Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.2.173-183
Оlga U. Stetsiouk, I. Andreeva, А. Lekmanov, Еlena V. Haykina
Abstract The increasing number of infections caused by multidrug-resistant gram-negative bacteria in children is a serious problem all over the world. Ceftazidim-avibactam is a promising antimicrobial drug recently approved in Russia for use in pediatric practice. This review provides information on the possible use of ceftazidime-avibactam in children with complicated intraabdominal infections (in combination with metronidazole); complicated urinary tract infections, including pyelonephritis; hospital-acquired pneumonia, including ventilator-associated pneumonia; infections caused by aerobic gram-negative microorganisms in patients with limited choice of antibacterial therapy. Based on the data on the in vitro activity of the drug, the results of clinical studies of pharmacokinetics, safety and efficacy of ceftazidimeavibactam for the treatment of infections in children the main clinical cases in which the use of ceftazidimeavibactam in pediatric practice is most justified and appropriate are identified.
{"title":"Ceftazidimeavibactam use in children and adolescents","authors":"Оlga U. Stetsiouk, I. Andreeva, А. Lekmanov, Еlena V. Haykina","doi":"10.36488/cmac.2021.2.173-183","DOIUrl":"https://doi.org/10.36488/cmac.2021.2.173-183","url":null,"abstract":"Abstract The increasing number of infections caused by multidrug-resistant gram-negative bacteria in children is a serious problem all over the world. Ceftazidim-avibactam is a promising antimicrobial drug recently approved in Russia for use in pediatric practice. This review provides information on the possible use of ceftazidime-avibactam in children with complicated intraabdominal infections (in combination with metronidazole); complicated urinary tract infections, including pyelonephritis; hospital-acquired pneumonia, including ventilator-associated pneumonia; infections caused by aerobic gram-negative microorganisms in patients with limited choice of antibacterial therapy. Based on the data on the in vitro activity of the drug, the results of clinical studies of pharmacokinetics, safety and efficacy of ceftazidimeavibactam for the treatment of infections in children the main clinical cases in which the use of ceftazidimeavibactam in pediatric practice is most justified and appropriate are identified.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.3.220-225
Y. Bocharova, T.A. Saviniova, A. V. Chaplin, A. Lyamin, O. Kondratenko, S. Polikarpova, S. Zhilina, N. Fedorova, M. Korzhanova, N. A. Mayansky, I. Chebotar
Objective. To determine species, sequence-types, antimicrobial resistance and virulence genes in Achromobacter spp. isolates obtained from cystic fibrosis (CF) patients in Russia. Materials and Methods. Samples (sputum, nasopharyngeal swab) from 168 CF patients from 48 regions were studied. Whole-genome sequencing (WGS) was performed on MGISEQ-2000 platform. SPAdes software, Galaxy, ResFinder, Integrall, PubMLST were used for analysis of WGS data. Results. A total of 18 strains of Achromobacter spp. were isolated from 16 of 168 CF patients.Achromobacter xylosoxidans was the most prevalent and detected in 13⁄18 cases (72%). Studied Achromobacter spp. isolates belonged to 14 sequence types, including 8 new sequence types. An adaptive resistance gene carriage was a rare phenomenon (1⁄18 isolates). Conclusions. The Achromobacter spp. colonization rate of respiratory system in CF patients in Russia corresponds to the data reported in other countries. A. xylosoxidans isolates were the most prevalent (72%). Achromobacter spp. isolates from CF patients in Russia and show a high clonal diversity.
{"title":"Genomic properties in Achromobacter spp. strains from cystic fibrosis patients in Russia","authors":"Y. Bocharova, T.A. Saviniova, A. V. Chaplin, A. Lyamin, O. Kondratenko, S. Polikarpova, S. Zhilina, N. Fedorova, M. Korzhanova, N. A. Mayansky, I. Chebotar","doi":"10.36488/cmac.2021.3.220-225","DOIUrl":"https://doi.org/10.36488/cmac.2021.3.220-225","url":null,"abstract":"Objective. To determine species, sequence-types, antimicrobial resistance and virulence genes in Achromobacter spp. isolates obtained from cystic fibrosis (CF) patients in Russia. Materials and Methods. Samples (sputum, nasopharyngeal swab) from 168 CF patients from 48 regions were studied. Whole-genome sequencing (WGS) was performed on MGISEQ-2000 platform. SPAdes software, Galaxy, ResFinder, Integrall, PubMLST were used for analysis of WGS data. Results. A total of 18 strains of Achromobacter spp. were isolated from 16 of 168 CF patients.Achromobacter xylosoxidans was the most prevalent and detected in 13⁄18 cases (72%). Studied Achromobacter spp. isolates belonged to 14 sequence types, including 8 new sequence types. An adaptive resistance gene carriage was a rare phenomenon (1⁄18 isolates). Conclusions. The Achromobacter spp. colonization rate of respiratory system in CF patients in Russia corresponds to the data reported in other countries. A. xylosoxidans isolates were the most prevalent (72%). Achromobacter spp. isolates from CF patients in Russia and show a high clonal diversity.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.3.280-291
R. Kozlov, I. S. Azyzov, A. Dekhnich, N. Ivanchik, A. Kuzmenkov, Alexey А. Martinovich, A.V. Mikotina, M. Sukhorukova, I. V. Trushin, M. Edelstein
Objective. To evaluate in vitro activity of biapenem and other clinically available carbapenems against Russian clinical isolates of Enterobacterales, Pseudomonas aeruginosa и Acinetobacter spp., including isolates with acquired fermentative mechanisms of resistance to β-lactams. Materials and Methods. A total of 3139 Enterobacterales isolates, 793 P. aeruginosa isolates and 634 Acinetobacter spp. isolates from hospitalized patients in 63 hospitals from 35 Russian cities were included in the study during 2018-2019. Minimal inhibitory concentrations (MIC) for biapenem and other antimicrobials were determined in accordance with ISO 20776-1:2006. Carbapenemases genes were detected by commercially available real-time PCR kits AmpliSens® MDR KPC/OXA-48-FL and AmpliSens® MDR MBL-FL (Central Research Institute of Epidemiology, Russia). Data analysis and reporting was performed using AMRcloud online platform (www.amrcloud.net). Results. For all tested Escherichia coli isolates MIC50/90 were 0.06/0.125 mg/l for biapenem, 0.125⁄0.25 mg/l for imipenem, and 0.06/0.06 mg/l for meropenem. When MIC50/90 for ertapenem (0.015/0.125 mg/l for all isolates tested) were comparable to those of biapenem, a greater number of nosocomial E. coli isolates had MIC >4 mg/l for ertapenem (3.6%) than for biapenem (2.6%). MIC50/90 of Klebsiella pneumoniae for biapenem were 0.5⁄16 mg/l, for both imipenem and meropenem – 0.5⁄32 mg/l, for ertapenem – 2⁄32 mg/l. Resistance to oxyimino-β-lactams had no significant influence on activity of biapenem against Enterobacterales isolates. For 321 carbapenemase-producing K. pneumoniae isolates (ОХА-48 – 63.9%, NDM – 27.7%) biapenem has shown no advantages over imipenem and meropenem. МПК50/90 for nosocomial and community-acquired P. aeruginosa isolates were 8⁄64 mg/l and 0,5⁄16 mg/l for biapenem, 8⁄128 mg/l and 1⁄16 mg/l – for imipenem, 16⁄64 mg/l and 0,5⁄32 mg/l – for meropenem. All carbapenems, including biapenem, had very low in vitro activity against carbapenemaseproducing P. aeruginosa isolates. МПК50/90 of Acinetobacter spp. were 64⁄128 mg/l for biapenem, 64⁄128 mg/l – for imipenem, and 128⁄128 mg/l – for meropenem. Conclusions. According to the MIC distributions and MICs50/90 values independently of the presence of fermentative mechanisms of resistance to β-lactams, in vitro activity of biapenem against Russian clinical isolates of Enterobacterales, P. aeruginosa and Acinetobacter spp. was comparable to those of imipenem and meropenem.
{"title":"In vitro activity of biapenem and other carbapenems against Russian clinical isolates of Pseudomonas aeruginosa, Acinetobacter spp., and Enterobacterales","authors":"R. Kozlov, I. S. Azyzov, A. Dekhnich, N. Ivanchik, A. Kuzmenkov, Alexey А. Martinovich, A.V. Mikotina, M. Sukhorukova, I. V. Trushin, M. Edelstein","doi":"10.36488/cmac.2021.3.280-291","DOIUrl":"https://doi.org/10.36488/cmac.2021.3.280-291","url":null,"abstract":"Objective. To evaluate in vitro activity of biapenem and other clinically available carbapenems against Russian clinical isolates of Enterobacterales, Pseudomonas aeruginosa и Acinetobacter spp., including isolates with acquired fermentative mechanisms of resistance to β-lactams. Materials and Methods. A total of 3139 Enterobacterales isolates, 793 P. aeruginosa isolates and 634 Acinetobacter spp. isolates from hospitalized patients in 63 hospitals from 35 Russian cities were included in the study during 2018-2019. Minimal inhibitory concentrations (MIC) for biapenem and other antimicrobials were determined in accordance with ISO 20776-1:2006. Carbapenemases genes were detected by commercially available real-time PCR kits AmpliSens® MDR KPC/OXA-48-FL and AmpliSens® MDR MBL-FL (Central Research Institute of Epidemiology, Russia). Data analysis and reporting was performed using AMRcloud online platform (www.amrcloud.net). Results. For all tested Escherichia coli isolates MIC50/90 were 0.06/0.125 mg/l for biapenem, 0.125⁄0.25 mg/l for imipenem, and 0.06/0.06 mg/l for meropenem. When MIC50/90 for ertapenem (0.015/0.125 mg/l for all isolates tested) were comparable to those of biapenem, a greater number of nosocomial E. coli isolates had MIC >4 mg/l for ertapenem (3.6%) than for biapenem (2.6%). MIC50/90 of Klebsiella pneumoniae for biapenem were 0.5⁄16 mg/l, for both imipenem and meropenem – 0.5⁄32 mg/l, for ertapenem – 2⁄32 mg/l. Resistance to oxyimino-β-lactams had no significant influence on activity of biapenem against Enterobacterales isolates. For 321 carbapenemase-producing K. pneumoniae isolates (ОХА-48 – 63.9%, NDM – 27.7%) biapenem has shown no advantages over imipenem and meropenem. МПК50/90 for nosocomial and community-acquired P. aeruginosa isolates were 8⁄64 mg/l and 0,5⁄16 mg/l for biapenem, 8⁄128 mg/l and 1⁄16 mg/l – for imipenem, 16⁄64 mg/l and 0,5⁄32 mg/l – for meropenem. All carbapenems, including biapenem, had very low in vitro activity against carbapenemaseproducing P. aeruginosa isolates. МПК50/90 of Acinetobacter spp. were 64⁄128 mg/l for biapenem, 64⁄128 mg/l – for imipenem, and 128⁄128 mg/l – for meropenem. Conclusions. According to the MIC distributions and MICs50/90 values independently of the presence of fermentative mechanisms of resistance to β-lactams, in vitro activity of biapenem against Russian clinical isolates of Enterobacterales, P. aeruginosa and Acinetobacter spp. was comparable to those of imipenem and meropenem.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.3.293-303
O. Romashov, O. Ni, A. Bykov, A. Kruglov, D. Protsenko, I. N. Tyurin
Objective. assessment of the evolution of the microbiological landscape of the hospital for the period of operation in 2020 into a pandemic of a new coronavirus infection in various departments, including intensive care units; change depending on the results of antibacterial therapy regimens. Materials and Methods. In a retrospective study, conducted from June to December 2020, in a multidisciplinary hospital working with COVID-19 infection, the resistance of isolated strains of microorganisms was analyzed in patients of different age groups. Resistance was assessed with test points in June and November 2020; depending on this, proposals were made to correct the internal (local) protocols of antimicrobial therapy. Results. The need for frequent and regular microbiological monitoring was confirmed. Further, we understood that the territories of the main and temporary hospital of the City Clinical Hospital No. 40 are heterogeneous and there are obvious differences both in structure and in the level of sensitivity. “In practice, these are two different hospitals”. Within the territories, the branches also differ from each other. When analyzing resistance in ICUs, it was revealed that within each hospital in each department, albeit similar in structure and profile of patients, there is a different level of resistance of strains. Conclusions. The structure of sensitivity generally corresponds to the world data, but for some pathogens it differs significantly. Microbiological monitoring should be carried out not only inside the hospital, but also inside the department. The increase in consumption of carbapenems and protected cephalosporins requires a reassessment of the practice of using AMP in any covid hospital, due to the impact on the epidemic situation both in the ICUs and in the hospital.
{"title":"Antimicrobial resistance and antimicrobial therapy modification during COVID19 pandemic in large tertiary hospital","authors":"O. Romashov, O. Ni, A. Bykov, A. Kruglov, D. Protsenko, I. N. Tyurin","doi":"10.36488/cmac.2021.3.293-303","DOIUrl":"https://doi.org/10.36488/cmac.2021.3.293-303","url":null,"abstract":"Objective. assessment of the evolution of the microbiological landscape of the hospital for the period of operation in 2020 into a pandemic of a new coronavirus infection in various departments, including intensive care units; change depending on the results of antibacterial therapy regimens. Materials and Methods. In a retrospective study, conducted from June to December 2020, in a multidisciplinary hospital working with COVID-19 infection, the resistance of isolated strains of microorganisms was analyzed in patients of different age groups. Resistance was assessed with test points in June and November 2020; depending on this, proposals were made to correct the internal (local) protocols of antimicrobial therapy. Results. The need for frequent and regular microbiological monitoring was confirmed. Further, we understood that the territories of the main and temporary hospital of the City Clinical Hospital No. 40 are heterogeneous and there are obvious differences both in structure and in the level of sensitivity. “In practice, these are two different hospitals”. Within the territories, the branches also differ from each other. When analyzing resistance in ICUs, it was revealed that within each hospital in each department, albeit similar in structure and profile of patients, there is a different level of resistance of strains. Conclusions. The structure of sensitivity generally corresponds to the world data, but for some pathogens it differs significantly. Microbiological monitoring should be carried out not only inside the hospital, but also inside the department. The increase in consumption of carbapenems and protected cephalosporins requires a reassessment of the practice of using AMP in any covid hospital, due to the impact on the epidemic situation both in the ICUs and in the hospital.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.1.55-64
T. Perepanova, A. Kazachenko, P. L. Khazan, Yu A Malova
In connection with growing problem of antimicrobial resistance, the search for alternative treatments for infection is popular topic nowadays. This article represents an overview of published data on the therapeutic use of bacteriophages, specifically in urinary tract infections. The history of phage therapy of infectious diseases from the beginning of the 20th century to the present days is presented. The paper also discuss the mechanism of bacteriophages activity, differences between lytic and lysogenic phages, mechanisms of bacterial tolerance to phages and ways of its overcoming are. Authors present their own data on 30 years of clinical use of “bacteriophage cocktails” in the treatment and prevention of urological infection.
{"title":"Bacteriophage therapy: back to the future","authors":"T. Perepanova, A. Kazachenko, P. L. Khazan, Yu A Malova","doi":"10.36488/cmac.2021.1.55-64","DOIUrl":"https://doi.org/10.36488/cmac.2021.1.55-64","url":null,"abstract":"In connection with growing problem of antimicrobial resistance, the search for alternative treatments for infection is popular topic nowadays. This article represents an overview of published data on the therapeutic use of bacteriophages, specifically in urinary tract infections. The history of phage therapy of infectious diseases from the beginning of the 20th century to the present days is presented. The paper also discuss the mechanism of bacteriophages activity, differences between lytic and lysogenic phages, mechanisms of bacterial tolerance to phages and ways of its overcoming are. Authors present their own data on 30 years of clinical use of “bacteriophage cocktails” in the treatment and prevention of urological infection.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.3.314-329
G. I. Syraeva, S. Mishinova, A. Kolbin, E.O. Eremenko
Objective. To review and summarize literature data in studies of safety of the drug products used for the pathogenetic treatment of COVID-19. Materials and Methods. As the first stage of monitoring the drug’s safety, which are used in the treatment of COVID-19 in Russia, a systematic review of studies of the drug’s safety profiles was carried out: mefloquine, hydroxychloroquine, azithromycin, lopinavir/ritonavir, favipiravir, tocilizumab, olokizumab, baricitinib in the international databases Medline, PubMed, ClinicalTrials.gov and Cochrane Library for the period 2019–2021. Results. The review included 51 articles that met the selection criteria. Based on the results of the review, it can be concluded that the safety profile (frequency, severity and severity) of most drugs repurposed for COVID-19 corresponds to those for the registered indications. At the same time, according to world experience, there is an increase in the number of reports of adverse drug reactions of hydroxychloroquine and azithromycin, which is provoked by the active use of these drugs for combination therapy. Conclusions. According to the literature, a high incidence of adverse events was noted in hydroxychloroquine, chloroquine and azithromycin. Subsequent analysis and comparison of the safety profiles of hydroxychloroquine, chloroquine and azithromycin with data from the national automated information system (AIS) database of Roszdravnadzor is a necessary component of effective and safe pharmacotherapy for COVID-19.
{"title":"Safety profile assessment of drug products used for the pathogenetic treatment of COVID19","authors":"G. I. Syraeva, S. Mishinova, A. Kolbin, E.O. Eremenko","doi":"10.36488/cmac.2021.3.314-329","DOIUrl":"https://doi.org/10.36488/cmac.2021.3.314-329","url":null,"abstract":"Objective. To review and summarize literature data in studies of safety of the drug products used for the pathogenetic treatment of COVID-19. Materials and Methods. As the first stage of monitoring the drug’s safety, which are used in the treatment of COVID-19 in Russia, a systematic review of studies of the drug’s safety profiles was carried out: mefloquine, hydroxychloroquine, azithromycin, lopinavir/ritonavir, favipiravir, tocilizumab, olokizumab, baricitinib in the international databases Medline, PubMed, ClinicalTrials.gov and Cochrane Library for the period 2019–2021. Results. The review included 51 articles that met the selection criteria. Based on the results of the review, it can be concluded that the safety profile (frequency, severity and severity) of most drugs repurposed for COVID-19 corresponds to those for the registered indications. At the same time, according to world experience, there is an increase in the number of reports of adverse drug reactions of hydroxychloroquine and azithromycin, which is provoked by the active use of these drugs for combination therapy. Conclusions. According to the literature, a high incidence of adverse events was noted in hydroxychloroquine, chloroquine and azithromycin. Subsequent analysis and comparison of the safety profiles of hydroxychloroquine, chloroquine and azithromycin with data from the national automated information system (AIS) database of Roszdravnadzor is a necessary component of effective and safe pharmacotherapy for COVID-19.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.2.127-137
R. Kozlov, A. Muravyev, A. Chagaryan, N. Ivanchik, A. Kurkova, A. Kuzmenkov, I. V. Trushin, M. Sukhorukova
Objective. To estimate prevalence and antimicrobial susceptibility of circulated S. pneumoniae serotypes in adult population in different regions of the Russian Federation. Materials and Methods. A total of 500 isolates of S. pneumoniae obtained from patients with invasive pneumococcal disease (IPD), community-acquired pneumonia (CAP), sinusitis/acute otitis media (AOM) and healthy carriers from 29 centers were included in the study from 01 June 2019 to 15 January 2020. Re-identification, typing using real-time PCR with 27 primer pairs and antimicrobial susceptibility testing were performed in the central laboratory by standardized methods. Results. Among 50 isolates from patients with IPD, the following serotypes were detected: 3 (20.0%), 23F (10.0%), 6ABCD (8.0%), 19F (6.0%), 12ABF, 4, 7AF, 8, 9NL, 9VA, 15B (4.0% each), 1, 10A, 11AD, 14, 15AF, 18ABCF, 22AF, 33F/33A/37 (2.0% each). PCV-13 and PPV-23 covered 62.0% and 86.0% of those serotypes, respectively. Among 357 isolates from patients with CAP, the following serotypes were detected: 19F (12.3%), 6ABCD (11.5%), 3 (10.1%), 23F (5.9%), 14 (5.3%), 22AF (5.0%), 11AD (4.8%), 9NL (3.4%), 15AF (2.8%), 9VA (2.2%), 18ABCF (2.0%), 19A (1.7%), 12ABF (1.4%), 17F (0.8%), 16, 33F/33A/37, 7AF and 8 (0.6% each), 10A and 4 (0,3% each); serotypes were not specified due to the PCR typing protocol limitations for 106 (29.8%) isolates. PCV-13 and PPV-23 covered 51.9% and 68.7% of those serotypes, respectively. In patients with sinusitis/AOM (n = 48), serotypes were: 19F (18.8%), 6ABCD (16.7%), 23F (12.5%), 3 (12.5%), 18ABCF (6.3%), 11AD (4.2%), 14 (4.2%), 22AF (4.2%), 15AF, 4, 9VA (2.1% each). PCV-13 and PPV-23 covered 75.0% and 83.3% of those serotypes, respectively. In healthy nasopharyngeal carriers (n = 45), the following serotypes were detected: 19F (24.4%), 3 (17.8%), 6ABCD (17.8%), 11AD (13.3%), 23F (8.9%), 22AF (6.7%), 14 and 15AF (2.2% each). PCV-13 and PPV-23 covered 71.1% and 91.1% of those serotypes, respectively. Serotypes 14, 19F, and 19A were frequently resistant to three antibiotics – penicillin, erythromycin, and tetracycline. Resistance to respiratory quinolones was very low (0.7%) and detected among serotypes 14 and 9NL only. The majority of non-vaccine serotypes did not have substantial antimicrobial resistance problems. Conclusions. Despite the relatively low number of isolates in all but CAP group and limitations of PCR typing protocol, results of our study support the use of pneumococcal vaccines (PPV-23 and PCV-13) in Russian adult population, with some advantages of PPV-23 over PCV-13.
{"title":"The prevalence and antimicrobial susceptibility of circulating S. pneumoniae serotypes in adult population in Russia (epidemiological study «SPECTRUM»)","authors":"R. Kozlov, A. Muravyev, A. Chagaryan, N. Ivanchik, A. Kurkova, A. Kuzmenkov, I. V. Trushin, M. Sukhorukova","doi":"10.36488/cmac.2021.2.127-137","DOIUrl":"https://doi.org/10.36488/cmac.2021.2.127-137","url":null,"abstract":"Objective. To estimate prevalence and antimicrobial susceptibility of circulated S. pneumoniae serotypes in adult population in different regions of the Russian Federation. Materials and Methods. A total of 500 isolates of S. pneumoniae obtained from patients with invasive pneumococcal disease (IPD), community-acquired pneumonia (CAP), sinusitis/acute otitis media (AOM) and healthy carriers from 29 centers were included in the study from 01 June 2019 to 15 January 2020. Re-identification, typing using real-time PCR with 27 primer pairs and antimicrobial susceptibility testing were performed in the central laboratory by standardized methods. Results. Among 50 isolates from patients with IPD, the following serotypes were detected: 3 (20.0%), 23F (10.0%), 6ABCD (8.0%), 19F (6.0%), 12ABF, 4, 7AF, 8, 9NL, 9VA, 15B (4.0% each), 1, 10A, 11AD, 14, 15AF, 18ABCF, 22AF, 33F/33A/37 (2.0% each). PCV-13 and PPV-23 covered 62.0% and 86.0% of those serotypes, respectively. Among 357 isolates from patients with CAP, the following serotypes were detected: 19F (12.3%), 6ABCD (11.5%), 3 (10.1%), 23F (5.9%), 14 (5.3%), 22AF (5.0%), 11AD (4.8%), 9NL (3.4%), 15AF (2.8%), 9VA (2.2%), 18ABCF (2.0%), 19A (1.7%), 12ABF (1.4%), 17F (0.8%), 16, 33F/33A/37, 7AF and 8 (0.6% each), 10A and 4 (0,3% each); serotypes were not specified due to the PCR typing protocol limitations for 106 (29.8%) isolates. PCV-13 and PPV-23 covered 51.9% and 68.7% of those serotypes, respectively. In patients with sinusitis/AOM (n = 48), serotypes were: 19F (18.8%), 6ABCD (16.7%), 23F (12.5%), 3 (12.5%), 18ABCF (6.3%), 11AD (4.2%), 14 (4.2%), 22AF (4.2%), 15AF, 4, 9VA (2.1% each). PCV-13 and PPV-23 covered 75.0% and 83.3% of those serotypes, respectively. In healthy nasopharyngeal carriers (n = 45), the following serotypes were detected: 19F (24.4%), 3 (17.8%), 6ABCD (17.8%), 11AD (13.3%), 23F (8.9%), 22AF (6.7%), 14 and 15AF (2.2% each). PCV-13 and PPV-23 covered 71.1% and 91.1% of those serotypes, respectively. Serotypes 14, 19F, and 19A were frequently resistant to three antibiotics – penicillin, erythromycin, and tetracycline. Resistance to respiratory quinolones was very low (0.7%) and detected among serotypes 14 and 9NL only. The majority of non-vaccine serotypes did not have substantial antimicrobial resistance problems. Conclusions. Despite the relatively low number of isolates in all but CAP group and limitations of PCR typing protocol, results of our study support the use of pneumococcal vaccines (PPV-23 and PCV-13) in Russian adult population, with some advantages of PPV-23 over PCV-13.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.1.27-42
D. Ruzanov, A. M. Skriagina, I. Buinevich, S. Goponiako, G. Balasaniantc, E. Khimova
Rapid tests detecting Mycobacterium tuberculosis and drug resistance which are universally implemented in medical practice has dramatically improved the diagnosis of rifampicin-resistant tuberculosis and shortened turnaround time thus enabling early etiotropic therapy. However, permanently increasing drug resistance of M. tuberculosis makes treatment less effective. Furthermore, long treatment courses are required due to low sterilizing activity of treatment regimens used for drug-resistant tuberculosis which leads to greater toxic effects, reduces patients’ adherence to treatment and consumes resources of medical care systems. Current phthisiology needs new effective medications and short treatment regimens, otherwise elimination of tuberculosis by 2050 is impossible. This review summarizes the information about treatment of drugresistant TB, including repurposed drugs, new medications and treatment regimens.
{"title":"New regimens and new medications in the treatment of tuberculosis: keeping step?","authors":"D. Ruzanov, A. M. Skriagina, I. Buinevich, S. Goponiako, G. Balasaniantc, E. Khimova","doi":"10.36488/cmac.2021.1.27-42","DOIUrl":"https://doi.org/10.36488/cmac.2021.1.27-42","url":null,"abstract":"Rapid tests detecting Mycobacterium tuberculosis and drug resistance which are universally implemented in medical practice has dramatically improved the diagnosis of rifampicin-resistant tuberculosis and shortened turnaround time thus enabling early etiotropic therapy. However, permanently increasing drug resistance of M. tuberculosis makes treatment less effective. Furthermore, long treatment courses are required due to low sterilizing activity of treatment regimens used for drug-resistant tuberculosis which leads to greater toxic effects, reduces patients’ adherence to treatment and consumes resources of medical care systems. Current phthisiology needs new effective medications and short treatment regimens, otherwise elimination of tuberculosis by 2050 is impossible. This review summarizes the information about treatment of drugresistant TB, including repurposed drugs, new medications and treatment regimens.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.3.226-238
M. Popova, Y. Rogacheva
Over the last decade, the introduction of new antifungal drugs and diagnostic procedures has improved the prognosis of hematological patients with invasive fungal disease (IFD), primarily invasive aspergillosis. Despite effective antifungal prophylaxis against the most common IFD caused by Aspergillus spp., rates of IFD due to rare pathogens being resistant to most antifungal drugs, including mucormycosis have been increased. The main group of patients having a high risk of mucormycosis is deeply immunocompromised patients who received chemotherapy for acute leukemia, patients undergoing allogeneic bone marrow transplantation, or treated with corticosteroids for graft-versushost disease. Currently, the urgency of this complication is significantly higher due to COVID-19 pandemic and extensive use of corticosteroids for the treatment of COVID-19. Despite the fact that the criteria for the diagnosis of IFD EORTC/MSG 2008 and 2020 have been developed and implemented into practice in most countries, mucormycosis still remains a difficult-to-diagnose IFD, where the factor of rapid diagnosis is a main factor of treatment success. Medications available for the treatment of IFD include polyenes, triazoles, and echinocandins. For a long time, the drug of choice for the treatment of mucormycosis was liposomal amphotericin B. However, a new effective drug has been approved for the treatment of both mucormycosis and IFD, caused by multiple pathogens – isavuconazole. This review presents new data on the epidemiology of mucormycosis, diagnosis approaches and current international treatment guidelines.
{"title":"Mucormycosis: modern diagnostics and treatment, existing problems and new trends in antifungal therapy","authors":"M. Popova, Y. Rogacheva","doi":"10.36488/cmac.2021.3.226-238","DOIUrl":"https://doi.org/10.36488/cmac.2021.3.226-238","url":null,"abstract":"Over the last decade, the introduction of new antifungal drugs and diagnostic procedures has improved the prognosis of hematological patients with invasive fungal disease (IFD), primarily invasive aspergillosis. Despite effective antifungal prophylaxis against the most common IFD caused by Aspergillus spp., rates of IFD due to rare pathogens being resistant to most antifungal drugs, including mucormycosis have been increased. The main group of patients having a high risk of mucormycosis is deeply immunocompromised patients who received chemotherapy for acute leukemia, patients undergoing allogeneic bone marrow transplantation, or treated with corticosteroids for graft-versushost disease. Currently, the urgency of this complication is significantly higher due to COVID-19 pandemic and extensive use of corticosteroids for the treatment of COVID-19. Despite the fact that the criteria for the diagnosis of IFD EORTC/MSG 2008 and 2020 have been developed and implemented into practice in most countries, mucormycosis still remains a difficult-to-diagnose IFD, where the factor of rapid diagnosis is a main factor of treatment success. Medications available for the treatment of IFD include polyenes, triazoles, and echinocandins. For a long time, the drug of choice for the treatment of mucormycosis was liposomal amphotericin B. However, a new effective drug has been approved for the treatment of both mucormycosis and IFD, caused by multiple pathogens – isavuconazole. This review presents new data on the epidemiology of mucormycosis, diagnosis approaches and current international treatment guidelines.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36488/cmac.2021.3.239-246
N. Ovsyannikov, O. Bilevich
The novel coronavirus (COVID-19) pandemic announced by the World Health Organization in March 2020 assigned medical community to the new tasks that require immediate solutions. Recent studies have shown that invasive aspergillosis associated with COVID-19 often complicates a course of the disease and leads to death. This review aims to describe the diagnosis and therapy challenges due to COVID-19 associated invasive pulmonary aspergillosis.
{"title":"COVID19 associated pulmonary aspergillosis","authors":"N. Ovsyannikov, O. Bilevich","doi":"10.36488/cmac.2021.3.239-246","DOIUrl":"https://doi.org/10.36488/cmac.2021.3.239-246","url":null,"abstract":"The novel coronavirus (COVID-19) pandemic announced by the World Health Organization in March 2020 assigned medical community to the new tasks that require immediate solutions. Recent studies have shown that invasive aspergillosis associated with COVID-19 often complicates a course of the disease and leads to death. This review aims to describe the diagnosis and therapy challenges due to COVID-19 associated invasive pulmonary aspergillosis.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623845","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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