Healthcare Associated Deep Pelvic Tissue Infection and Other Infections of the Female Reproductive Tract in Ukraine

Abstract

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.

Healthcare-Associated Tubo-Ovarian Infections in Ukraine: Results of a Multicenter Study (2020-2022)

“…In addition, these infections may result in female infertility, ectopic pregnancy and chronic pelvic pain and other disease [1][2][3]. Prevalence of female RTI varies from country to country and ranges from 1.8% to 48% [4][5][6]. According to literature, in the United States, 1 million women are diagnosed with RTIs each year and the cost of their treatment is estimated at $ 4.2 billion [7].…”

“…These infections are one of the causes of infertility in women of re-productive age [8]. According to the literature, a significant part of salpingitis, oophoritis and / or TOA are detected after gynecological surgery [4,8]. Despite the introduction into medical practice of new diagnostic technologies for diagnosis and treatment, as well as broad-spectrum antibiotics, the number of healthcare-associated tubo-ovarian infections in female is not decreasing.…”

“…According to literature, one of the reasons for healthcare-associated RTIs is the wide spread of conditionally pathogenic microorganisms in Ukraine that are resistant to antibiotics [5,9]. Therefore, the emergence and spread of antimicrobial resistance has become a major public health threat in Ukraine, and the number of infections caused by resistant pathogens causing of RTIs continues to increase [4].…”