Spread of Multi-Antibiotic-Resistant Health-Care Pathogens in Hospitals to Treat COVID-19 Patients

Гончаров, А. Е.; Зуева, Л П; Мохов, А. С.; Колоджиева, В. В.; Meltser, Arnon; Smirnova, Maria; Khavlina, T. V.; Оришак, Е А

doi:10.31631/2073-3046-2021-20-2-68-73

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…В период пандемии многие лечебные учреждения, изначально не предназначенные для госпитализации инфекционных больных, были перепрофилированы в «ковидные» стационары. Как показал опыт, именно в этих учреждениях велика вероятность возникновения очагов внутрибольничных инфекций, чему способствуют экстренный характер оказания медицинской помощи, высокая загрузка отделений интенсивной терапии, привлечение к работе персонала без опыта трудовой деятельности в инфекционных стационарах [10].…”

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Comparative Analysis of Bacterial Microflora Isolated from Adult Pneumonia Inpatients and Hospital Objects in the Amur Region

Bondarenko¹,

Курганова²,

Троценко³

et al. 2022

PH&LE

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Background: The COVID-19 pandemic has exacerbated the problem of healthcare-associated infections and worsened the situation with the hospital spread of antibiotic resistant strains potentially inducing nosocomial infections. Objective: To compare bacterial microflora isolated from adult pneumonia inpatients and hospital objects and to assess the risk of hospital-acquired infections in the Amur Region. Materials and methods: The study was conducted in a multidisciplinary and a “COVID” hospital hereinafter referred to as Hospitals 1 and 2, respectively. Parallel bacteria culture testing of 519 sputum samples from 284 inpatients and 486 wipe samples collected weekly during 12 weeks in both hospitals was carried out using a classical method. AutoSCAN-4 and Vitek® 2 Compact 30 analyzers were applied to identify pathogens and determine their antimicrobial susceptibility. Results: Along with the detection of pathogenic bacteria in 33.8 % of hospitalized patients with pneumonia, we found pathogens in 23.3 % and 12.4 % of wipe samples from Hospitals 1 and 2, respectively, and established that the proportion of Gram-negative bacteria in them was 44.9 % and 15.4 % while the share of multidrug-resistant strains was 32.7 % and 3.8 %. The significant differences observed can be attributed to a more stringent disinfection regime in Hospital 2. The structure of multidrug-resistant Gram-negative bacteria was noted for a high proportion of carbapenem-resistant organisms isolated from both sputum (20.0 %) and wipe (38.9 %) samples. Conclusion: Our monitoring results helped define the composition and ratio of bacterial pathogens isolated from pneumonia cases and hospital objects. A wide range of pathogens, including those resistant to antibiotics, often detected in wipe samples and their accumulation over time indicate the potential hazard of the hospital environment posing an increased risk of hospital-acquired infections.

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Comparative Analysis of Bacterial Microflora Isolated from Adult Pneumonia Inpatients and Hospital Objects in the Amur Region

Bondarenko¹,

Курганова²,

Троценко³

et al. 2022

PH&LE

View full text Add to dashboard Cite

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Characteristics of respiratory tract bacterial microflora detected in patients suffering from community-acquired pneumonia during continuing spread of the new coronavirus infection in Khabarovsk city (december 2020 — march 2021)

Троценко

Bondarenko

Шмыленко

et al. 2022

Russian Journal of Infection and Immunity

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Objective of the research to specify respiratory tract bacterial microflora in patients suffering from community-acquired pneumonia (CAP) during initial and repeat examination. To determine local factors affecting microflora in the cohort examined. Materials and methods. Surveillance subject 241 patients with CAP differed by their status and age who stayed in two healthcare facilities of the Khabarovsk city. Examination of respiratory smears was performed. Results. Indices of Gram-negative enterobacteria (30.8% [22.639.7%]) and Gram-negative nonfermentable bacteria (14.5% [8.621.7%]), isolated from patients hospitalized in healthcare institution No. 1 and mostly comprised of the elderly (aged over 61 years 82.0%; 74.388.6%) with more severe disease state including patients at the ICU, were higher compared to data obtained from healthcare institution No. 2 (19.8% (13.427.0); 6.1% (2.710.8) respectively). Prevalent pathogen was Klebsiella pneumoniae 13.6% (7.820.6) and 10.7% (6.016.5). Identification of Acinetobacter baumannii complex 6.4% (2.611.7) and 3.1% (0.86.7) should be also noted. A high percentage of drug-resistant bacterial variants was observed and for Klebsiella pneumoniae totaled 66.7% (41.887.4) and 57.1% (32.280.2) at the healthcare institutions No. 1 and No. 2, respectively. A. baumannii complex drug resistant variants were found in 85.7% (52.799.97) at healthcare institution No. 1. All isolates of A. baumannii complex at the healthcare institution No. 2 were drug resistant. High prevalence of Candida spp. was revealed in both healthcare institutions reaching 54.5% (45.263.7) and 58.0% (49.566.3), respectively, with minimal detection rate of classic pathogens such as S. pneumoniae 5.4% (2.010.4) and 5.3% (2.19.8) and H. influenzae 3.6% (0.97.9) and 3.8% (1.27.7), respectively. Repeat examination of 122 patients conducted 710 days later showed diverse changes in microflora spectrum regardless of the healthcare institution that was manifested as loss or emergence of drug-resistant variants as well as simultaneous presence of different variants of the same pathogen. Conclusion. The results obtained evidence about complexity and variety of mechanisms underlying microorganism community formation during the course of infectious process in patients. Local factors influencing microflora characteristics of patients at the two healthcare institutions were revealed.

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Evaluation of the two in-patient hospitals on potential environmental hazard during the period of new coronavirus infection in the Khabarovsk city (december 2020 — march 2021)

Троценко

Bondarenko

Pshenichnaya

et al. 2022

Russian Journal of Infection and Immunity

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Abstract. Microbiological monitoring after infectious diseases in the system of epidemiological surveillance implies simultaneous pathogen identification both among patients as well as in hospital environment. Objective. To assess potential hospital environmental hazard for the two in-patient infectious disease hospitals of the Khabarovsk city by using bacteriological and epidemiological analysis during new coronavirus disease pandemic. Materials and methods. Bacteriological assessment of nasopharyngeal microflora in 241 patients suffering from community-acquired pneumonia that were hospitalized in the two medical-prophylactic institutions of the Khabarovsk city was performed. Sanitary-bacteriological control of hospital environment (428 hospital environment samples and 91 air samples) was carried out in parallel. Bacteriological assessment was performed with classical methods. Identification of isolated bacteriological pathogens and evaluation of drug-resistant strains were carried out by utilizing bacteriological analyzer Vitec 2 Compact. Results. Nine different pathogens (Psuedomonas aeruginosa, Pseudomonas stutzeri, Acinetobacter baumannii, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Pantoea, Enterococcus faecium, Staphylococcus haemolyticus) were isolated in 20 out of 428 samples – 4.7% [2.7–6.7]. Half of isolated agents – 2.3% [0.9–3.8] were represented by drug-resistant isolates (10 out of 20 isolates) including 5 carbapenem-resistant isolates (Acinetobacter baumannii, Psuedomonas aeruginosa, Klebsiella pneumoniae) and 5 isolates with multiple drug resistance (Enterobacter cloacae, Pantoea, Enterococcus faecium, Staphylococcus haemolyticus). Air samples contained pathogenic biological agents found in 6 out of 91 samples – 6.6% [1.5–11.7], and half of them – 3.3% [0.6–7.9] were identified as drug-resistant variants – including S. aureus и S. haemolyticus. One of the surveyed hospitals was recognized as more hazardous due to microflora isolated from intensive care unit (A. baumannii and P. aeruginosa were resistant to 3rd – 4th generation cephalosporins and carbapenems). Conclusion. Revealed circulation of wide range of microorganisms isolated from environment of two in-patient hospitals indicates high risk of healthcare-associated infections formation. Intensive care units can serve as a reservoir of healthcare-associated infections due to high percentage of patients with severe disease cases (“main reservoir” of drug-resistant strains).

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Spread of Multi-Antibiotic-Resistant Health-Care Pathogens in Hospitals to Treat COVID-19 Patients

Cited by 4 publications

References 13 publications

Comparative Analysis of Bacterial Microflora Isolated from Adult Pneumonia Inpatients and Hospital Objects in the Amur Region

Comparative Analysis of Bacterial Microflora Isolated from Adult Pneumonia Inpatients and Hospital Objects in the Amur Region

Characteristics of respiratory tract bacterial microflora detected in patients suffering from community-acquired pneumonia during continuing spread of the new coronavirus infection in Khabarovsk city (december 2020 — march 2021)

Evaluation of the two in-patient hospitals on potential environmental hazard during the period of new coronavirus infection in the Khabarovsk city (december 2020 — march 2021)

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