Etiological Characteristics in Causative Agents of Infectious Complications in Cancer Patients

Ю. Куцевалова, Д. А. Розенко, Ю. Козель, В. В. Семянников, Т. В. Аушева, В. Пустовая, Е. А. Марыков, А. И. Алавердян, Д. А. Гусак, А. В. Микутин, Д. И. Мирошниченко, А. Г. Анисимова, Л. Г. Боронина, O. Kutsevalova, Dmitri A. Rozenko, Y. Kozel, Vasily V. Semyannikov, Tatiana V. Ausheva, I. V. Pustovaya, E. A. Marykov, Artem I. Alaverdyan, Darya A. Gusak, Andrey V. Mikutin, D. I. Miroshnichenko, A. G. Anisimova, L. Boronina
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Abstract

Background. Infectious complications are the most frequent and severe among all complications in cancer patients. The development of fungal-bacterial infections is particularly difficult. The aim was to develop an etiological descrip-tion for the causative agents of infectious complications in oncological patients. Materials and methods. The study was conducted from January, 2020 to December (inclusive both dates), 2021. 3662 hospitalized patients (men and women) aged from 1 to 85 years with clinical manifestations of an infection were examined. The traditional micro- biological method was used to clarify the etiology of the infectious process and to verify the pathogen. Phenotypic and real-time PCR methods were used for detection of carbapenemase and ESBL production. Results . The organs of the respiratory system, skin, soft tissues, and blood are most susceptible to infectious complications. In the etiology of infectious complications, the leading place is occupied by gram-negative bacteria. The conducted microbiological study made it possible to establish that resistance to cephalosporins and carbapenems in enterobacteria is realized through various resistance mechanisms. Extended-spectrum β -lactamases and carbapenemases are particularly rel- evant and concerning. Monitoring revealed the growth of carbapenemase-producing isolates of Klebsiella pneumoniae (34.9%), the spread of carbapenemase among Escherichia coli strains (5.1%), the increase in the spread of Acineto- bacter baumannii strains with the production of NDM groups (32.6%). Conclusion . Prescription of antibacterial drugs should be based only on the results of microbiological diagnostics. The current situation requires modern methods of microbiological diagnostics: the use of only up-to-date (periodically updated) criteria for determining sensitivity to antimicrobial drugs, as well as the introduction of phenotypic tests that provide reliable information without mo- lecular genetic methods. in
癌症患者感染性并发症病原的病因学特征
背景。感染性并发症是癌症患者所有并发症中最常见和最严重的。真菌-细菌感染的发展尤其困难。目的是为肿瘤患者感染性并发症的病原体制定一种病因学描述。材料和方法。该研究于2020年1月至2021年12月(包括两个日期)进行。对1 ~ 85岁有感染临床表现的住院患者3662例(男、女)进行了检查。采用传统的微生物学方法,明确了感染过程的病原学,并对病原体进行了验证。采用表型法和实时PCR法检测碳青霉烯酶和ESBL的产生。结果。呼吸系统、皮肤、软组织和血液等器官最容易受到感染并发症的影响。在感染性并发症的病因学中,革兰氏阴性菌占据主导地位。所进行的微生物学研究使我们能够确定肠杆菌对头孢菌素和碳青霉烯类的耐药是通过多种耐药机制实现的。广谱β -内酰胺酶和碳青霉烯酶是特别相关和令人关注的。监测结果显示,产碳青霉烯酶的肺炎克雷伯菌(34.9%)、产碳青霉烯酶的大肠埃希菌(5.1%)、产NDM组的鲍曼不动杆菌(Acineto- bacter baumannii)菌株的传播增加(32.6%)。结论。抗菌药物的处方应仅以微生物诊断结果为依据。目前的情况需要现代微生物诊断方法:仅使用最新(定期更新)的标准来确定对抗菌药物的敏感性,以及引入表型试验,提供可靠的信息,而不需要分子遗传方法。在
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