Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia最新文献

{"title":"Point prevalence multicenter survey of antimicrobial consumption in Russian hospitals: results of the Global-PPS 2021","authors":"Yu.А. Belkova, S.А. Rachina, R.S. Kozlov, V.G. Kuleshov, I.S. Vasilieva, A.A Kurkova, Е.N. Bochanova, Е.V. Elokhina, D.А. Popov, U.S. Portnyagina, О.V. Reshetko, Igor N. Sychev, V.D. Shegimova, D.V. Drogashevskaya, M.S. Chesnokova, E.V. Dovgan, S.O. Korolkov, E.M. Kurtz, A.I. Levitan, T.S. Lutsevich, R.A. Osokina, L.D. Popova, E.E. Sventitskaya, L.V. Fedina","doi":"10.36488/cmac.2023.2.150-158","DOIUrl":"https://doi.org/10.36488/cmac.2023.2.150-158","url":null,"abstract":"Objective. To evaluate prescribing patterns of antimicrobials and quantify them in relation to quality indicators in Russian multi-field hospitals. Materials and Methods. Point Prevalence Survey of Antimicrobial Consumption as a part of an international Global-PPS project was conducted in 8 multi-field hospitals in different Russian cities (Krasnoyarsk, Moscow, Omsk, Saratov, Smolensk, Ulan-Ude, Yakutsk) during the period from May till December 2021. Case records of patients who received therapeutic or prophylactic systemic antimicrobial agents were analyzed. Local practices of antimicrobials’ utilization were evaluated in relation to quality indicators defined by the study protocol. Results. Common mistakes requiring a prompt intervention included low adherence to clinical guidelines, absence of stop/review dates in the medical records, extended duration of surgical prophylaxis, III generation cephalosporin’s overuse and low rate of targeted therapy. Conclusions. The results of the project can be valuable for the improvement to antimicrobial utilization approaches at the study centers as well as for monitoring of antimicrobial stewardship programs’ implementation.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135494745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial resistance-associated mutations in chromosomal genes of ESKAPE pathogens","authors":"Yu.A. Bocharova, Tatiana A. Savinova, Igor V. Chebotar","doi":"10.36488/cmac.2023.2.187-201","DOIUrl":"https://doi.org/10.36488/cmac.2023.2.187-201","url":null,"abstract":"The worldwide successful expansion of ESKAPE pathogens is largely due to their ability to rapidly acquire high antimicrobial resistance levels. The bacterial resistome includes (1) plasmid-encoded genes acquired as a result of horizontal gene transfer, and (2) chromosomal genes associated with the antimicrobial resistance development. This review represents the priority list of the ESKAPE group chromosomal genes, mutations in which are associated with antimicrobial resistance. The diversity of chromosomal genes carrying antimicrobial resistance (AMR) associated mutations confers the rapid pathogen adaptation to antimicrobials by generation of multilevel pathways to neutralize antibiotics. Analysis of the AMR mechanisms associated only with plasmid resistance genes is insufficient. A comprehensive description of AMR mechanisms should include also an analysis of chromosomal genes, mutations in which lead to increased levels of antimicrobial resistance.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse drug reactions of macrolide therapy: analysis of spontaneous reports according to the Pharmacovigilance system","authors":"A. Skryabina, V. Nikiforov, M. Shakhmardanov, M. Zastrozhin, V. Skryabin, D. Sychev","doi":"10.36488/cmac.2023.1.34-40","DOIUrl":"https://doi.org/10.36488/cmac.2023.1.34-40","url":null,"abstract":"Objective. To perform pharmacoepidemiological analysis of spontaneous reports of adverse drug reactions (ADRs) occurred during macrolide group antibiotics prescription and registered in the “Pharmacovigilance 2.0” subsystem of the Federal Service for Surveillance in Healthcare. Materials and Methods. A retrospective pharmacoepidemiological analysis of spontaneous reports of ADRs arising from the use of all macrolide and azalide antibiotics registered in Russia and registered in the electronic database of the “Pharmacovigilance 2.0” subsystem of the Federal Service for Surveillance in Healthcare for the period from 01.04.2019 to 30.11.2022 was performed. Results. Analysis of the number of spontaneous reports of ADRs, their structure, outcomes and severity criteria was performed. The most clinically significant ADRs were identified, the occurrence of which was reported to pharmacovigilance bodies. The results of a retrospective pharmacoepidemiological analysis showed that the development of complications of pharmacotherapy in most cases was associated with the use of azithromycin and clarithromycin. The main clinical manifestations of adverse drug reactions were skin and subcutaneous tissue disorders, gastrointestinal disorders, as well as general disorders and injection site reactions. Conclusions. It was found that the reported events generally corresponded to the general spectrum of ADRs typical for individual representatives of macrolide and azalide antibiotics.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69625121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promising antimycotics for the treatment of invasive infections","authors":"E.А. Ortenberg","doi":"10.36488/cmac.2023.2.165-170","DOIUrl":"https://doi.org/10.36488/cmac.2023.2.165-170","url":null,"abstract":"This paper provides a review of the largest studies (over the period of 2018 to 2023) of promising novel antimycotics and their possible role in the treatment of invasive mycoses, including infections caused by resistant Candida and Aspergillus isolates.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Report of the Russian database on adverse drug reactions for COVID-19-related drugs with a focus on favipiravir","authors":"S. Mishinova, G. Syraeva, A. Kolbin, Y. Polushin, E.V. Verbickaya","doi":"10.36488/cmac.2023.1.26-33","DOIUrl":"https://doi.org/10.36488/cmac.2023.1.26-33","url":null,"abstract":"Objective. The purpose of this study is to systematize and comprehensively evaluate safety data on the drug favipiravir using the national pharmacovigilance database of the Russian Federation. Materials and Methods. The report is based on spontaneous reports in the national automated information system of pharmacovigilance of the Russian Federation for the reporting period from 01.01.2020 – 04.07.2022. To identify safety signals we used disproportionality analysis, to estimate consumption of favipiravir – indicator of the number of consumed DDDs, we additionally performed review of concomitant therapy as a risk factor for serious adverse reactions. Results. A total of 412 reports of 585 adverse reactions was included in the analytic phase. The largest number of reports referred to liver and biliary tract disorders – 166 (38%), gastrointestinal disorders – 93 (16%), changes in laboratory and instrumental data – 53 (9%), and immune system disorders – 44 (7%). A total consumption of oral favipiravir expressed in the number of maintenance daily doses for 2021 was 46,417,274.87, i.e. 30 times the consumption of remdesivir and 6 times the consumption of hydroxychloroquine. One potential statistical safety signal such as hypercreatininemia was identified. Conclusions. Development of hypercreatininemia is a potential statistical safety signal of favipiravir, which requires further validation.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69625111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problems of assessing economic effectiveness of antimicrobial agents: an experience of the Russian Federation","authors":"Y. Gomon, A. Kolbin","doi":"10.36488/cmac.2022.1.23-29","DOIUrl":"https://doi.org/10.36488/cmac.2022.1.23-29","url":null,"abstract":"Objective. To assess the actual practice of conducting clinical and economic studies of antimicrobial medicines included in the federal drug restrictive lists in the period from 2017 to the present. Materials and Methods. As part of the study, the lists of Vital and Essential Drugs in the period from 2017 to 2021 were analyzed for the identification of newly included Class J medicines «Antimicrobial drugs for systemic use» followed by a search for available clinical and economic studies. Results. Data were obtained on 8 clinical and economic studies for 6 drugs used for systemic antimicrobial therapy. The evaluation of available methodological approaches to the assessment of the economic effectiveness of antimicrobial drugs was carried out. Sensitivity analysis was used to test the stability of the results to changes in the effectiveness of strategies over time. Information about the effectiveness was based on international, more often pre-registration randomized clinical trials and their meta-analyses, without taking into account the epidemiological situation in the Russian Federation. For chronic infections, the indicator of the degree of patients’ adherence to therapy remains not taken into account. In the vast majority of studies, only direct medical costs are taken into account. Conclusions. Evaluation of the economic effectiveness of the use of antimicrobial drugs requires, on the one hand, an expansion of the set of technical tools, taking into account the specific features of this group: the problem of bacterial resistance, epidemiological features of the spread of diseases, the importance of antibacterial therapy and prevention in the introduction of other medical technologies, on the other hand, a systematic analysis of the results of studies to assess the compliance of forecasts with the real economic effects of the introduction of medical technology.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enigmatic Achromobacter","authors":"I. Chebotar, Y. Bocharova","doi":"10.36488/cmac.2022.1.4-13","DOIUrl":"https://doi.org/10.36488/cmac.2022.1.4-13","url":null,"abstract":"This review aims to describe the microbiological characteristics, resistant features and pathogenic potential of Achromobacter spp. Achromobacter as an opportunistic pathogen can cause severe and even fatal infections. The current knowledge about molecular basis of clinically significant traits of Achromobacter spp. was critically analyzed. The understanding of pathogenicity factors of Achromobacter spp. are largely based on predictive analysis and the role of the most factors was not confirmed by in vivo and in vitro studies. Achromobacter spp. are intrinsically resistant to many groups of antibiotics and can rapidly acquire an adaptive antibiotic resistance. Only three antibiotics (meropenem, piperacillin/tazobactam, and trimethoprim/sulfamethoxazole) have the established breakpoints for Achromobacter spp. There is an unmet need to develop available and accurate methods for species identification of Achromobacter spp.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of healthcare workers’ smartphones for microbial contamination","authors":"N.A. ​Stepanov, T. Rukosueva, E. Bochanova, A. V. Borovleva, A.V. Ganzha, K.I. Eremina, V. Soboleva","doi":"10.36488/cmac.2022.1.83-88","DOIUrl":"https://doi.org/10.36488/cmac.2022.1.83-88","url":null,"abstract":"Objective. To assess bacterial contamination of smartphone surfaces belonging to medical staff and medical students who provide round-the-clock medical care in Krasnoyarsk hospitals and who do not work in those institutions. Materials and Methods. Bacterial contamination of 122 smartphones owned by medical staff and medical students was studied in the following groups: doctors (n = 31), nurses (n = 29), students, who work in MIs (n = 27), and students who do not work in MIs (n = 35). The study included a survey for all participants to assess frequency of their smartphones cleaning. Results. Every fifth smartphone (26 of 122) was found to be contaminated. Staphylococcus spp. were identified on the devices of 27.6% of nurses, 13% of doctors, 14.8% of students working in MIs, and 20% of students not working in MIs. E. coli strains were not found. However, four cultures belonging to Acinetobacter spp. with three samples belonging to the A. baumannii were isolated from nurses’ smartphones. According to the results of the survey, 18% (n = 22) of the study participants never clean their smartphones, including 3.5% (n = 1) of nurses, 9.7% (n = 3) of doctors, 22.2% (n = 6) of students who work in MIs and 34.3% (n = 12) of students who do not work in MIs. In general, healthcare workers (doctors, nurses, working students) disinfect their smartphones significantly more frequently (several times a day) than students who do not work in MIs (1⁄3 of these students never do this, (p ≤ 0.05)). About 88% of the responders who regularly clean their smartphones use alcohol or alcohol wipes. Conclusions. It is necessary to strengthen control over the microbiological safety of healthcare institutions staff’s smartphones. Also, it is essential to strengthen medical students’ training on the issue of healthcare-associated infections dissemination mechanisms.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69623887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of antimicrobial resistance among clinical and food Listeria monocytogenes isolated in Moscow in 2019–2021","authors":"S. Ermolaeva, T. Karpova, P. Andriyanov, P. A. Zhurilov, O. Voronina, N. Ryzhova, E. Aksenova, M. Kunda, E. A. Liskova, O. Gruzdeva, E. Klimova, E.A. Posukhovsky, G. Karetkina, A. Melkumyan, O. E. Orlova, E. Burmistrova, T. Pronina, I. Tartakovsky","doi":"10.36488/cmac.2022.2.156-164","DOIUrl":"https://doi.org/10.36488/cmac.2022.2.156-164","url":null,"abstract":"Objective. To determine the current state-of-art of acquired resistance to antimicrobial drugs among L. monocytogenes strains associated with listeriosis in humans and food contamination in Moscow. Materials and Methods. We used 39 L. monocytogenes strains isolated in Moscow in 2019–2021 from clinical material (n = 24) and food (n = 15). Resistance to 12 antibiotics of the first and second lines of defense was studied using disk-diffusion method. The parameters recommended for L. monocytogenes were used to interpret the results; in the absence of recommendations for L. monocytogenes, the criteria for Staphylococcus aureus and/or Enterococcus spp. were used. Results. All strains were susceptible to ampicillin, benzylpenicillin, erythromycin, vancomycin, imipenem, linezolid, and the amoxicillin/clavulanic acid. Resistance was observed to gentamicin (23%) as well as to meropenem, trimethoprim/sulfamethoxazole and ciprofloxacin (5%, 74% and 28% of strains, respectively). A total of 15 strains with multiple antibiotic resistance were identified (13 and 2 isolates were resistant to three and four antibiotics, respectively). Simultaneous resistance to trimethoprim/sulfamethoxazole, ciprofloxacin and levofloxacin was observed in 9 strains, 6 strains were resistant to gentamicin and trimethoprim/sulfamethoxazole, including 3 strains – to gentamicin, trimethoprim/sulfamethoxazole, levofloxacin, and 2 strains – to gentamicin, trimethoprim/sulfamethoxazole, ciprofloxacin. Comparison of the growth inhibition zones by ampicillin and benzylpenicillin in the studied strains with historical data on the strains isolated in Russia in 1950–1980 showed a significant downward shift in the size of growth inhibition zones. Comparison of the distribution of strains with different diameters of growth inhibition zones depending on the source of isolation did not show significant differences between clinical strains and strains of food origin isolated in 2019–2021. Conclusions. A wide spread of acquired resistance was shown among L. monocytogenes strains of clinical and food origin isolated in Moscow in 2019–2021. Despite the fact that all strains were susceptible to penicillins, the distribution of growth inhibition zone diameters showed a significant shift towards decreasing sensitivity to ampicillin and benzylpenicillin in strains isolated in 2019–2021 compared with L. monocytogenes strains isolated in Russia before 1980.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of the safety of anti-interleukin therapy in COVID-19","authors":"Y. Gomon, A. Kolbin, V. V. Strizheletsky, I. G. Ivanov, F. Sultanova, Y. Balykina","doi":"10.36488/cmac.2022.2.93-107","DOIUrl":"https://doi.org/10.36488/cmac.2022.2.93-107","url":null,"abstract":"Objective. To evaluate safety of anti-interleukin drugs used as a pathogenetic therapy of COVID-19 as assessed by risks of infectious complications. Materials and Methods. A systematic review of publications related to safety assessment of anti-interleukin drugs recommended as pathogenetic therapy in COVID-19 patients in terms of incidence of serious adverse events and adverse events of “Infections and Invasions” class and a meta-analysis of the data were performed. Results. The meta-analysis included 16 randomized and 3 non-randomized studies. The hazard ratio of serious adverse events between the comparison groups was 0.93 95% CI 0.85; 1.01, the hazard ratio of adverse event of “Infections and Invasions” class was 0.9 95% CI 0.8; 1.02, showing no differences in the incidence of those events. Conclusions. This meta-analysis did not demonstrate statistically significant differences in the relative risks of serious adverse events and adverse events of “Infections and Invasions” class for the use of antiinterleukin drugs in COVID-19 patients.","PeriodicalId":53392,"journal":{"name":"Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69624579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}