Antimicrobial Resistance (AMR) is one of the most serious threats in modern medicine which requires the constant monitoring of emerging trends amongst clinical isolates. However, very limited surveillance data is available in the Latvian context. In the present study, we conducted a retrospective analysis of microbiological data from one of the largest public multispecialty hospitals in Latvia from 2017 to 2020. AMR trends for 19 Gram-negative bacterial (GNB) genera were investigated. During the study period, 11,437 isolates were analyzed with Escherichia spp. (34.71%), Klebsiella spp. (19.22%) and Acinetobacter spp. (10.05%) being the most isolated. Carbapenems like Meropenem and Ertapenem were the most effective against GNBs (3% and 5.4% resistance rates, respectively) while high resistance rates (>50%) were noted against both Ampicillin and Amoxicillin/Clavulanic acid. Enterobacter spp. and Klebsiella spp. showed a significant increase in resistance rate against Ertapenem (p = 0.000) and Trimethoprim-Sulfamethoxazole (p = 0.000), respectively. A decrease in the prevalence of Extended-Spectrum Beta-Lactamase positive (ESBL+) Enterobacterales was noted. Despite the lower prescription levels of the penicillin group antimicrobials than the European average (as reported in ESAC-Net Surveillance reports), GNBs showed high average resistant rates, indicating the role of ESBL+ isolates in driving the resistance rates. Constant and careful vigilance along with proper infection control measures are required to track the emerging trends in AMR in GNBs.
Nosocomial fungal infections are an emerging global public health threat that requires urgent attention and proper management. With the limited availability of treatment options, it has become necessary to understand the emerging epidemiological trends, mechanisms, and risk factors. However, very limited surveillance reports are available in the Latvian and broader European context. We therefore conducted a retrospective analysis of laboratory data (2017–2020) from Pauls Stradinš Clinical University Hospital (PSCUH), Riga, Latvia, which is one of the largest public multispecialty hospitals in Latvia. A total of 2278 fungal isolates were analyzed during the study period, with Candida spp. comprising 95% of the isolates, followed by Aspergillus spp. and Geotrichum spp. Amongst the Candida spp., C. albicans and C. glabrata made up about 75% of the isolates. The Department of Lung Diseases and Thoracic Surgery had the highest caseload followed by Intensive Care Department. Majority of the fungal isolates were collected from the bronchoalveolar lavage (37%), followed by urine (19%) and sputum (18%) samples. A total of 34 cases of candidemia were noted during the study period with C. albicans being the most common candidemia pathogen. Proper surveillance of emerging epidemiological trends serve as the most reliable and powerful cornerstone towards tackling this emerging threat.
Clostridium difficile Associated Disease Clinical and Molecular Data Introduction. A balanced microflora of the gastrointestinal tract plays a significant role in the protection of an organism. Dramatic changes may take place in the composition of normal microflora during antibacterial therapy, because part of sensitive microorganisms die and microflora detrimental to an organism proliferates there causing gastrointestinal tract disorders (7). C. difficile is an important agent causing gastrointestinal tract disorders. It may induce manifestations ranging from asymptomatic colonization of the gastrointestinal tract to severe diarrhea, pseudomembranous colitis, toxic megacolon, intestinal perforation, and death. All these severity levels are included in the term Clostridium difficile associated disease (CDAD). A patient at risk for C. difficile is an elderly person with a severe principal disease, who receives long-term inpatient treatment, has been receiving antibiotics, antacid and antiulcer agents for a long time, has had a gastrointestinal surgical intervention or any organ transplantation, which is always related to immune suppression (11). Aim of the study. Molecular typing of Latvian strains of C. difficile and clinical data analysis. Materials and methods. The research includes data collected during the time period from August 2006 to the end of 2008 from three Latvian hospitals. A pure culture of C. difficile bacteria was isolated and cultured from fecal material. Ribotyping was done by amplification of specific regions of the 16S and 23S RNA genes and amplification products were separated in 1.5% agarose gel. Results. Fecal samples of 500 patients having manifestations of clinical symptoms of CDAD were microbiologically and molecularly studied from August 2006 to the end of 2008. 130 samples were tcdA + tcdB + toxin-positive. Conclusions. All samples were cultured on agar in anaerobic conditions. As a result, 55 pure cultures were obtained. The average age of patients is 65 years. Women get infected more frequently than men. In 95% patients CDAD was induced by antibacterial therapy. In 86% cases, having received a positive response for C.difficile antibacterial therapy is changed. Disease development risk factors are previous antibacterial therapy, previous hospitalization, GIT manipulations and C.difficile infection in anamnesis. The biggest number of CDAD patients was found in Nephrology Department of P. Stradins Clinical University Hospital. A hypervirulent Cl.difficile ribotype 027 was not found in Latvia yet, bat 16 different ribotypes were determined using Bionumerics software. 4 of them are domineering ribotypes with 17, 14, 5 and 4 isolates in every group.
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