The aim: To determine the current prevalence of healthcare-associated tubo-ovarian infections in female and antimicrobial resistance of the responsible pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on healthcare-associated infections surveillance data. Definitions of health¬care-associated tubo-ovarian infections were used from the CDC/ NHSN. The susceptibility to antibiotics was determined by disk diffusion method according to the EUCAST. Results: Among all the 1,528 of women in this study, the prevalence of healthcare-associated tubo-ovarian infections was 31.2%. Of these cases, Salpingitis, Oophoritis, and tubo-ovarian abscess were 47.5%, 34% and 18.5%, respectively. Of all cases tubo-ovarian infections in female, 74.7% were detected after hospital discharge. The predominant pathogens were: Escherichia coli (27.7%), Enterobacter spp. (12.2%), Klebsiella pneumoniae (9.6%), Staphylococcus aureus (8.2%), Pseudomonas aeruginosa (8.1%), and Enterococcus faecalis (7.5%), followed by Proteus mirabilis (5.1%), Streptococcus spp. (4.5%), Staphylococcus epidermidis (4.4%), and Acinetibacter spp. (4%). Methicillin-resistance was ob¬served in 16.8% of S. aureus (MRSA). No strains S.aureus and E. faecalis resistant to vancomycin. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 24.7%. The prevalence of ESBL production among E. coli isolates was 28.6% and among K. pneumoniae 12.8%. Resistance to third-generation cephalosporins was observed in 14.9% E.coli and 11.3% K. pneumoniae isolates. Carbapenem resistance was identified in 11.3% of P.aeruginosa isolates. Conclusions: A healthcare-associated tubo-ovarian infections of the female in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics.
The aim: To obtain the first estimates of the current incidence, and risk factors for Surgical Site Infection (SSI) after laparoscopic hysterectomy, and antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a multicenter prospective cohort study was patient-based on surveillance data for SSIs were according to CDC/NHSN methodology. This study included women’s undergoing a laparoscopic hysterectomy in 8 hospitals from different regions of Ukraine from January 2018 to December 2020. Results: A total of 1184 women underwent a laparoscopic hysterectomy and 14.9% SSI were identified within 30 days of the operation. Majority of SSI were deep/organ-space. The deep/organ-space SSI incidence rate was 9.2% in total laparoscopic hysterectomy, 15.2% in laparoscopic-assisted vaginal hysterectomy, and 17% in laparoscopic supracervical hysterectomy. The predominant SSI types were Pelvic abscess or cellulitis (19.1%), Salpingitis (16%), Oophoritis (15.3%), Adnexa utery (14.5%), Vaginal cuff infections (13.7%), Endometritis (11.1%), and Chorioamnionitis (9.9%). 93.8% of SSIs were detected post discharge. The most commonly identified pathogen were Escherichia coli (21.6%), Enterobacter spp. (13.1%), followed by Klebsiella spp. (8,1%), Streptococcus spp. (7%), and Pseudomonas aeruginosa (7%). The overall proportion of extended spectrum beta-lactamase production (ESBL) among Enterobacteriaceae was 17.1% and of methicillin-resistance in S. aureus (MRSA)15.8%. Resistance to third-generation cephalosporins was observed in 13.7% E.coli and 8.5% Klebsiella spp. isolates. Carbapenem resistance was in 9.7% of P.aeruginosa strains. Conclusions: Our study identified high incidence rates of SSI within 30 days surveillance of the laparoscopic hysterectomy in Ukraine, and many cases were caused by pathogens that are resistant to antibiotics.
A retrospective analysis of medical records of infertile patients using assisted reproductive technologies and melatonin was performed. 76 infertile women were examined. Group 1 included 33 patients who received 3 mg of melatonin two weeks before and during ovulation induction, and group 2 included 43 patients who did not take melatonin. The average age of patients in the groups did not differ. The data of gynecological and ultrasound examinations, structure and thickness of the endometrium, antral follicle count, hormone levels: anti-mullerian, follicle-stimulating, luteinizing, progesterone, estradiol, prolactin, thyrotropin, and thyroxine were evaluated. The primary infertility incidence was significantly higher in all examined patients. Patients in the first group tended to decrease ovarian reserve, recurrent loss, and unexplained infertility; in the second group, more endometriosis, tubal and male infertility factors were observed. The incidence of extragenital pathology in the examined patients did not differ as well as antral follicle count and the thickness of the endometrium. We also did not find any significant difference in the level of hormones in the blood of the examined women, except that patients taking melatonin had significantly higher levels of lutropin but lower levels of the anti-mullerian hormone in the blood.
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