Antimicrobial resistance of Gram-negative pathogens of nosocomial pneumonia in intensive care unit patients | CMAC

Antimicrobial resistance of Gram-negative pathogens of nosocomial pneumonia in intensive care unit patients

Clinical Microbiology and Antimicrobial Chemotherapy. 2019; 21(1):62-68

​ Pervukhin S.A., Statzenko I.A., Ivanova E.Yu., Palmash A.V., Vitkovskaya I.V., Zhidkova O.V.
10.36488/cmac.2019.1.62-68
nosocomial pneumonia Gram-negative microorganisms antimicrobial resistance carbapenemases
Section
Antimicrobial Resistance
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2019; 21(1):62-68

Abstract

In order to study etiology and antimicrobial resistance rates in Gram-negative pathogens of nosocomial pneumonia, a total of 1410 isolates obtained from sputum in 75 ICU patients with nosocomial pneumonia in 2012 and 2017 was tested. The most common pathogens of nosocomial pneumonia in the both periods were aerobic Gram-negative microorganisms, such as P. aeruginosa, A. baumannii, K. pneumoniae. There was a 2.8-fold increase in the proportion of K. pneumoniae in 2017. The study shows an increase in resistance rates among Gram-negative pathogens to the main antimicrobial classes. Compared to 2012, the proportion of meropenem-resistant P. aeruginosa, A. baumannii and K. pneumoniae isolates was increased by 20.3%, 29.8%, and 74.3%, respectively. Particular attention is drawn to the appearance of P. aeruginosa and A. baumannii isolates resistant to all classes of the tested antibiotics. Of 38 sputum samples tested by polymerase chain reaction (PCR) using the GeneXpert analyzer, 20 (52.6%) samples were positive for carbapenemases VIM, NDM, OXA-48.

Sergey A. Pervukhin

Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tzivyan, Novosibirsk, Russia

Statzenko I.A.

Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tzivyan, Novosibirsk, Russia

Ivanova E.Yu.

Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tzivyan, Novosibirsk, Russia

Palmash A.V.

Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tzivyan, Novosibirsk, Russia

Vitkovskaya I.V.

Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tzivyan, Novosibirsk, Russia

Zhidkova O.V.

Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tzivyan, Novosibirsk, Russia

  • 1. Gelfand B.R., Protsenko D.N., Belotserkovsky B.Z. Nosocomial pneumonia in adults: Russian national recommendations. M.: OOO "Publishing house" Medical information agency"; 2016:176.
  • 2. Zverkov A.V., Zouzova A.P. Prevention of Hospital-Acquired Pneumonia in Patients with Acute Stroke. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2013;15(2):95-102.
  • 3. Rudnov V.A., Belsky D.V., Dehnich A.V. Infections in the ICU of Russia: the results of a national multicentre study. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2011;13(4):294-303.
  • 4. Vincent J.L., Rello J., Marshal J., et al. International study of prevalence and outcomes of infection in ICU. JAMA. 2009;302:2323-2329. DOI: 10.1001/jama.2009.1754
  • 5. Sprung C., Sakr Y., Vincent J.L., et al. An evaluation of SIRS sings in the sepsis occurrence in acutely ill patients. Intensive Care Med. 2006;32:421-427. DOI: 10.1007/s00134-005-0039-8
  • 6. Galstyan G.M., Klyasova G.A., Katrysh S.A., et al. Etiology of nosocomial pneumonia in oncohematological patients in intensive care unit. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2011;13(3):231-240.
  • 7. Gordinskaya N.A., Sabirova E.V., Abramova N.V., Dudareva E.V., Savochkina Yu.A. Features of nosocomial strains of Acinetobacter spp. in the trauma clinic. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2013;15(2):143-146.
  • 8. Svetlichnaya Yu.S. Features of the epidemic process of purulentseptic infections among patients in intensive care units, taking into account the phenotype of resistance of the pathogen. PhD thesis. St. Petersburg: North-West Medical University. 2016:1-144.
  • 9. European Committee on Antimicrobial Susceptibility testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Ver. 6.0 2016. Available at: www.eucast.org/clinical_breakpoints/.
  • 10. Kozlov R.S., Sukhorukova M.V., Eidelshtein M.V., et al. Determination of the susceptibility of microorganisms to antimicrobial agents. Clinical recommendations. Version 2015-02. 2015:162.
  • 11. Magiorakos A.P., Srinivasan A., Carey R.B., et al. Multidrugresistant, extensively drug-resistant and pundrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268-81. DOI: 10.1111/j.1469-0691.2011.03570.x
  • 12. Pendleton J.N., Gorman S.P., Gilmore B.F. Clinical relevance of the ESKAPE pathogens. Expert Rev Anti Infect Ther. 2013;11:297-308. DOI: 10.1586/eri.13.12
  • 13. Eidelshtein M.V., Sukhorukova M.V., Skleenova E.Yu., et al. Antimicrobial resistance of nosocomial Pseudomonas aeruginosa isolates in" 2013-20
  • 14. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2017;19(1):37-41.
  • 15. Sukhorukova M.V., Eidelshtein M.V., Skleenova E.Yu., et al. Antimicrobial resistance of nosocomial Acinetobacter spp. isolates in Russia: the results of a multicenter epidemiological study "MARATHON" 20132014. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2017;19(1):42-48.
  • 16. Bogomolova N.S., Bolshakov L.V., Kuznetsova S.М. Problems of treatment of purulent-inflammatory complications caused by Acinetobacter. Anesteziologija i reanimatologija. 2014;1:26-32.
  • 17. Martinovich A.A. Dynamics of antimicrobial resistance and epidemiology of infections caused by Acinetobacter spp. in Russia. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2010;12(2):96-105.
  • 18. Zarrilli R., Pournaras S., Giannouli M., Tsakris A. Global evolution of multidragresistant Acinetobacter baumannii clonal lineages. Int J Antimicrob Agents. 2013;41:11-9.
  • 19. Sukhorukova M.V., Eidelshtein M.V., Skleenova E.Yu., et al. Antimicrobial resistance of nosocomial Enterobacteriaceae isolates in Russia: results of a multicentre epidemiological study "MARATHON" 2013-2014. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2017;19(1):49-56.
  • 20. Haley J.M., Jason M.P., Keith S.K., Kerry L. Treatment options for carbapenem-resistant Enterobacteriaceae infections. Open Forum Infect Dis. 2015;2(2):ofv050. DOI: 10.1093/ofid/ofv050
  • 21. Barantsevich E.P., Barantsevich N.E., Shlyakhto E.V. Products of carbapenemases with nosocomial isolates of K. pneumoniae in St. Petersburg. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2016;18(3):196-199.
  • 22. Poirel L., Bonnin R.A., Nordmann P. Genetic features of the widespread plasmid coding for the carbapenemase OXA-48. Antimicrob Agents Chemother. 2012;56(1):559-562. DOI: 10.1128/AAC.05289-11
  • 23. Kumar A., Roberts D., Wood K.E., et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. J Crit Care Med. 2006;34(6):15891596. DOI: 10.1097/01.CCM.0000217961.75225.E9
  • 24. Popov D.A., Vostrikova T.Yu. The first experience of using PCR in real time for the diagnosis of bacteremia in the postoperative period in cardiosurgical patients. Klinicheskaja laboratornaja diagnostika. 2011;8:49-52.
  • 25. Popov D.A., Nadtochia E.A., Vostrikov T.YU., Ovseenko S.T. Accelerated methods for identification of positive blood cultures using MALDI-TOF mass spectrometry. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2016;18:296-307.
  • 26. Price C., Douglas I., Tuttle E., et al. Rapid identification and antimicrobial susceptibility testing of bacteria in bloodstream infections using the Accelerate ID/AST technology. ECCMID. 2015; EV0493.
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