Epidemiological significance of microbiote monitoring of arctic settlements along the Northern Sea Route

Monitoring of polar ecosystems is one of the most important areas of research in the use of Arctic territories in economic activities. An important place in such work is occupied by biomedical research aimed at identifying the risks of the occurrence of foci of infectious diseases in the areas of polar settlements.The purpose: to develop an algorithm for microbiological monitoring in the Arctic region.Materials and methods: classical bacteriological, mycological research, molecular-genetic, MALDI-TOF mass spectrometric analysis, phenotypic methods for determining antibiotic resistance, methods of mathematical data processing.Results and their discussion. The paper considers the scientific and methodological principles and the main stages of microbiota monitoring in the areas of polar settlements. The results of the study of samples from several territories along the Northern Sea Route are presented. The main habitats where potentially dangerous microorganisms should be detected are indicated. The role of anthropogenic invasion in the formation of Arctic microbiocenoses is noted. The trends of increasing the number and diversity of pathogenic microorganisms, both in the natural biocenoses of the Arctic and in the areas of polar settlements, are discussed. The necessity of microbiological monitoring as an integral part of epidemiological monitoring in the areas of Arctic settlements along the Northern Sea Route is substantiated.

MICROBIOLOGICAL MONITORING OF INTRAHOSPITAL INFECTION IN SURGICAL HOSPITAL

За 2020 год было обследовано на носительство патогенного стафилакокка - 144 человека. По стационару за год было проведено 5666 операций, (прооперировано больных - 5197), зарегистрировано осложнений - 88 (1,6%). На микробиологические исследования были взяты пробы из воздуха - 446, смывы 2686, материалы на стерильность - 842 и на носительство 445 проб. По результатам микробиологического мониторинга с внешней среды в основном высевался условно патогенный стафилакокк в 54 % случаях от всех положительных результатов и бактерии группы кишечной палочки в 15,5 % случаев соответственно. При проведении анализа обследования пациентов на микрофлору отмечено, что по стационару исследовано бактериологически - 26,2% пациентов (всего пролечено - 5824, обследовано - 1524, выявлено положительных результатов - 768 - 50,4 %). Анализ выделенной микрофлоры у пациентов показал, что наибольший процент приходится на выявления клебсиеллы (19,3%), стрептококков (18,5 %), золотистого стафилакокка (15,1%), синегнойной палочки (4,0%). В 21,2 % случаев высев кандида, это указывает на то, что пациенты получают большое количество антибиотиков, а также не в полном объеме проводится противогрибкового лечения. Проведенный мониторинг нозокомиальных инфекций важны с позиции эпидемиологического надзора, так как они создают предпосылки для планирования научно-обоснованных мер борьбы и профилактики госпитальных инфекций. Постоянный микробиологический мониторинг внутрибольничной инфекции повысит выявление групп и факторов риска возникновения внутрибольничной инфекций, определить во время предвестников осложнения эпидемиологической обстановки, оценить и прогнозировать эпидемиологические ситуации. In 2020, 144 people were examined for the carriage of pathogenic staphylococcus. In the hospital, 5666 operations were performed during the year (5197 patients were operated on), complications were registered - 88 (1.6%). For microbiological studies, samples were taken from the air - 446, washes - 2686, materials for sterility - 842 and 445 samples for carrier. According to the results of microbiological monitoring from the external environment, conditionally pathogenic staphylococcus was mainly sown in 54% of cases of all positive results and bacteria of the E. coli group in 15.5% of cases, respectively. When analyzing the examination of patients for microflora, it was noted that 26.2% of patients were bacteriologically examined in the hospital (in total, 5824 were treated, 1524 were examined, positive results were found - 768 - 50.4%). The analysis of the isolated microflora in patients showed that the largest percentage is due to the detection of Klebsiella (19.3%), streptococci (18.5%), Staphylococcus aureus (15.1%), Pseudomonas aeruginosa (4.0%). In 21.2% of cases of Candida sowing, this indicates that patients receive a large amount of antibiotics, and also that antifungal treatment is not fully carried out. The monitoring of nosocomial infections is important from the point of view of epidemiological surveillance, since they create the prerequisites for planning evidence-based measures to combat and prevent hospital infections. Continuous microbiological monitoring of nosocomial infections will increase the identification of groups and risk factors for nosocomial infections, determine during the harbingers of complications of the epidemiological situation, assess and predict epidemiological situations

Pediatric surgical sepsis: diagnostics and intensive therapy

The aim: Optimization of diagnostics and schemes of pathogenetic intensive therapy of surgical sepsis in children based on clinical and laboratory criteria and bacteriological monitoring. Materials and methods: The research period is 2018-2020. The object of the study (n=73) – children with surgical pathology (widespread peritonitis, bacterial destruction of the lungs, post-traumatic brain hematomas, abdominal trauma, etc.). Research methods: microbiological monitoring to determine the sensitivity of the microorganism to antibiotics was carried out before and at the stages of treatment (sputum, urine, wound, bronchoalveolar lavage, tracheal aspirate, blood, contents from drainages, wound surface). Determination of the sensitivity of the isolated strains to antibiotics was carried out by the disk-diffusion method. To determine predictors of sepsis in surgical patients, clinical (mean arterial pressure (mAP), heart rate (HR), respiratory rate (RR), SpO2, etc. and laboratory parameters on days 1–2 (up to 48 hours) of sepsis identification, days 4 and 8 of intensive therapy. Procalcitonin was determined by immunofluorescence on a Triage® MeterPro analyzer (Biosite Diagnostics, USA). Blood gases and electrolytes were analyzed using a Stat Profile CCX analyzer (Nova Biomedical, USA). Results: studies have shown the effectiveness of complex intensive care in 86.3 % of cases. Mortality was found in 13.7 % of cases. Patients with severe surgical pathology died: widespread peritonitis, severe TBI + coma with irreversible neurological disorders, urosepsis against the background of chronic renal failure, after repeated surgical interventions, due to the development of refractory septic shock (SS). Conclusions. Early diagnosis of sepsis, rational early ABT under the control of microbiological monitoring, non-aggressive infusion therapy with early prescription of vasopressors (SS) with constant monitoring of the child's main life support organs contribute to an improvement in sepsis outcomes and a decrease in mortality

Effect of Differences in the CLSI and EUCAST Criteria on the Interpretation of Enterobacteriaceae Sensitivity to Carbapenems

Relevance: The two systems for determining the susceptibility of bacteria to antimicrobial drugs, CLSI and EUCAST, are recommended for use in the global system of epidemiological surveillance of antimicrobial resistance of the World Health Organization. However, they differ in the methodology of setting an antimicrobial susceptibility testing, threshold values of cut-off points, as well as interpretation of results. The true significance of methodological differences between these systems for global microbiological monitoring is unclear.The aim of the study was to evaluate the influence of differences in the cut-off points of CLSI and EUCAST on the interpretation of antimicrobial sensitivity of microorganisms to carbapenems in Saint Petersburg.Design: screening and comparative study.Materials and methods. Sensitivity to Meropenem was studied in Escherichia coli (n=2956), as well as Klebsiella pneumoniae (n=1189) for the period of 2011–2013 and 2016–2019, and interpreted according to the threshold values of the two guidelines (2020). Results. The weighted Kappa showed good agreement between the EUCAST vs CLSI standards for both E.coli (0.58; 95% CI 0.55–0.61) and K.pneumoniae (0.77; 0.73–0.81). Mcnemar's Chi-square test revealed differences between the two standards in assessing sensitivity to Meropenem of E.coli which were 5.31% (95% CI 5.06–5.31%, P<0.0001), and of K.pneumoniae — 3.95% (95% CI 3.36–3.95%, P<0.0001).Conclusion. The reliability of determining sensitivity bacteria to anti-microbial drugs has a significant impact on their rational use and the results of microbiological monitoring. The first priority is to develop national standards that take regional characteristics into account.

Microbiological Monitoring of the Environment Using the “Association Rules” Approach and Disinfection Procedure Evaluation in a Hospital Center in Morocco

Background. The hospital environment, especially surfaces and medical devices, is a source of contamination for patients. Objective. This study carried out, to the best of our knowledge, for the first time at Taza Hospital in Morocco aimed to assess the microbiological quality of surfaces and medical devices in surgical departments and to evaluate the disinfection procedure in time and space. Methods. Samples were taken by swabbing after cleaning the hospital surface or medical device, to isolate and identify germs which were inoculated on semiselective culture media then identified by standard biochemical and physiological tests, using the analytical profile index (API) galleries. Moreover, the association rules extraction model between sites on the one hand and germs on the other hand was used for sampling. Results. The study showed that 83% of the samples have been contaminated after biocleaning. The most contaminated services have been men’s and women’s surgeries. 62% of isolated germs have been identified as Gram-positive bacteria, 29% as Gram-negative bacteria, and 9% as fungi. Concerning the association rules extraction model, a strong association between some contaminated sites and the presence of germ has been found, such as the association between wall and nightstand and door cuff, meaning that the wall and nightstand contamination is systematically linked to that of the door cuff. The disinfection procedure efficacy evaluation has enabled suggesting renewing it each 4 h. Conclusion. Microbiological monitoring of surfaces is necessary at hospital level through the use of the association rule extraction model, which is very important to optimize the sampling, cleaning, and disinfection site scenarios of the most contaminated ones.

Microbiological monitoring as a component of efficient prevention and treatment of purulent-septic infections in an orthopedics and traumatology department

Efficient monitoring of circulating purulent-septic infectious agents in a clinical setting and a study on antibiotic susceptibility of isolated strains of microorganisms allows identifying changes in the pathogen structure and trends in antibiotic resistance development, which helps to determine the tactics of antibacterial therapy and elaborate appropriate measures. The aim of the study. Retrospective analysis of the results of microbiological monitoring of purulent-septic infectious (PSI) agents in the Orthopedics and Traumatology Department (OTD) of the Zaporizhzhia Central Ambulance and Emergency Care Hospital over the period 2017–2020 to determine the main antibacterial drugs for empirical therapy. Materials and methods. We analyzed the bacteriological test results of 664 clinical material samples obtained from OTD patients using bacteriological examination statistical reporting and analytical data of the WHONET 5.6 software. Results. The main PSI pathogens in the OTD were from the ESKAPE group: E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa and S. epidermidis, P. mirabilis, C. amycolatum. Isolates of E. faecalis were sensitive to vancomycin, linezolid, S. aureus – to linezolid, tigecycline, netilmicin, A. baumannii – to tigecycline. All P. aeruginosa strains were resistant to ticarcillin/clavulanate, cefepime, chloramphenicol, imipenem, meropenem, aztreonam, ciprofloxacin. E. coli and K. pneumoniae were resistant to ampicillin, ticarcillin/clavulanate, aztreonam, ceftriaxone, cefepime. The number of isolates sensitive to piperacillin/tazobactam, carbapenems, levofloxacin, gentamicin, amikacin, chloramphenicol ranged from 37 % to 65 %. Conclusions. E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa, S. epidermidis, P. mirabilis, C. amycolatum play an important role in the structure of PSI pathogens in the Orthopedics and Traumatology Department of Zaporizhzhia Central Ambulance and Emergency Care Hospital. The antibiotics of choice as the antibacterial empirical therapy for enterococcal infections are vancomycin, linezolid, for staphylococcal infections – vancomycin, linezolid, tigecycline, netilmicin. PSI pathogens continually evolve developing antibiotic resistance, and it is of particular importance to monitor antibiotic susceptibility of microorganisms within the OTD.