Проблема глобального развития антибиотикоустойчивости возбудителей нозокомиальных инфекций
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Gabrielyan N.I., Sharapchenko S.О., Kisil О.V., et al. The problem of global development of antibiotic resistant nosocomial pathogens. Therapeutic Archive. 2020; 92 (11): 110–116. DOI: 10.26442/00403660.2020.11.000783
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Ключевые слова: антибиотикорезистентность, Klebsiella, Acinetobacter, Pseudomonas, Staphylococcus, нозокомиальные инфекции, трансплантация органов, карбапенемы, эпидемиологический надзор.
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The problem of global expansion of multidrug-resistant nosocomial infections pathogens is under special attention at the moment. Antibiotic resistance increasing give us the limited treatment options. This problem is particularly acute for transplant clinics, because of patients need lifelong immunosuppressive therapy. From the one hand this ensures stable allograft functioning, but from the other – increases the risk of severe infectious complications in the postoperative period. The purpose of this article is analysis carbapenem resistance dynamics of Klebsiella spp., Acinetobacter spp., Pseudomonas spp. and Staphylococcus spp. isolated from the blood of recipients of donor organs from 2009 to 2019 in the Shumakov National Medical Research Center of Transplantology and Artificial Organs. A significant annual decrease of carbapenem-sensitive strains of Klebsiella spp. and Acinetobacter spp. are shown. The study of a distinctive pathogen resistance profile specific to each institution can help one in selecting an adequate antimicrobial strategy and is an effective predictive tool for controlling the growth of multidrug-resistant microorganisms.
Keywords: antibiotic resistance, Klebsiella, Acinetobacter, Pseudomonas, Staphylococcus, nosocomial infections, organ transplantation, carbapenems, epidemiological surveillance.
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2. Boucher HW, Talbot GH, Bradley JS, et al. Bad bugs, no drugs: no ESKAPE! An update from the infectious diseases society of America. Clin Infect Dis. 2009;48(1):1-12. doi: 10.1086/595011
3. Tacconelli E, Carrara E, Savoldi A, et al. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. Lancet Infect. 2018;18(3):318-27. doi: 10.1016/S1473-3099(17)30753-3
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7. Lee JS, Lee SH, Kim KS, et al. Bacterial infection monitoring in the early period after liver transplantation. Ann Surg Treat Res. 2018;94(3):154-8. doi: 10.4174/astr.2018.94.3.154
8. Biderman P, Bugaevsky Y, Ben-Zvi H, et al. Multidrug-resistant Acinetobacter baumannii infections in lung transplant patients in the cardiothoracicintensive care unit. Clin Transplant. 2015;29(9):756-62. doi: 10.1111/ctr.12575
9. Руднов В.А., Колотова Г.Б., Багин В.А. и др. Роль управления антимикробной терапией в службе реанимации и интенсивной терапии многопрофильного стационара. Клиническая микробиология и антимикробная химиотерапия. 2018:20(2):132-40 [Rud-
nov VA, Kolotova GB, Bagin VA, et al. The role of antimicrobial therapy management in the resuscitation and intensive care service of a multidisciplinary Hospital. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2018:20(2):132-40 (In Russ.)]. https://elibrary.ru/download/elibrary_35411377_39194466.pdf
10. Petrosillo N, Drapeau CM, Di Bella S. Emerging infectious disease. In: Elsevier. Academic Press. 2014:20:255-72. doi: 10.1016/B978-0-12-416975-3.00020-0
11. Gabrielyan NI, Aref'eva LI, Stolyarova LG. Organization and implementation of epidemiological and microbiological monitoring in a cardiac surgery clinic. Tutorial. Moscow: Rossijskaya medicinskaya akademiya poslediplomnogo obrazovaniya, 2013 (In Russ.)
12. Freire MP, Villela Soares Oshiro IC, Bonazzi PR, et al. Surveillance culture for multidrug-resistant gram-negative bacteria: performance in liver transplant recipients. Infect Control. 2017;45(3):e40-e44. doi: 10.1016/j.ajic.2016.12.010
13. Bertuzzo VR, Giannella M, Cucchetti A, et al. Impact of preoperative infection on outcome after liver transplantation. Br J Surg. 2017;104(2):e172-e181. doi: 10.1002/bjs.10449
14. Karampatakis T, Tsergouli K, Iosifidis E, et al. Impact of active surveillance and infection control measures on carbapenem-resistant gram-negative bacterial colonization and infections in intensive care. J Hosp Infect. 2018;99(4):396-404. doi: 10.1016/j.jhin.2018.05.010
15. Gabrielyan NI, Sharapchenko SO, Drabkina IV, et al. Gram-negative hospital-acquired pathogens at risk of developing severe bacterial infections. Med. alfavit. 2019;1(15):31-5 (In Russ.) doi: 10.33667/2078-5631-2019-1-15(390)-31-35
16. Beloborodov BV, Gusarov VG, Dehnich AV, et al. Diagnostics and antimicrobial therapy of infections caused by multidrug-resistant microorganisms. Vestn. anesteziologii i reanimatologii. 2020;16(1):52-83 (In Russ.) doi: 10.21292/2078-5658-2020-16-1-52-83
17. Machuca I, Gutiérrez-Gutiérrez B, Gracia-Ahufinger I, et al. Associated with bacteremia due to colistin-resistant Klebsiella pneumoniae with high-level meropenem resistance: importance of combination therapy without colistin and carbapenems. Antimicrob Agents Chemother. 2017;61(8):e00406-17. doi: 10.1128/AAC.00406-17
18. Dong N, Yang X, Zhang R, et al. Tracking microevolution events among ST11 carbapenemase-producing hypervirulent Klebsiella pneumoniae outbreak strains. Emerg Microbes Infect. 2018;7(1):146. doi: 10.1038/s41426-018-0146-6
19. De Man TJB, Lutgring JD, Lonsway DR, et al. Genomic analysis of a pan-resistant isolate of Klebsiella pneumoniae, United States 2016. MBio. 2018;9(2):e00440-18. doi: 10.1128/mBio.00440-18
20. Kozlova NS, Barancevich NE, Barancevich EP. Antibiotic susceptibility of Klebsiella pneumoniae strains isolated in a general hospital. Infekcija i immunitet. 2018;8(1):79-84 (In Russ.) doi: 10.15789/2220-7619-2018-1-79-84
21. Skleenova EJu, Azizov IS, Shek EA, et al. Pseudomonas aeruginosa in the Russian Federation: the history of one of the most successful nosocomial pathogens. Klin. mikrobiologija i antimikrobnaja himioterapija. 2018;20(3):164-71 (In Russ.) doi: 10.36488/cmac.2018.3.164-171
22. Tommasi R, Brown DG, Walkup GK, et al. ESKAPEing the labyrinth of antibacterial discovery. Nature Rev Drug Dis. 2015;14:529-42. doi: 10.1038/nrd4572
23. Eren, E. Vijayaraghavan J, Liu J, et al. Substrate specificity within a family of outer membrane carboxylate channels. PLoS Biol. 2012;10:e1001242. doi: 10.1371/journal.pbio.1001242
24. Poirel L, Nordmann P. Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. Clin Microbiol Infect. 2006;12(9):826-36. doi: 10.1111/j.1469-0691.2006.01456.x
25. Amaral L, Martins A, Spengler G, Molnar J. Efflux pumps of Gram-negative bacteria: what they do, how they do it, with what and how to deal with them. Front Pharmacol. 2014;4:168. doi: 10.3389/fphar.2013.00168
26. Bush K. Bench-to-bedside review: The role of β-lactamases in antibiotic-resistant Gram-negative infections. Critical Care. 2010;14:224. doi: 10.1186/cc8892
27. Partridge SR, Kwong SM, Firth N, Jensen SO. Genetic Elements Associated with Antimicrobial Resistanc. Clin Microbiol Rev. 2018;31(4):e00088-17. doi: 10.1128/CMR.00088-17
28. Ciofu O, Tolker-Nielsen T. Tolerance and resistance of Pseudomonas aeruginosa biofilms to antimicrobial agents – how P. aeruginosa can escape antibiotics. Front Microbiol. 2019;10:913. doi: 10.3389/fmicb.2019.00913
29. Lin Q, Deslouches B, Montelaro RC, Di YP. Prevention of ESKAPE pathogen biofilm formation by antimicrobial peptides WLBU2 and LL37. Int J Antimicrob Agents. 2018;52:667-72. doi: 10.1016/j.ijantimicag.2018.04.019
30. Macia MD, Rojo-Molinero E, Oliver A. Antimicrobial susceptibility testing in biofilm-growing bacteria. Clin Microbiol Infect. 2014;20:981-90. doi: 10.1111/1469-0691.12651
31. Bjarnsholt T. The role of bacterial biofilms in chronic infections. APMIS. 2013;136:1-51. doi: 10.1111 / apm.12099
32. El-Saed A, Balkhy HH, Alshamrani MM, et al. High contribution and impact of resistant gram negative pathogens causing surgical site infections at a multi-hospital healthcare system in Saudi Arabia, 2007-2016. BMC Infect Dis. 2020;20(1):275. doi: 10.1186/s12879-020-4939-6
33. Peneş NO, Muntean AA, Moisoiu A, et al. An overview of resistance profiles ESKAPE pathogens from 2010-2015 in a tertiary respiratory center in Romania. Morphol Embryol. 2017;58(3):909-22. https://rjme.ro/RJME/resources/files/580317909922.pdf
34. Zemko VJu, Okulich VK, Dzjadz'ko AM. Monitoring of antibiotic resistance of microorganisms in the intensive care unit of a multidisciplinary hospital. Transplantologija. 2018;10(4):284-97 (In Russ.) doi: 10.23873/2074-0506-2018-10-4284-297
35. Liu S, Wang M, Zheng L, Guan W. Antimicrobial resistance profiles of nosocomial pathogens in regional China: a brief report from two tertiary hospitals in Сhina. Sci Monit. 2018;24:8602-7. doi: 10.12659/MSM.911229
36. Zeana C, Larson E, Sahni J, et al. The epidemiology of multidrug-resistant Acinetobacter baumannii: does the community represent a reservoir? Infect Control Hosp Epidemiol. 2003;24:275-9. doi: 10.1086/502209
37. Vinogradova AG, Kuz'menkov AJu. Practical application of AMRmap: elements of a general-to-specific approach using the example of Klebsiella pneumoniae. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2019;21(2):181-6 (In Russ.) doi: 10.36488/cmac.2019.2.181-186
38. Lanini S, Costa AN, Puro V, et al. Incidence of carbapenem-resistant gram negatives in Italian transplant recipients: a nationwide surveillance study. PLoS One. 2015;10(4):e0123706. doi: 10.1371/journal.pone.0123706
39. Geladari A, Karampatakis T, Antachopoulos C, et al. Epidemiological surveillance of multidrug-resistant gram-negative bacteria in a solid organ transplantation department. Transpl Infect Dis. 2017;19(3):e12686. doi: 10.1111/tid.12686
40. Küpeli E, Ulubay G, Akkurt ES, et al. Long-term pulmonary infections in heart transplant recipients. Exp Clin Transplant. 2015;13(Suppl. 1):356-60. doi: 10.6002/ect.mesot2014.p205
1 ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов им. акад. В.И. Шумакова» Минздрава России, Москва, Россия;
2 ФГБНУ «Научно-исследовательский институт по изысканию новых антибиотиков им. Г.Ф. Гаузе», Москва, Россия;
3 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
4 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
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N.I. Gabrielyan1, S.О. Sharapchenko1, О.V. Kisil2, V.G. Kormilitsina1, I.V. Drabkina1, Т.B. Safonova3, М.I. Petrukhina3, R.Sh. Saitgareev1, V.М. Zakharevich1,4
1 Shumakov National Medical Research Center of Transplantology and Artificial Organs, Moscow, Russia;
2 Gause Institute of New Antibiotics, Moscow, Russia;
3 Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
4 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia