scholarly journals SURGICAL SITE INFECTIONS AND ANTIMICROBIAL RESISTANCE IN KYIV CITY HOSPITALS, UKRAINE

2019 ◽  
Vol 72 (5) ◽  
pp. 760-764
Author(s):  
Aidyn G. Salmanov ◽  
Olena A. Dyndar ◽  
Yuriy P. Vdovychenko ◽  
Tetiana R. Nykoniuk ◽  
Igor V. Maidannyk ◽  
...  

Introduction: Surgical site infections (SSIs) are associated with increased morbidity and mortality. Scant information is available on the SSI in Ukrainian hospitals. The aim: to determine the incidence of SSIs and estimates antimicrobial resistance of the major responsible pathogens in Kyiv city hospitals. Materials and methods: This study was conducted from January 2011 to December 2013 in 3 hospitals. Definitions of SSIs were adapted from the CDC/NHSN. The identification and antimicrobial susceptibility of cultures were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby - Bauer antibiotic testing. Results: Among 9,162 patients, 1,912 (20.9%) SSIs were observed. The high SSI case in appendectomy (29.8 %), gastric, small and large bowel surgeries (28.4 %), cholelithiasis (25.7%), and orthopedic procedures (22.9 %). Low infection rate in excision of dermoid cysts, lipoma (5.3%) and lower segment caesarean structure (6.5%). Staphylococcus aureus were most commonly reported, accounting for 27,8% of all organisms, followed by Escherichia coli (18.4 %), Pseudomonas aeruginosa (11.9 %) and Enterococcus faecalis (11.6 %). The antimicrobial resistance in the isolates associated with SSIs showed, among the Gram-positive bacteria, that 43.8% and 4.7% of CoNS isolates were β-lactam (oxacillin) - and glycopeptide (teicoplanin) - resistant, respectively. Meticillin resistance was reported in 35.7 % of S. aureus isolates Conclusions: SSIs and antimicrobial resistance of the responsible pathogens is an actually problem. One essential step in the prevention of SSIs is to implement a national system for their surveillance.

2018 ◽  
Vol 2 (4) ◽  
pp. 39-45
Author(s):  
A.G. Salmanov ◽  
O.M. Verner

Objective. To determine activity of antimicrobials against Enterobacter spp. isolated from patients hospitalized to surgical departments in different Ukrainian hospitals. Materials and methods. A total of 3991 Enterobacter spp. isolated from patients with surgical site infections in 24 surgical hospitals in 17 Ukrainian regions. The identification and antimicrobial susceptibility of Enterobacter spp. were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby - Bauer antibiotic testing. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute (CLSI). Results. The most potent antimicrobials were imipenem, meropenem, cefixime and amikacinum. The high rates of resistance were found to penicillin (46,2%), ampicillin/sulbactam (42,9%), gentamicin (40,4%), ceftazidime (39,4%), ampicillin (38,2%), and cefuroxime (36,3%). Conclusions. (1) Resistance of nosocomial strains of Enterobacter spp. at in patient medical institutions, that are subject to research, is a serious therapeutic and epidemiologic issue. Imipenem, meropenem, cefixime and amikacinum have been the most active to nosocomial strains of Enterobacter spp. (2) Taking into account resent changes and resistance levels of nosocomial strains of Enterobacter spp., which take place in various regions, constant monitoring over resistance to antimicrobials at every in patient medical institution is required. Also, hospital record sheets of antibiotics should be elaborated based upon the local data received. (3) Antibiotics utilization policy in each surgical in patient institution should be determined based in accordance with the local data on resistance to antimicrobials. (4) System of epidemiologic surveillance over antimicrobial resistance should be established on the local, regional, and national level.


2018 ◽  
Vol 38 (11) ◽  
pp. 2150-2154 ◽  
Author(s):  
Ruben V. Horn ◽  
Windleyanne G.A. Bezerra ◽  
Elisângela S. Lopes ◽  
Régis S.C. Teixeira ◽  
Isaac N.G. Silva ◽  
...  

ABSTRACT: This study aimed to isolate Escherichia coli and Salmonella enterica from captured feral pigeons in Fortaleza, Brazil, and, in addition to evaluate the antimicrobial susceptibility profiles and diagnose diarrheagenic E. coli strains. Pigeons were captured in four public locations in Fortaleza with three techniques. Individual cloacal swab samples were collected and submitted to bacterial isolation, biochemical identification and antimicrobial susceptibility test. Disk diffusion technique was used with twelve antibiotics. E. coli strains were submitted to DNA extraction followed by PCR to diagnose five diarrheagenic pathotypes. A total of 124 birds were captured. One bird was positive for Salmonella enterica (0.81%) and 121 (97.58%) were positive for E. coli. Among these, 110 isolates were submitted to antimicrobial susceptibility test and 28.18% (31/110) presented resistance to at least one antibiotic. Resistance to azithromycin was the most frequent (21.82%), followed by tetracycline (10.91%) and sulfamethoxazole with trimethoprim (8.9%). Multidrug resistance, calculated as a resistance to at least 3 antimicrobial classes, was identified in 3.64% (4/110) of strains. The maximum number of antimicrobial classes to which one strain was resistant was seven. Results demonstrated nine different resistance profiles and the most frequent was tetracycline and sulfamethoxazole with trimethoprim (4 strains), followed by chloramphenicol, azithromycin, tetracycline and sulfamethoxazole with trimethoprim (3 strains). Amoxicillin with clavulanic acid and tobramycin presented lowest levels of antimicrobial resistance, to which none of the tested strains were resistant. A single strain was positive for the eltB gene, which is a diagnostic tool to identify the Enterotoxigenic E. coli (ETEC) pathotype. None of the other investigated genes (stx1, stx2, estA, eaeA, ipaH, aatA and aaiC) were identified. The single isolate of S. enterica was a rough strain of Salmonella enterica subsp. enterica, but serotype identification was not possible. However, this isolate presented resistance to amoxicillin, amoxicillin with clavulanic acid, tetracycline and sulfamethoxazole with trimethoprim. Therefore, captured feral pigeons of Fortaleza presented a low prevalence of S. enterica and diarrheagenic E. coli. Considering the investigated pathogens, our results suggest a good health status and a low public health risk. However, important antimicrobial resistance profiles were identified.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Fanta Gashe ◽  
Eshetu Mulisa ◽  
Mekidim Mekonnen ◽  
Gemechu Zeleke

Background. Drug resistant microorganisms lead to an increase in morbidity and mortality as they boost the risk of inappropriate therapy. Hence, data on antimicrobial resistance help define the best possible treatment for individual patients. Therefore, this study aimed to screen the antimicrobial resistant profile of 3rd generation cephalosporin drugs in Jimma University Specialized Teaching Hospital. Methods. A hospital based prospective cross-sectional study was conducted in Jimma University Specialized Hospital (JUSH) from April to August 2016. The clinical samples such as wound swab, urine, sputum, and stool were collected from hospitalized patients. Then, bacterial species were isolated and identified as per the standard microbiological methods. Antimicrobial susceptibility tests were carried out using various antimicrobial discs by Kirby–Bauer disc diffusion method. Results. Totally, 248 bacterial isolates were obtained from 154 (62.1%) male and 94 (37.9%) female patients. Escherichia coli (25.4%) and Staphylococcus aureus (19.0 %) were the predominant organisms isolated from specimens. About 140 (56.5%) and 149 (60.1%) of the total bacterial isolates were found to be resistant to ceftriaxone and ceftazidime, respectively. The majority of Escherichia coli isolates 46 (73%) were resistant to ceftriaxone and 41 (65%) of them were resistant to ceftazidime. Staphylococcus aureus, which accounted 19% of the total bacterial isolates, showed 23.4% and 34% resistance to ceftriaxone and ceftazidime, respectively. Among the bacterial strains revealing resistant to ceftriazone and ceftazidime, about 109 (44%) and 108 (43.5%) of them were resistant to two, three, or four other drugs, respectively. Conclusion. Bacterial resistance towards third-generation cephalosporin (ceftriaxone and ceftazidime) is escalating as more than half of the isolated strains demonstrated resistance to these drugs. Moreover, these strains also revealed multidrug resistance mainly against clinically used drugs which could render therapy unsuccessful. Therefore, in clinical use appropriate medications should be selected based on the data obtained from antimicrobial susceptibility tests.


2018 ◽  
Vol 2 (1) ◽  
pp. 18-29 ◽  
Author(s):  
A.G. Salmanov ◽  
Yu.P. Vdovychenko ◽  
M.Yu. Nychytailo ◽  
D.V. Andriuschenko ◽  
O.M. Verner

OBJECTIVE — to analyses the results of patients’ surgery, to determine the incidence rate of surgical site infections (SSIs) and to identify prevailing pathogens and their resistance to antibiotics in Ukrainian hospitals. MATERIALS AND METHODS. The investigation included 9,408 patients who underwent surgeries during 2015 in 12 surgical hospitals in different Ukrainian regions. In order to determine the incidence rates of SSIs were used the standard definition that were developed by the CDС (USA). The investigation included the analysis of 1,248 strains from patients with clinical symptoms SSIs. The identification and antimicrobial susceptibility of cultures were determined, using automated microbiology analyzer Vitek 2 Compact (BioMerieux, France). Susceptibility to antibiotics was determined using AST cards (BioMerieux, France). Some antimicrobial susceptibility test used Kirby — Bauer antibiotic testing. Interpretative criteria were those suggested by the CLSI (USA). RESULTS AND DISCUSSION. Data analysis demonstrated that 13.3 % (CI 95 %: 12.3—14.2 %) patients developed postoperative SSIs. Infection rates after various surgical procedures at surgical sites were observed. Shows the high infection rate in appendectomy (17.47 %), gastric, small and large bowel surgeries (18.23 %). The infection rate in orthopedic procedures (13.27 %), cholelithiasis (hepatobiliary) (14.93 %), uterus and adnexal structures (11.10 %), urinary tract and genitalia (9.37 %) and hernia (14.1 %) are comparatively lower. The infection rate in lower segment caesarean structure is 4.24 % and excision of dermoid cysts, lipomas 3.22 %. Staphylococcus aureus was identified as the most common causative agent of SSIs (27.6 %), followed by Escherichia coli (14.1 %), Enterococcus faecalis (13.5 %), and Pseudomonas aeruginosa (10.1 %). Frequency of Klebsiella pneumoniae, Acinetobacter baumannii, Enterobacter aerogenes, Enterococcus faecium, Streptococcus spp., Staphylococcus epidermidis and Proteus vulgaris was 7.1 %, 6.9 %, 6.1 %, 4.7 %, 4.6 %, 3.6 %, and 1.6 %, respectively. Antibiotic susceptibility testing showed that all strains of S. aureus resistant to penicillin. The most active antibiotics found were linezolid, tigecycline, and mupirocin, showing growth inhibition of 100 % strains tested, followed by nitrofurantoin, trimethoprim/ sulphamethoxazole, to fusidic acid, teicoplanin, fosfomycin, gentamycin, vancomycin. Susceptibility to tetracycline, rifampicin, erythromycin, and clindamycin was observed to be some lower. Methicillin-resistant S. aureus comprised 1 %, while Vancomycin-resistant S. aureus comprised 9.3 %. Resistance E. faecalis to ceftibuten, chloramphenicol, moxifloxacin, and teicoplanin was 100 % and to cefepime 96 %. The proportion of vancomycin-resistant enterococci was 6.9 %. 26.5 % of E. coli strains showed resistance to all tested antibiotics. The most potent antimicrobials were imipenem, tobramycin, meropenem, levofloxacin and amikacinum. The high rates of resistance were found to penicillum, lincomycin, clindamycin, ampicillin, clarithromycin, amoxicillin, and to cefuroxime. K. pneumoniae showed the lowest resistance to amikacin and imipenem, and was moderately sensitive to cefepime, gentamicin, ceftriaxone, tobramycin, piperacillin/ tazobactam, ciprofloxacin, tetracycline, ceftazidime, and aztreonam. 39.6 % of P. aeruginosa were resistant to all tested antibiotics. The most potent antimicrobials were meropenem, tobramycin, imipenem and levofloxacin. The high rates of resistance were found to penicillin, erythromycin, rifampicin, tetracycline, azithromycin, amoxicillin, cefalexin, ampicillin/sulbactam, clarithromycin, and to pefloxacin. P. aeruginosa were 100 % resistant to oxacillin, ceftibuten, tetracycline, and erythromycin. CONCLUSIONS. SSIs remain an important cause of postoperative morbidity. Antimicrobial resistance among these and other clinically important pathogens is an increasing problem. The clinical should choose antimicrobial drug in accordance with the local bacterial resistance characteristics for reduce the production of drug resistance and improve the effect of anti-infection treatment possibly.


Author(s):  
A. Aksoy

Background: Mycoplasma bovis (Gram-positive bacteria) belongs the class Mollicutes and to the family Mycoplasmataceae (Maunsell and Donovan, 2009). It is a cell wall-less bacterium and are instead enveloped by a complex plasma membrane. In cattle, M. bovis is widely known causes various diseases, such respiratory disease, mastitis, arthritis and otitis.Methods: The present study was aimed to determine the antimicrobial susceptibility and identify the genes for antimicrobial resistance of Mycoplasma bovis PG45, Staphylococcus aureus and Escherichia coli. M. bovis PG45, S. aureus and E.coli were subjected to test for their sensitivity to various clinically important antibiotics (Cefotaxime, Cefuroxime, Cefaclor Cefalexin, Ofloxacin, Norfloxacin, Nalidixic acid, Amikacin, Ampicillin, Oxacilin, Amoxyclav, Rifampicin, Penicillin G and Tylosin). The minimal inhibitory concentration (MIC) of each antimicrobial agent was determined by applying an agar dilution method. Polymerase Chain reaction (PCR) was used to amplify specific DNA fragments and thus to determine the presence or absence of a target gene (VspA, tet k and tetA). Result: Showed the MIC values and the presence of VspA, tetK and tetA in M. bovis PG45, S. aureus and E. coli respectively.


2019 ◽  
Vol 72 (2) ◽  
pp. 154-158 ◽  
Author(s):  
Aidyn G. Salmanov ◽  
Volodymyr O. Shkorbotun ◽  
Yaroslav V. Shkorbotun

Introduction: Staphylococcus aureus is one of the major pathogens that causes of surgical site infection (SSI). Scant information is available on the occurrence and antimicrobial susceptibility of S. aureus in patients with SSI in Ear, Nose and Throat (ENT) surgery. The aim: To assess the activity of antimicrobials against S.aureus, isolated from patients with SSI by the ENT departments of Kyiv hospitals. Materials and methods: A total of 516 S. aureus isolates from of patients with SSI in ENT surgery. Antimicrobial susceptibility of S. aureus were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby – Bauer antibiotic testing. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute (CLSI). Results: The most active antibiotics found in the study were linezolid and tigecycline, showing growth inhibition of 100% strains tested. Susceptibility to the other antimicrobials was also on a high level: 98,4% of strains were found susceptible to nitrofurantoin, 98.1% – to trimethoprim/sulphamethoxazole, 97.6% – to fusidic acid, 97.1% – to mupirocin, 95.9% – to teicoplanin, 94.7% – to vancomycin and fosfomicin, 90.6% – to moxifloxacin, 89.1% – to tobramycin, 87.3% – to gentamycin. Susceptibility to rifampicin (85.5%), cefoxitin (84.6%), levofloxacin (84.3%), erythromycin (82.6%), tetracycline (76.3%), and clindamycin (75.4%) was observed to be some lower. Resistance to oxacyllin S.aureus (MRSA) came up to 21.1%. Conclusions: S. aureus in ENT departments to be a serious therapeutic and epidemiologic problem. The constant monitoring of antimicrobials resistance in every hospital is required. Antibiotics application tactics should be determined in accordance with the local data of resistance to them.


Author(s):  
Anusuya Devi Devaraju S. Latha Roy

Background Surgical site infections are ranked among the most common health care associated infections. They cause significant morbidity, increased cost of care and prolonged hospital stay. A spectrum of microorganisms with varied antimicrobial susceptibility patterns have been identified as causative agents of SSI which vary with time, hospital, and with the type of surgical procedure performed. We conducted this study with an objective to assess the burden of SSI, its causative aerobic bacteria and their in vitro antibiotic susceptibility patterns. Aims & objectives 1) To identify the aerobic bacteriological profile of isolates causing surgical site infections. 2) To determine the antibiotic sensitivity pattern of the isolates. Method: This study includes 266 clinically diagnosed cases of SSIs over a period of 8 months. Isolates were identified by conventional methods. Isolates of Staphylococcus aureus were tested for methicillin resistance by cefoxitin. Isolates of Escherichia coli and Klebsiella pneumoniae which showed resistance to cefotaxime and ceftazidime were tested for ESBL production by CLSI guidelines. Isolates of Pseudomonas aeruginosa were screened for MBL production using Imipenem disc diffusion test. Results of the 266 samples processed, 193(72.5%) were culture positive samples which yielded 204 isolates. Staphylococcus aureus 60 (29.4%) was found to be the predominant organism causing SSI followed by Pseudomonas aeruginosa 40 (19.6%). Methicillin resistance was observed in 12 (20%) of Staphylococcus aureus strains. ESBL production was observed in 20.5% of Klebsiella pneumoniae isolates and 13.2 % Escherichia coli isolates. MBL production was not seen Pseudomonas aeruginosa isolates. Conclusion: The present study showed the commonest bacteria responsible for the surgical site infections like Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. Hence Implementation of an effective infection control programme and judicious use of antibiotic prophylaxis reduces the incidence of SSI in the hospital.


2021 ◽  
Vol 11 (5) ◽  
pp. 41-52
Author(s):  
Stephen Mwisiya Mubita ◽  
Wila Simbile ◽  
Barbara Mulunda

Background: The ever-increasing magnitude of antimicrobial resistance encountered in human pathogens has led to limited treatment options for bacterial infections, consequently reducing antimicrobial efficacy while increasing treatment costs, morbidity, and mortality. In clinical setup, laboratory-based in vitro antimicrobial susceptibility testing is the cornerstone for guiding therapy and enables the monitoring of antimicrobial resistance trends. Aim: To characterize the distribution of bacteria isolated from various specimens and their antibiotic susceptibility profiles in Mary Begg Health facilities. Material & Methods: This was a retrospective, cross-sectional, quantitative, descriptive study that involved the review of 569 laboratory files from three Mary Begg Health facilities from the period of January 2019 to June 2020. A systematic random sampling method was used and SPSS version 21.0 was used for data analysis. Results: The distribution of bacteria based on Gram stain reaction found that most bacteria that were isolated were Gram negative bacilli, 79.5% (171/215). The most common bacterium isolated was Escherichia coli, 46.5% (100/215) followed by Staphylococcus aureus, 12.1% (26/215) and Klebsiella pneumoniae, 17 7.9% (17/215). The study found that E. coli was highly resistant to amoxicillin (95.0%), Ampicillin (90.0%) and Cotrimoxazole (77.0%), respectively. In contrast, E. coli was highly sensitive to Amikacin (96.0%), Ertapenem (91.0%) and Ceftriaxone (80.0%) S. aureus species isolated were sensitive to Gentamicin (65.4%) and Clindamycin (46.2%) but highly resistant to Cotrimoxazole (80.8%). Conclusion: The most frequent isolates were Escherichia coli followed by Staphylococcus aureus and majority of them were from urine specimens. Key words: Antimicrobial, Resistant, Antimicrobial Resistance, Antimicrobial susceptibility testing, Mary Begg Health services.


Animals ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 812 ◽  
Author(s):  
Albertine Léon ◽  
Sophie Castagnet ◽  
Karine Maillard ◽  
Romain Paillot ◽  
Jean-Christophe Giard

The present study described the evolution of antimicrobial resistance in equine pathogens isolated from 2016 to 2019. A collection of 7806 bacterial isolates were analysed for their in vitro antimicrobial susceptibility using the disk diffusion method. The most frequently isolated pathogens were group C Streptococci (27.0%), Escherichia coli (18.0%), Staphylococcus aureus (6.2%), Pseudomonas aeruginosa (3.4%), Klebsiella pneumoniae (2.3%) and Enterobacter spp. (2.1%). The majority of these pathogens were isolated from the genital tract (45.1%, n = 3522). With the implementation of two French national plans (named ECOANTIBIO 1 and 2) in 2012–2016 and 2017–2021, respectively, and a reduction in animal exposure to veterinary antibiotics, our study showed decreases in the resistance of group C Streptococci, Klebsiella pneumoniae and Escherichia coli against five classes, four classes and one class of antimicrobials tested, respectively. However, Staphylococcus aureus, Escherichia coli and Enterobacter spp. presented an increased resistance against all the tested classes, excepted for two fifths of E. coli. Moreover, the percentages of multi-drug resistant strains of Staphylococcus aureus and Enterobacter spp. also increased from 24.5% to 37.4% and from 26.3% to 51.7%, respectively. The data reported here are relevant to equine practitioners and will help to improve knowledge related to antimicrobial resistance in common equine pathogens.


Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 469
Author(s):  
Leta Elias ◽  
Ajay S. Balasubramanyam ◽  
Olena Y. Ayshpur ◽  
Iryna U. Mushtuk ◽  
Nataliya O. Sheremet ◽  
...  

Bovine mastitis is the predominant cause for antimicrobial use on dairy farms and is a major source of economic losses in the dairy industry. In this study, the antimicrobial susceptibility profiles of common mastitis-causing pathogens, Staphylococcus aureus (n = 62), Streptococcus agalactiae (n = 46), and Escherichia coli (n = 129), were determined for dairy cattle with mastitis across 142 Ukrainian farms. The results showed that there were more gentamicin resistant S. aureus isolates (16.95%) identified in this study than previously reported for Ukrainian dairy cattle. Moreover, low levels of amoxicillin susceptibly (13.51%) were observed for St. agalactiae, which contrasted a previous study showing susceptibility levels of >50%. St. agalactiae resistance to tetracycline was observed in 80% of the isolates. Cephalosporin use was most ineffective against E. coli, with 43.27–56% of the isolates exhibiting this resistant trait. Overall, this study performed a preliminary analysis of antimicrobial resistance on mastitis isolates from Ukrainian farms. However, given the limited numbers of the isolates tested in this study and that the publications on antimicrobial resistance in animal husbandry of Ukraine are very few, more extensive investigations are needed to comprehensively examine susceptibility patterns of mastitis-causing pathogens in dairy cattle in Ukraine.


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