids and/or immunosuppressive therapy, as well as HSCT. The predominant etiological agents of IA were Aspergillus niger (33%), A. nidulans (33%) and A. fumigatus (17%), of mucormycosis – Lichtheimia corymbifera (50%) and Rhizomucor spp. (50%). Based on EORTC/MSGERG 2019 criteria, «proven» mucormycosis was diagnosed in 83% of patients, «probable» – in 17%. «Probable» IA was found in 100% of patients. The most common clinical sites of IAM were the lungs (75%) and paranasal sinuses (43%), multifocal involvement was revealed in 33% of patients. Mucormycosis developed during antifungal therapy of IA in 83% of patients. Antifungal therapy of mucormycosis received 75% of patients (amphotericin B lipid complex – 89%, posaconazole – 78%, caspofungin – 33%), combined antifungal therapy – 33%, surgery – 50%; combination of surgical and antifungal treatment was used in 42% of patients. The overall 12-week survival was 77.8%. The use of combined surgical and antifungal treatment significantly improved the survival of children with IAM (p = 0.023). Conclusions. Mucormycosis was diagnosed in 8% of children with IA. IAM developed mostly in patients with hematological malignancies (83%), prolonged lymphopenia (75%) and neutropenia (67%) against the background of chemotherapy, systemic corticosteroids and/or immunosuppressive therapy, as well as HSCT. In 83% of patients mucormycosis was diagnosed during antifungal therapy for IA. The development of IAM increased overall 12-week mortality (50%). The combination of antifungal therapy with surgical treatment significantly improved prognosis of IAM (p = 0.023).
{"title":"Combination of invasive aspergillosis and mucormycosis in children: a case report and the results of a multicenter study","authors":"Y. Dinikina, E. Shagdileeva, S. Khostelidi, O. Shadrivova, Y. Avdeenko, A. G. Volkova, M. Popova, L. S. Zubarovskaya, T. Bogomolova, S. Ignatyeva, A. Kolbin, M. Belogurova, E. Boychenko, N. Klimko","doi":"10.36488/cmac.2022.1.14-22","DOIUrl":"https://doi.org/10.36488/cmac.2022.1.14-22","url":null,"abstract":"Objective. To study risk factors, etiology, clinical signs and treatment outcomes of invasive aspergillosis (IA) and mucormycosis combination (IAM) in children. Materials and Methods. A retrospective review of Saint-Petersburg register (1998–2021) of patients with IA was done and children with IAM were included. EORTC/MSGERG 2019 criteria were used for diagnosing and treatment results evaluation of invasive mycosis. We presented a clinical case of IAM in a child with acute lymphoblastic leukemia relapse. Results. A total of 12 children with IAM were included. They accounted 8% of all pediatric patients with invasive aspergillosis (n = 152). IAM was diagnosed in children with hematological malignancies and solid tumors from 4 to 16 years (median age – 11.5 years), mostly in girls (83%). Main risk factors of IAM were prolonged lymphopenia (75%, median 22 days) and neutropenia (67%, median 30 days) due to chemotherapy, systemic corticosteroids and/or immunosuppressive therapy, as well as HSCT. The predominant etiological agents of IA were Aspergillus niger (33%), A. nidulans (33%) and A. fumigatus (17%), of mucormycosis – Lichtheimia corymbifera (50%) and Rhizomucor spp. (50%). Based on EORTC/MSGERG 2019 criteria, «proven» mucormycosis was diagnosed in 83% of patients, «probable» – in 17%. «Probable» IA was found in 100% of patients. The most common clinical sites of IAM were the lungs (75%) and paranasal sinuses (43%), multifocal involvement was revealed in 33% of patients. Mucormycosis developed during antifungal therapy of IA in 83% of patients. Antifungal therapy of mucormycosis received 75% of patients (amphotericin B lipid complex – 89%, posaconazole – 78%, caspofungin – 33%), combined antifungal therapy – 33%, surgery – 50%; combination of surgical and antifungal treatment was used in 42% of patients. The overall 12-week survival was 77.8%. The use of combined surgical and antifungal treatment significantly improved the survival of children with IAM (p = 0.023). Conclusions. Mucormycosis was diagnosed in 8% of children with IA. IAM developed mostly in patients with hematological malignancies (83%), prolonged lymphopenia (75%) and neutropenia (67%) against the background of chemotherapy, systemic corticosteroids and/or immunosuppressive therapy, as well as HSCT. In 83% of patients mucormycosis was diagnosed during antifungal therapy for IA. The development of IAM increased overall 12-week mortality (50%). The combination of antifungal therapy with surgical treatment significantly improved prognosis of IAM (p = 0.023).","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":"69623707","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.2022.1.31-38
A. Kuzmenkov, A. G. Vinogradova, I. V. Trushin, R. Kozlov
Objective. To analyze the features of local antibiotic resistance monitoring at hospitals in the Russian Federation. Materials and Methods. The study involved a survey of 305 institutions. The duration of data collection was 1 year (March 2020 – April 2021). The responses received were analyzed using the «R» programming language. Special packages were used for data processing and calculation of confidence intervals. Results were assessed by descriptive analysis with calculation of absolute and relative frequencies, and 95% confidence intervals according to the Wilson method. Frequencies were compared using Fisher’s exact test. The significance level α was set at 0.05. Results. Hospitals at various levels of organization participated in the survey. Data on local epidemiology of antibiotic resistance was available for 54.1% of institutions. The use of computer tools to automate the collection and analysis of antibiotic resistance monitoring data was noted by 26.23%. The implementation of an antimicrobial management system in the work of a medical center was confirmed by 25.3%. Data on identification of pathogens and antibiotic susceptibility test were available in the LIS/MIS – 12.46%. Over 70% of participants indicated that they update interpretation criteria annually. Storage of the AST results for more than 1 year was implemented by over 90% of hospitals. Availability of local antimicrobial therapy protocols was confirmed by 34.75% of the respondents. Conclusions. Access to data on the local epidemiology of antimicrobial resistance was unavailable for most specialists. Insufficient use of special tools to automate the collection and evaluation of antimicrobial resistance data has been identified. Implementation of an antimicrobial stewardship program and development of local antimicrobial therapy protocols were in a limited number of institutions. The data obtained indicate significant problems in the systemic organization of local antibiotic resistance monitoring.
{"title":"Practice of local antibiotic resistance monitoring at hospitals in various regions of the Russian Federation","authors":"A. Kuzmenkov, A. G. Vinogradova, I. V. Trushin, R. Kozlov","doi":"10.36488/cmac.2022.1.31-38","DOIUrl":"https://doi.org/10.36488/cmac.2022.1.31-38","url":null,"abstract":"Objective. To analyze the features of local antibiotic resistance monitoring at hospitals in the Russian Federation. Materials and Methods. The study involved a survey of 305 institutions. The duration of data collection was 1 year (March 2020 – April 2021). The responses received were analyzed using the «R» programming language. Special packages were used for data processing and calculation of confidence intervals. Results were assessed by descriptive analysis with calculation of absolute and relative frequencies, and 95% confidence intervals according to the Wilson method. Frequencies were compared using Fisher’s exact test. The significance level α was set at 0.05. Results. Hospitals at various levels of organization participated in the survey. Data on local epidemiology of antibiotic resistance was available for 54.1% of institutions. The use of computer tools to automate the collection and analysis of antibiotic resistance monitoring data was noted by 26.23%. The implementation of an antimicrobial management system in the work of a medical center was confirmed by 25.3%. Data on identification of pathogens and antibiotic susceptibility test were available in the LIS/MIS – 12.46%. Over 70% of participants indicated that they update interpretation criteria annually. Storage of the AST results for more than 1 year was implemented by over 90% of hospitals. Availability of local antimicrobial therapy protocols was confirmed by 34.75% of the respondents. Conclusions. Access to data on the local epidemiology of antimicrobial resistance was unavailable for most specialists. Insufficient use of special tools to automate the collection and evaluation of antimicrobial resistance data has been identified. Implementation of an antimicrobial stewardship program and development of local antimicrobial therapy protocols were in a limited number of institutions. The data obtained indicate significant problems in the systemic organization of local antibiotic resistance monitoring.","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":"69623755","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.2022.2.134-138
T.N. Rybalkina, N. L. Pulnova, N. Karazhas, R. E. Bosh’ian, M. Kornienko, Y. Chereshneva, M. Ivanova, A.S. Spiridonova, O. F. Kabikova, N. Gabrielyan
Objective. To study the prevalence of pneumocystosis among heart recipients (persons awaiting heart transplantation), persons with heart transplantation (patients with orthotopic heart transplantation) and to determine the role of pneumocysts in the etiology of bronchopulmonary complications in them. Materials and Methods. The paper presents an analysis of the results of a study of 94 samples of blood sera of patients who were treated at the Shumakov Institute of Transplantation and Artificial Organs of the Ministry of Health of Russia (Moscow). As a comparison group, samples were taken from 90 donors aged 18 to 60 years. Results. The detection of various markers of pneumocystosis made possible to establish the total number of infected among the examined and determine the stage of the disease in them. Total antibodies were found in a significant number of examined patients (donors, heart recipients, patients with OTTS. They were 2.1 times more often detected in patients with OTT (53.5%) than in the comparison group (23.3%). The indicators of heart recipients did not differ much from those of blood donors, and amounted to 25.0%. Active pneumocystis infection was most often detected in patients with OTT, which in 27.9% of cases was due to primary acute infection, in 2.3% – reactivation and in 3.5% – convalescence. Active pneumocystosis was diagnosed 2.7 times less frequently in OTT recipients than in patients after heart transplantation. All cases of pneumocystosis in them are associated with primary acute infection. It should be noted that the incidence of pneumocystosis among donors is practically absent, active infection was 2.2%, all cases are due to primary acute infection. Conclusions. The identification of such a significant number of cases of active pneumocystosis in patients after heart transplantation gives grounds to carry out laboratory diagnostics on a regular basis, which will prevent the development of pneumocystis pneumonia.
{"title":"The role of pneumocysts in the etiology of bronchopulmonary complications in patients with orthotopic heart transplantation","authors":"T.N. Rybalkina, N. L. Pulnova, N. Karazhas, R. E. Bosh’ian, M. Kornienko, Y. Chereshneva, M. Ivanova, A.S. Spiridonova, O. F. Kabikova, N. Gabrielyan","doi":"10.36488/cmac.2022.2.134-138","DOIUrl":"https://doi.org/10.36488/cmac.2022.2.134-138","url":null,"abstract":"Objective. To study the prevalence of pneumocystosis among heart recipients (persons awaiting heart transplantation), persons with heart transplantation (patients with orthotopic heart transplantation) and to determine the role of pneumocysts in the etiology of bronchopulmonary complications in them. Materials and Methods. The paper presents an analysis of the results of a study of 94 samples of blood sera of patients who were treated at the Shumakov Institute of Transplantation and Artificial Organs of the Ministry of Health of Russia (Moscow). As a comparison group, samples were taken from 90 donors aged 18 to 60 years. Results. The detection of various markers of pneumocystosis made possible to establish the total number of infected among the examined and determine the stage of the disease in them. Total antibodies were found in a significant number of examined patients (donors, heart recipients, patients with OTTS. They were 2.1 times more often detected in patients with OTT (53.5%) than in the comparison group (23.3%). The indicators of heart recipients did not differ much from those of blood donors, and amounted to 25.0%. Active pneumocystis infection was most often detected in patients with OTT, which in 27.9% of cases was due to primary acute infection, in 2.3% – reactivation and in 3.5% – convalescence. Active pneumocystosis was diagnosed 2.7 times less frequently in OTT recipients than in patients after heart transplantation. All cases of pneumocystosis in them are associated with primary acute infection. It should be noted that the incidence of pneumocystosis among donors is practically absent, active infection was 2.2%, all cases are due to primary acute infection. Conclusions. The identification of such a significant number of cases of active pneumocystosis in patients after heart transplantation gives grounds to carry out laboratory diagnostics on a regular basis, which will prevent the development of pneumocystis pneumonia.","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":"69623934","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.2022.4.395-400
N. Ignatova, V. Elagin, I. Budruev, A. Antonyan, O. Streltsova, V. Kamensky
Photodynamic inactivation (PDI) is an alternative to antibiotic therapy method for biocidal action against microorganisms, which can be used for lithotripsy and sanitation of the bladder cavities. Objective. Selection of parameters and application PDI against uropathogenic microorganisms. Materials and Methods. In this study we used bacterial strains isolated from urine samples of patients. Differentiation media and biochemical plates were used for identification of microorganisms. The sensitivity of uropathogenic microorganisms to PDI was studied on pure cultures and in native urine. The photosensitizer “Photoditazine” (50 µg/ml) was used in the work, as well as Triton X-100 (5 % vol.) was applying to increase the permeability of the cell wall of gram-negative microorganisms. The samples were irradiated by a medical laser device “Latus-K” with a wavelength of 662 nm. To assess the effectiveness of PDI, the values of the logarithmic decrease of colony-forming unit (CFU) of the microorganisms were calculated. Statistical analysis was made by Statistica 10.0 and Mann-Whitney criterion. Results. 50 strains of uropathogens belonging to 18 species were isolated from 36 samples of native urine. Among them, the most common were S. aureus, E. coli, P. aeruginosa, K. pneumoniae. The value of logarithmic decrease in CFU for gram-positive bacteria ranged from 5 to 6, which corresponds to inactivation 99.999-99.9999% of bacterial cells in a sample. For gram-negative strains, this value was slightly lower and ranged from 4 to 5.5, which, nevertheless, corresponds to inactivation 99.99-99.999% of CFU bacteria. The addition of Triton X-100 increase the efficiency from 46% to 99.99% for E. coli, from 99% to 99.99% for P. mirabilis, from 16% to 94% for K. pneumoniae and from 97% to 99.999% for P. aeruginosa. It should be noted that the PDI was affect microorganisms both in isolated pure cultures and in native urine. Conclusions. Photodynamic inactivation may be considered as an alternative to antibiotic therapy method of biocidal action against uropathogenic microorganisms.
{"title":"Application of photodynamic inactivation against pathogens of urinary tract infections","authors":"N. Ignatova, V. Elagin, I. Budruev, A. Antonyan, O. Streltsova, V. Kamensky","doi":"10.36488/cmac.2022.4.395-400","DOIUrl":"https://doi.org/10.36488/cmac.2022.4.395-400","url":null,"abstract":"Photodynamic inactivation (PDI) is an alternative to antibiotic therapy method for biocidal action against microorganisms, which can be used for lithotripsy and sanitation of the bladder cavities. Objective. Selection of parameters and application PDI against uropathogenic microorganisms. Materials and Methods. In this study we used bacterial strains isolated from urine samples of patients. Differentiation media and biochemical plates were used for identification of microorganisms. The sensitivity of uropathogenic microorganisms to PDI was studied on pure cultures and in native urine. The photosensitizer “Photoditazine” (50 µg/ml) was used in the work, as well as Triton X-100 (5 % vol.) was applying to increase the permeability of the cell wall of gram-negative microorganisms. The samples were irradiated by a medical laser device “Latus-K” with a wavelength of 662 nm. To assess the effectiveness of PDI, the values of the logarithmic decrease of colony-forming unit (CFU) of the microorganisms were calculated. Statistical analysis was made by Statistica 10.0 and Mann-Whitney criterion. Results. 50 strains of uropathogens belonging to 18 species were isolated from 36 samples of native urine. Among them, the most common were S. aureus, E. coli, P. aeruginosa, K. pneumoniae. The value of logarithmic decrease in CFU for gram-positive bacteria ranged from 5 to 6, which corresponds to inactivation 99.999-99.9999% of bacterial cells in a sample. For gram-negative strains, this value was slightly lower and ranged from 4 to 5.5, which, nevertheless, corresponds to inactivation 99.99-99.999% of CFU bacteria. The addition of Triton X-100 increase the efficiency from 46% to 99.99% for E. coli, from 99% to 99.99% for P. mirabilis, from 16% to 94% for K. pneumoniae and from 97% to 99.999% for P. aeruginosa. It should be noted that the PDI was affect microorganisms both in isolated pure cultures and in native urine. Conclusions. Photodynamic inactivation may be considered as an alternative to antibiotic therapy method of biocidal action against uropathogenic microorganisms.","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":"69624259","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.2022.4.303-307
E. A. Ortenberg
This paper provides a review of the largest studies (over the period of 2017 to 2022) on cost-effectiveness analysis of the recommended treatment algorithms for Clostridioides difficile infection in patients with antibiotic-associated diarrhea (AAD), including pseudomembranous colitis. The review showed that professional medical societies in Russia, EU and US as well as meta-analyses consistently consider vancomycin as the most important treatment option for AAD and pseudomembranous colitis. The role of metronidazole and fidaxomicin in the treatment of AAD is considered ambiguous. Teicoplanin is recommended for using more commonly based on cost-effectiveness analysis.
{"title":"С. difficile infection: clinical and pharmacoeconomic assessment of treatment regimens in antibiotic-associated diarrhea","authors":"E. A. Ortenberg","doi":"10.36488/cmac.2022.4.303-307","DOIUrl":"https://doi.org/10.36488/cmac.2022.4.303-307","url":null,"abstract":"This paper provides a review of the largest studies (over the period of 2017 to 2022) on cost-effectiveness analysis of the recommended treatment algorithms for Clostridioides difficile infection in patients with antibiotic-associated diarrhea (AAD), including pseudomembranous colitis. The review showed that professional medical societies in Russia, EU and US as well as meta-analyses consistently consider vancomycin as the most important treatment option for AAD and pseudomembranous colitis. The role of metronidazole and fidaxomicin in the treatment of AAD is considered ambiguous. Teicoplanin is recommended for using more commonly based on cost-effectiveness analysis.","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":"69624539","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.2022.2.181-192
S. D. Mitrokhin, O. E. Orlova, O. Yankovskaya, I. V. Gosteva, A. Galitskiy, I. Karpova, S.G. Vedyashkina, A. Shkoda
Objective. Development of local clinical protocols for antibacterial therapy of COVID-19-associated bacterial pneumonia in the therapeutic department of the city clinical hospital based on an analysis of the treatment process in patients with COVID-19-associated pneumonia. Materials and Methods. A retrospective analysis of 1382 cases of hospitalization in the therapeutic department of patients with COVID-19-associated pneumonia for the period from 2020 to 2021 was carried out. The structure of etiotropic therapy, the frequency and timing of microbiological studies of the biomaterial, the manifestations of the main markers of bacterial infection during dynamic monitoring of clinical and laboratory parameters in patients prescribed antibiotic therapy, as well as statistics of the stay of patients in the therapeutic department of the hospital were assessed. Based on the results obtained in the course of microbiological studies, an assessment was made of the microbial landscape of the lower respiratory tract of patients with an analysis of the sensitivity of strains of the leading microflora to a wide range of antibiotics. Results. The study found that the dominant flora in COVID-19-associated pneumonia in hospitalized patients was gram-negative bacteria – K. pneumoniae, P. aeruginosa and A. baumannii – their proportion was more than 50%. Among K. pneumoniae strains, 89.4% were ESBL producers, 63.5% of the strains were resistant to carbapenems, which with a high probability allows them to be considered carbapenemaseproducing strains. Among the strains of P. aeruginosa, the proportion of strains resistant to carbapenems and with a high degree of probability being strains – producers of carbapenemase was 41.1%. Among strains of Acinetobacter spp. these were 76.4%, and associated resistance to fluoroquinolones and aminoglycosides was also demonstrated. Gram-positive microorganisms were found in 34.3% of cases and were mainly represented by strains of S. aureus (74.9%), only 26.4% of strains of this pathogen were methicillin-resistant. Conclusions. Microbiological monitoring conducted in 2020–2021 revealed the presence, among the pathogens of viral-bacterial pneumonia, at an early stage of hospitalization, a significant proportion of gram-negative bacteria with resistance of the MDR and XDR types. Based on the obtained microbiological data, starting empirical schemes for antibacterial therapy of secondary viral and bacterial pneumonia, which complicated the course of a new coronavirus infection COVID-19 caused by the SARS-CoV-2 virus, were developed and proposed.
目标。通过对新型冠状病毒肺炎患者治疗过程的分析，制定市临床医院治疗科新型冠状病毒肺炎相关细菌性肺炎的局部临床抗菌治疗方案。材料与方法。回顾性分析2020 - 2021年收治的1382例新冠肺炎相关肺炎患者治疗科住院病例。评估致病因治疗的结构、生物材料微生物学研究的频率和时间、处方抗生素治疗患者临床和实验室参数动态监测中细菌感染主要标志物的表现，以及患者在医院治疗部门的住院统计。基于结果的过程中微生物的研究,评估了微生物的景观分析患者下呼吸道的菌株的敏感性的主要微生物区系广泛antibiotics.Results.The研究发现COVID-19-associated肺炎住院患者的主要菌群是革兰氏阴性细菌- k .肺炎,铜绿假单胞菌和a . baumannii——他们的比例超过50%。肺炎克雷伯菌中产生ESBL的菌株占89.4%，对碳青霉烯类耐药的菌株占63.5%，有很高的概率可以认为是碳青霉烯类产生菌株。在铜绿假单胞菌中，对碳青霉烯类耐药且极有可能产生碳青霉烯酶的菌株占41.1%。在不动杆菌中，这一比例为76.4%，并显示出对氟喹诺酮类药物和氨基糖苷类药物的耐药性。革兰氏阳性菌占34.3%，以金黄色葡萄球菌(74.9%)为主，耐甲氧西林菌株仅占26.4%。2020-2021年开展的微生物监测显示，在病毒性细菌性肺炎的病原体中，在住院早期存在相当比例的耐多药和广泛耐药型革兰氏阴性菌。根据获得的微生物学数据，制定并提出了继发性病毒性和细菌性肺炎抗菌治疗的启动经验方案，该方案使SARS-CoV-2病毒引起的新型冠状病毒感染COVID-19的病程复杂化。
{"title":"Real-life antimicrobial therapy in hospitalized patients with COVID-19 (preliminary results and recommendations)","authors":"S. D. Mitrokhin, O. E. Orlova, O. Yankovskaya, I. V. Gosteva, A. Galitskiy, I. Karpova, S.G. Vedyashkina, A. Shkoda","doi":"10.36488/cmac.2022.2.181-192","DOIUrl":"https://doi.org/10.36488/cmac.2022.2.181-192","url":null,"abstract":"Objective. Development of local clinical protocols for antibacterial therapy of COVID-19-associated bacterial pneumonia in the therapeutic department of the city clinical hospital based on an analysis of the treatment process in patients with COVID-19-associated pneumonia. Materials and Methods. A retrospective analysis of 1382 cases of hospitalization in the therapeutic department of patients with COVID-19-associated pneumonia for the period from 2020 to 2021 was carried out. The structure of etiotropic therapy, the frequency and timing of microbiological studies of the biomaterial, the manifestations of the main markers of bacterial infection during dynamic monitoring of clinical and laboratory parameters in patients prescribed antibiotic therapy, as well as statistics of the stay of patients in the therapeutic department of the hospital were assessed. Based on the results obtained in the course of microbiological studies, an assessment was made of the microbial landscape of the lower respiratory tract of patients with an analysis of the sensitivity of strains of the leading microflora to a wide range of antibiotics. Results. The study found that the dominant flora in COVID-19-associated pneumonia in hospitalized patients was gram-negative bacteria – K. pneumoniae, P. aeruginosa and A. baumannii – their proportion was more than 50%. Among K. pneumoniae strains, 89.4% were ESBL producers, 63.5% of the strains were resistant to carbapenems, which with a high probability allows them to be considered carbapenemaseproducing strains. Among the strains of P. aeruginosa, the proportion of strains resistant to carbapenems and with a high degree of probability being strains – producers of carbapenemase was 41.1%. Among strains of Acinetobacter spp. these were 76.4%, and associated resistance to fluoroquinolones and aminoglycosides was also demonstrated. Gram-positive microorganisms were found in 34.3% of cases and were mainly represented by strains of S. aureus (74.9%), only 26.4% of strains of this pathogen were methicillin-resistant. Conclusions. Microbiological monitoring conducted in 2020–2021 revealed the presence, among the pathogens of viral-bacterial pneumonia, at an early stage of hospitalization, a significant proportion of gram-negative bacteria with resistance of the MDR and XDR types. Based on the obtained microbiological data, starting empirical schemes for antibacterial therapy of secondary viral and bacterial pneumonia, which complicated the course of a new coronavirus infection COVID-19 caused by the SARS-CoV-2 virus, were developed and proposed.","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":"69624560","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.2022.4.369-374
O. Obraztsova, M. V. Shpilevaya, G. Katunin, A. Obukhov, Yu.Z. Shagabieva, V. Solomka
Objective. To investigate prevalence of the A2058G mutation in the Russian population of T. pallidum and its association with molecular subtypes. Materials and Methods. We analyzed DNA isolated from 325 samples of clinical material obtained from patients of dermatovenereological treatment and prophylactic institutions in 6 federal districts of the Russia in the period from 2014 to 2021. Patients were diagnosed with primary syphilis of the genital organs, primary syphilis of other sites, or secondary syphilis of the skin and mucous membranes. DNA was isolated using the Proba-NK reagent kit (DNA-technology, Russia) according to the manufacturer’s instructions. The presence of T. pallidum genetic material was confirmed by PCR with primers for the species-specific polA gene. Molecular typing was performed based on the analysis of polymorphic regions of species-specific T. pallidum genes. The primary decoding of the nucleotide sequences of the 23S rRNA gene fragment was carried out using the Sequencing Analysis 5.3.1 program. The analyzed fragments were aligned using the Mega 5 program. Results. Eight molecular subtypes of T. pallidum – 14d/f, 14d/g, 14b/f, 14c/f, 14i/f, 9d/f, 14b/g and 14e/f with stable dominance of subtype 14d/f – were identified in the Russian Federation in the interval 2014–2021. Three subtypes, 14d/g, 14b/g and 14b/f, carrying the A2058G mutation associated with azithromycin resistance, were identified. Conclusions. Studies on molecular typing of T. pallidum strains in the Russia have shown significant population heterogeneity. Three sublines containing the A2058G mutation were shown to exist, one of which – 14b/f – is described as rare. The obtained data confirm the relevance of continuous monitoring of the emergence of resistant strains and the development of new mutations.
{"title":"Prevalence of the A2058G mutation in 23S rRNA gene, which determines Treponema pallidum macrolide resistance in Russian population","authors":"O. Obraztsova, M. V. Shpilevaya, G. Katunin, A. Obukhov, Yu.Z. Shagabieva, V. Solomka","doi":"10.36488/cmac.2022.4.369-374","DOIUrl":"https://doi.org/10.36488/cmac.2022.4.369-374","url":null,"abstract":"Objective. To investigate prevalence of the A2058G mutation in the Russian population of T. pallidum and its association with molecular subtypes. Materials and Methods. We analyzed DNA isolated from 325 samples of clinical material obtained from patients of dermatovenereological treatment and prophylactic institutions in 6 federal districts of the Russia in the period from 2014 to 2021. Patients were diagnosed with primary syphilis of the genital organs, primary syphilis of other sites, or secondary syphilis of the skin and mucous membranes. DNA was isolated using the Proba-NK reagent kit (DNA-technology, Russia) according to the manufacturer’s instructions. The presence of T. pallidum genetic material was confirmed by PCR with primers for the species-specific polA gene. Molecular typing was performed based on the analysis of polymorphic regions of species-specific T. pallidum genes. The primary decoding of the nucleotide sequences of the 23S rRNA gene fragment was carried out using the Sequencing Analysis 5.3.1 program. The analyzed fragments were aligned using the Mega 5 program. Results. Eight molecular subtypes of T. pallidum – 14d/f, 14d/g, 14b/f, 14c/f, 14i/f, 9d/f, 14b/g and 14e/f with stable dominance of subtype 14d/f – were identified in the Russian Federation in the interval 2014–2021. Three subtypes, 14d/g, 14b/g and 14b/f, carrying the A2058G mutation associated with azithromycin resistance, were identified. Conclusions. Studies on molecular typing of T. pallidum strains in the Russia have shown significant population heterogeneity. Three sublines containing the A2058G mutation were shown to exist, one of which – 14b/f – is described as rare. The obtained data confirm the relevance of continuous monitoring of the emergence of resistant strains and the development of new mutations.","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":"69624653","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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