VAGINAL CUFF INFECTION AFTER HYSTERECTOMY IN UKRAINE

2021 ◽  
Vol 74 (2) ◽  
pp. 196-201
Author(s):  
Aidyn G. Salmanov ◽  
Alla D. Vitiuk ◽  
Solomiia Ya. Hrynchuk ◽  
Anna S. Bober ◽  
Oksana B. Hrynchuk ◽  
...  
Keyword(s):  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Laparoscopic Hysterectomy ◽  
Resistant Bacteria ◽  
Esbl Production ◽  
Vaginal Cuff ◽  
Multicenter Cohort Study ◽  
Beta Lactamases ◽  
Current Prevalence ◽  
Extended Spectrum Beta Lactamases

The aim: To obtain the first estimates of the current prevalence of vaginal cuff infection after hysterectomy and antimicrobial resistance of causing pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population consisted of women who had an abdominal, vaginal or laparoscopic hysterectomy from 2017 to 2019 in 7 women hospitals of Ukraine. Definitions of vaginal cuff infections were used from the Centers for Disease Control and Prevention’s National Healthcare Safety Network, USA. Results: Total 12.6% women’s after hysterectomy had vaginal cuff infections. Of these cases, 20.3% after abdominal, 15.5% vaginal and 4.1% laparoscopic hysterectomy were identified. The predominant pathogens of VCUF infections were: Escherichia coli (18.6%), Enterobacter spp. (12.4%), Staphylococcus aureus (10.8%), Streptococcus spp. (9,7%), Klebsiella pneumoniae (8.2%), Pseudomonas aeruginosa (7.6%), Enterococcus faecalis (7,0%) and Proteus spp. (7.0%). Methicillin-resistance was observed in 12.9% of S. aureus (MRSA) and 9.7% CoNS. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Resistance to thirdgeneration cephalosporins was observed in 8.9% K. pneumoniae and E.coli 11.9% isolates. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 22.7%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (32.6%, vs 12.3%). Conclusions: Vaginal cuff infections in women after hysterectomy are common in Ukraine and most of these infections caused by antibiotic-resistant bacteria. The incidence of VCUF infections after hysterectomy differs depending on the type of surgical procedure.

EPISIOTOMY INFECTIONS IN THE PUERPERIUM AND ANTIMICROBIAL RESISTANCE OF RESPONSIBLE PATHOGENS IN UKRAINE

2020 ◽  
Vol 73 (11) ◽  
pp. 2325-2331
Author(s):  
Aidyn G. Salmanov ◽  
Taras G. Voitok ◽  
Igor V. Maidannyk ◽  
Serhiy Yu. Vdovychenko ◽  
Olena О. Chorna ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Vaginal Delivery ◽  
Prevalence Rate ◽  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Resistant Bacteria ◽  
Esbl Production ◽  
Multicenter Cohort Study ◽  
Klebsiella Spp

1 2 ABSTRACT The aim: To obtain the first estimates of the current prevalence rate of episiotomy infections in the puerperium and antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population consisted of all women who had a vaginal delivery in 7 Regional Women’s Hospitals of Ukraine. Definitions of episiotomy infections were used from the Centers for Disease Control and Prevention’s National Healthcare Safety Network (CDC/NHSN). Results: Total 35.6% women after vaginal delivery had episiotomy done. The prevalence rate of episiotomy infections was 17.7%. The predominant pathogens were: Escherichia coli (49.2%), Enterobacter spp. (11.1%), Streptococcus spp. (9.1%), Enterococcus faecalis (6.5%), Klebsiella spp. (8.1%), followed by Pseudomonas aeruginosa (4.7%), Staphylococcus aureus (4.2%), Proteus spp.(2.9%) and Staphylococcus epidermidis (2.8%). The overall proportion of methicillin-resistance was observed in 17.3% of Staphylococcus aureus (MRSA). Vancomycin resistance was observed in 6.8% of isolated enterococci. Carbapenem resistance was identified in 8% of P.aeruginosa isolates. Resistance to third-generation cephalosporins was observed in 15.2% Klebsiella spp. and E.coli 16.4% isolates. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 26.4%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (31.4%, vs 12.5%). Conclusions: Episiotomy infections in the puerperium are common in Ukraine and most of these infections caused by antibiotic-resistant bacteria. Optimizing the management and empirical antimicrobial therapy may reduce the burden of episiotomy infections, but prevention is the key element.

scholarly journals HEALTHCARE ASSOCIATED DEEP PELVIC TISSUE INFECTION AND OTHER INFECTIONS OF THE FEMALE REPRODUCTIVE TRACT IN UKRAINE

2021 ◽  
Vol 74 (3) ◽  
pp. 406-412
Author(s):  
Aidyn G. Salmanov ◽  
Lidiya V. Suslikova ◽  
Svitlana A. Pandei ◽  
Victor O. Rud ◽  
Igor V. Kokhanov ◽  
...  
Keyword(s):  
Reproductive Tract ◽  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Pelvic Abscess ◽  
Female Reproductive Tract ◽  
Tissue Infection ◽  
Esbl Production ◽  
Multicenter Cohort Study ◽  
Reproductive Tract Infection ◽  
Healthcare Associated

The aim: To obtain the first estimates of the current prevalence of healthcare-associated deep pelvic tissue infection and other infections of the female reproductive tract (vagina, ovaries, uterus) including chorioamnionitis, and antimicrobial resistance of causing pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population included 3,053 women’s who underwent gynecological surgery or other procedures from 2017 to 2019 in 7 women hospitals in Ukraine. Definitions of healthcare-associated reproductive tract infection were used from the CDC/ NHSN. Results: The prevalence of healthcare-associated deep pelvic tissue infection and other infections of the female reproductive tract was 26.3%. Incidence of infection was: 13.3% Pelvic abscess or cellulitis, 14.6% Adnexa utery, 9.5% Salpingitis, 7.1% Oophoritis, 12.2% Parametritis, 4.6% Chorioamnionitis, and 38.8% Bacterial Vaginitis. The predominant pathogens were: Escherichia coli (25.6%), Enterobacter spp. (11.4%), Klebsiella pneumoniae (10.6%), Staphylococcus aureus (8.5%), Enterococcus faecalis (7.2%) and Pseudomonas aeruginosa (7.1%). Methicillin-resistance was observed in 14.3% of S. aureus (MRSA). The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 20.8%. The prevalence of ESBL production among E. coli isolates was 24.7% and among K. pneumoniae 11.9%. Resistance to thirdgeneration cephalosporins was observed in 12.8% E.coli and 9.2% K. pneumoniae isolates. Carbapenem resistance was identified in 8.5% of P.aeruginosa isolates. Conclusions: Healthcare associated deep pelvic tissue infection and other infections of the female reproductive tract in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics.

scholarly journals Laboratory Diagnostic Approach and Interpretation in Gram-Negative Bacterial Infection: A-Case Report of Sepsis in Secondary Hospital Settings

2020 ◽  
Vol 26 (3) ◽  
Author(s):  
Adhi Kristianto Sugianli ◽  
Ida Parwati
Keyword(s):  
Case Report ◽  
Positive Culture ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamases ◽  
Secondary Hospital

Gram-Negative Bacteria (GNB) have been widely reported to cause worldwide infections and life-threatening. The high prevalence of drug-resistant GNB causes the treatment of GNB to become difficult. This case report describes a stepwise laboratory approach and interpretation for Gram-negative bacteria infection in sepsis patients. An 84-year-old female patient with a history of congestive heart failure, after three weeks of hospitalization, GNB was proven as the cause of sepsis. Laboratory approach for inflammation (C-reactive protein, procalcitonin) was made and confirmed with a positive culture of several specimens (sputum, urine, and blood). The identification of bacterial-culture revealed as Carbapenem-resistance Klebsiella pneumoniae and Extended-spectrum Beta-lactamases Escherichia coli. This case highlights GNB as a potential agent to worsen the infection (sepsis) and also a useful approach for the detection of multidrug-resistant bacteria, particularly in secondary hospital settings. The application and interpretation of integrated clinical and laboratory criteria may bring out better and effective patient management.

scholarly journals Characterization of ESBL-Producing Enterobacteria from Fruit Bats in an Unprotected Area of Makokou, Gabon

2020 ◽  
Vol 8 (1) ◽  
pp. 138 ◽  
Author(s):  
Pierre Philippe Mbehang Nguema ◽  
Richard Onanga ◽  
Guy Roger Ndong Atome ◽  
Jean Constant Obague Mbeang ◽  
Arsène Mabika Mabika ◽  
...  
Keyword(s):  
Resistant Bacteria ◽  
Fruit Bats ◽  
Antibiotic Resistant ◽  
Disk Diffusion Test ◽  
Beta Lactamases ◽  
E Coli ◽  
Terrestrial Mammals ◽  
Extended Spectrum Beta Lactamases ◽  
First Time

In Gabon, terrestrial mammals of protected areas have been identified as a possible source of antibiotic-resistant bacteria. Some studies on antibiotic resistance in bats have already been carried out. The main goal of our study was to detect extended-spectrum beta-lactamases (ESBLs) that are produced by enterobacteria from bats in the Makokou region in Gabon. Sixty-eight fecal samples were obtained from 68 bats caught in the forests located 1 km from the little town of Makokou. After culture and isolation, 66 Gram-negative bacterial colonies were obtained. The double-disk diffusion test confirmed the presence of ESBLs in six (20.69%) Escherichia coli isolates, four (13.79%) Klebsiella pneumoniae isolates, and one (3.45%) Enterobacter cloacae isolate. The analysis based on the nucleotide sequences of the ESBL resistance genes showed that all cefotaximase-Munichs (CTX-Ms) were CTX-M-15 and that all sulfhydryl variables (SHVs) were SHV-11: 41.67% CTX-M-15-producing E. coli, 16.67% CTX-M-15+SHV-11-producing E. coli, 8.33% CTX-M-15-producing K. pneumoniae, 25% CTX-M-15+SHV-11-producing K. pneumoniae, and 8.33% CTX-M-15-produced E. cloacae. This study shows for the first time the presence of multiresistant ESBL-producing enterobacteria in fruit bats in Makokou.

scholarly journals Extended-spectrum beta-lactamases producing Escherichia coli and Klebsiella pneumoniaei: A Multi-centric Study Across Karnataka

2014 ◽  
Vol 6 (01) ◽  
pp. 007-013 ◽  
Author(s):  
Sridhar PN Rao ◽  
Prasad Subba Rama ◽  
Vishwanath Gurushanthappa ◽  
Radhakrishna Manipura ◽  
Krishna Srinivasan
Keyword(s):  
Escherichia Coli ◽  
Clinical Isolates ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Esbl Production ◽  
Beta Lactamases ◽  
E Coli ◽  
Karnataka State ◽  
Extended Spectrum Beta Lactamases ◽  
Esbl Producers

ABSTRACT Background: There are sporadic reports on detection of extended-spectrum beta-lactamases (ESBL) producers from Karnataka; hence, this is a first multicentric study across Karnataka state to determine the prevalence of ESBL production among clinical isolates of Escherichia coli and Klebsiella pneumoniaei. Aims and objectives: To determine the prevalence of ESBL producing clinical isolates of E. coli and K. pneumoniae from five geographically distributed centers across Karnataka, to study the susceptibility of ESBL producing isolates to other beta-lactam and beta-lactam-beta-lactamase inhibitors and to demonstrate transferability of plasmids coding for ESBL phenotype. Materials and Methods: Two hundred isolates of E. coli and K. pneumoniae each were collected from each of the five centers (Bellary, Dharwad, Davangere, Kolar and Mangalore). They were screened for resistance to screening agents (ceftazidime, cefotaxime, ceftriaxone, aztreonam) and positive isolates were confirmed for ESBL production by test described by Clinical and Laboratory Standards Institute . Co-production of ESBL and AmpC beta-lactamase was identified by using amino-phenylboronic acid disk method. Susceptibility of ESBL producers to beta-lactam antibiotics and beta-lactamase inhibitors was performed. Transferability of plasmids was performed by conjugation experiment. Results: Overall prevalence of ESBL production among E. coli and K. pneumoniae across five centers of the state was 57.5%. ESBL production was found to be 61.4% among E. coli and 46.2% among K. pneumoniae. ESBL production was significantly more among E. coli than K. pneumoniae. Significant variations in distribution of ESBL across the state was observed among E. coli isolates, but not among K. pneumoniae isolates. All ESBL producers demonstrated minimum inhibitory concentration levels ≥2 μg/ml towards cefotaxime, ceftazidime and ceftriaxone. Conclusion: Overall prevalence of ESBL production among clinical isolates of E. coli and K. pneumoniae across Karnataka state was high. The prevalence of ESBL production was significantly higher with E. coli than K. pneumoniae isolates. Higher rates of resistance to ceftriaxone and cefotaxime than to ceftazidime suggests the possibility of presence of CTX-M type ESBLs. Of all the beta-lactam/beta-lactamase inhibitor combinations tested, cefepime-tazobactam demonstrated highest in-vitro activity against ESBL producers. There was no statistical difference in the transferability of plasmids among E. coli and K. pneumoniae.

scholarly journals Multidrug-resistant bacteria in unaccompanied refugee minors arriving in Frankfurt am Main, Germany, October to November 2015

2016 ◽  
Vol 21 (2) ◽  
Author(s):  
Ursel Heudorf ◽  
Bernhard Krackhardt ◽  
Maria Karathana ◽  
Niels Kleinkauf ◽  
Christian Zinn
Keyword(s):  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
German Population ◽  
Unaccompanied Refugee Minors ◽  
Frankfurt Am Main ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamases ◽  
Additional Resistance ◽  
Gram Negative Organisms ◽  
Refugee Minors

Many refugees arriving in Germany originate or have travelled through countries with high prevalence of multidrug-resistant Gram-negative organisms. Therefore, all unaccompanied refugee minors (<18 years-old) arriving in Frankfurt am Main between 12 October and 6 November 2015, were screened for multidrug-resistant Enterobacteriaceae in stool samples. Enterobacteriaceae with extended spectrum beta-lactamases (ESBL) were detected in 42 of 119 (35%) individuals, including nine with additional resistance to fluoroquinolones (8% of total screened), thus exceeding the prevalences in the German population by far.

scholarly journals The effect of Enterococcus faecium M74 feed additive on the extended-spectrum beta-lactamases/AmpC-positive Escherichia coli faecal counts in pre-weaned dairy calves

2017 ◽  
Vol 86 (4) ◽  
pp. 333-338 ◽  
Author(s):  
Jana Šmídková ◽  
Alois Čížek
Keyword(s):  
Escherichia Coli ◽  
Enterococcus Faecium ◽  
Dairy Calves ◽  
Resistant Bacteria ◽  
Beta Lactamases ◽  
New Born ◽  
Extended Spectrum ◽  
Faecal Samples ◽  
Probiotic Treatment ◽  
Extended Spectrum Beta Lactamases

The increasing occurrence of extended-spectrum beta-lactamases and/or AmpC-positive Escherichia coli among different species of food producing animals poses a threat to public health. The animal gut plays a key role in the development of antibiotic resistant bacteria, allowing the selection, multiplication and subsequent contamination of the farm environment. However, applicable procedures for reducing such bacteria on farms are currently unavailable. The present study was aimed to determine whether a probiotic administration to new-born dairy calves would reduce faecal shedding of extended-spectrum beta-lactamases and/or AmpC-positive Escherichia coli during the pre-weaning period. Ten randomly assigned new-born Holstein calves on a dairy farm with recent evidence of high occurrence of AmpC-positive Escherichia coli among calves were treated by a probiotic mix within 12 h after birth. Nine control calves were not treated. Faecal samples were collected from each calf daily on days 2 through 5, and then on days 7, 10, and 14. The faecal samples were cultured, and the mean numbers of cefotaxime-resistant Escherichia coli and confirmed enteroaggregative Escherichia coli were compared between the two groups. Results suggested that the Enterococcus faecium probiotic treatment (Enterococcus faecium M74, NCIMB 11181) of new-born calves did not reduce the enteroaggregative Escherichia coli counts in their faeces. There was no significant difference in the shedding of enteroaggregative Escherichia coli between the probiotic-treated and control calves throughout the two-week study period.

scholarly journals Prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in wastewater: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Nawel Zaatout ◽  
Samia Bouras ◽  
Nouria Slimani
Keyword(s):  
Pathogenic Bacteria ◽  
Meta Analysis ◽  
Sewage Treatment ◽  
Cochrane Library ◽  
Resistant Bacteria ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Pooled Prevalence ◽  
Extended Spectrum Beta Lactamases ◽  
Random Effects Modeling

Abstract Wastewater is considered a hotspot niche of multi-drug and pathogenic bacteria such as Enterobacteriaceae-producing extended-spectrum beta-lactamases (ESBL-E). Thus, the aim of this meta-analysis was to evaluate the prevalence of ESBL-E in different wastewater sources. Different databases (Medline, EMBASE, and Cochrane Library) were searched from inception to March 2021. Data were analyzed using random-effects modeling, and subgroup and meta-regression analyses were used to ascertain heterogeneity among the subgroups. Fifty-seven observational studies were selected, and the pooled prevalence of ESBL-E in wastewater was 24.81% (95% CI, 19.28–30.77). Escherichia coli had the highest ESBL prevalence. The blaCTX-M genes were the most prevalent in the selected studies (66.56%). The pooled prevalence of ESBL was significantly higher in reports from America (39.91%, 95% CI, 21.82–59.51) and reports studying hospital and untreated wastewaters (33.98%, 95% CI, 23.82–44.91 and 27.36%, 95% CI, 19.12–36.42). Overall, this meta-analysis showed that the prevalence of ESBL-E in wastewater is increasing over time and that hospital wastewater is the most important repository of ESBL-E. Therefore, there is a need for developing new sewage treatment systems that decrease the introduction of resistant bacteria and antibiotic residues.

scholarly journals Community Origin and Previous Use of Antimicrobials Increase the Risk of Nosocomial Multidrug-resistant Bacteria Colonisation in the Intensive Care Unit in a Brazilian Hospital

2019 ◽  
Vol 12 (1) ◽  
pp. 449-454
Author(s):  
Debora Vandresen ◽  
Maria Helena B. Werlang ◽  
Mirian Carla B. Silva ◽  
Juliana S. Link ◽  
Paulo Cezar N. Fortes
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Beta Lactamases ◽  
Hospitalised Patients ◽  
Extended Spectrum Beta Lactamases ◽  
Hospital Acquired

Background: Hospitalised patients are often surrounded by microorganisms, and antibiotic-resistant pathogens are a major and growing threat to public health. Objective: This study aimed to investigate the epidemiology and the risk factors for colonisation by multidrug-resistant organisms (MDROs) in a Brazilian hospital. Methods: Patients in the Intensive Care Unit (ICU) who underwent nasal and rectal swab cultures for the surveillance of colonisation by MDROs were evaluated in a retrospective study. MDROs were determined by routine microbiological cultures. Results: Of the 785 patients included in this study, 86 presented positive results for MDRO colonisation. Overall, the most frequently isolated organism was Klebsiella pneumoniae (41.9%), followed by Escherichia coli (33.7%). The main type of resistance was the production of extended-spectrum beta-lactamases (ESBL). The prevalence of MDRO infections was significantly associated with the patient's origin (community or hospital-acquired). Having been submitted to previous antimicrobial drug therapy was significantly associated with MDRO infection (relative risk [RR]: 4.02 [2.60 - 6.23]). Conclusion: MDRO ICU colonisation was variable, with similar frequencies as other centres, and important factors, including previous hospital stay and antibiotic use, were closely related to MDRO colonisation. Therefore, control interventions should reduce their rates, especially considering the particularities of each geographic centre.

scholarly journals HEALTHCARE-ASSOCIATED INFECTION IN NEUROSURGICAL PATIENTS IN UKRAINE: RESULTS OF A MULTICENTER STUDY (2017-2019)

2021 ◽  
Vol 74 (8) ◽  
pp. 1945-1951
Author(s):  
Aidyn G. Salmanov ◽  
Dmytro V. Shchehlov ◽  
Oleh Svyrydiuk ◽  
Ihor M. Bortnik ◽  
Maryna Mamonova ◽  
...  
Keyword(s):  
Carbapenem Resistance ◽  
Surveillance Data ◽  
Healthcare Associated Infection ◽  
Surveillance Period ◽  
Multicenter Cohort Study ◽  
Mortality And Morbidity ◽  
Current Prevalence ◽  
Neurosurgical Patients ◽  
Enterococcus Spp ◽  
Healthcare Associated

The aim: To obtain the estimates of the current prevalence of healthcare-associated infection among neurosurgical patients and determine the antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data of HAIs among neurosurgical patients from 2017 to 2019 in 7 regional hospitals. Definitions of HAI were used from the CDC/ NHSN. Results: Of 9,711 neurosurgical patients, 1,031 (20.9%) HAIs were observed. The most frequently of HAI types were surgical site infection (53.2%), pneumonia (17.3%), urinary tract infection (15.1%) and bloodstream infection (14.4%). The overall prevalence of HAIs was 20.9% within three months and was 12.8% during one month surveillance period. Death during hospitalization was reported in 11.3% of HAI cases. Escherichia coli were most commonly reported, accounting for 24.3% of all organisms, followed by Staphylococcus aureus (15.9%), Enterococcus spp (14.6%), Pseudomonas aeruginosa (13.4%), and Klebsiella pneumoniae (9.8%). Meticillin resistance was 34.6% of S.aureus isolates. Vancomycin resistance was in 7.1% of isolated enterococci. Among the gram-negative bacteria, third-generation cephalosporins resistance was found in 48.5% of K.pneumoniae and in 34.3% of E. coli isolates. Carbapenem resistance was reported in 11.7% of all included Enterobacteriaceae, also highest in K.pneumoniae, and in 32.4% of P.aeruginosa isolates and in 67.2% of Acinetobacter spp. isolates. Conclusions: Healthcare-associated infections are a cause for mortality and morbidity among hospitalized neurosurgical patients. This is due to increase emergence of antimicrobial-resistant pathogens. Routinely collected surveillance data are of great value as a basis for studying the consequences of HAIs.

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