Monitoring of the urinary tract infection caused by antibiotic-resistant organisms

Centrul Naţional de Sănătate PublicăMicrobial resistance to antibiotics, a process that has known a rapid uncontrolled growth in the entire world, are now recognized as one of the major problems of public health at the world’s level. It manifests itself by the seriousness of infectious diseases including urinary tract infections (UTI), duration, increase in the number of hospitalization days, and, last but not least, by the resulting costs It is extremely important to clearly understand the molecular mechanisms of antibiotic resistance of the bacteria. All laboratories should strive to implement an efficient quality system of the antimicrobial resistance monitoring. Rezistența microbiană la antibiotice, un proces care a cunoscut o creștere necontrolată rapidă în întreaga lume, fiind actualmente recunoscută ca una dintre problemele majore de sănătate publică la nivel mondial. Aceasta se manifestă prin gravitatea maladiilor infecțioase inclusiv a infecțiilor de tract urinar (ITU), creșterea numărului de zile de spitalizare, și, nu în ultimul rând, de costurile aferente. Este extrem de important să se înțeleagă clar mecanismele moleculare ale rezistenței la antibiotice a bacteriilor. Toate laboratoarele trebuie să pună în aplicare un sistem de calitate eficient de monitorizare a rezistenței antimicrobiene

Distribuţia speciilor clinice de candida şi sensibilitatea acestora la antifungice

Background. Opportunistic infections of fungal origin are a challenge of the 21st century. The correct identification of Candida species involved in human mycoses and testing of susceptibility to antifungals are key elements in the management of these infections, especially in the case of antifungal resistance Objective of the study. Analysis of the distribution and antifungal sensitivity patterns of Candida species isolated from various pathological samples during the years 2017-2018. Material and Methods. A descriptive study of Candida species distribution and antifungal susceptibility profile was performed. Identification of isolated Candida species was performed by the MALDI-TOF system, and antifungal susceptibility profiles by Fungitest (Bio-Rad SDP Paris, France). Results. Of the 83 recovered strains, Candida non albicans species predominated - 50.6% and Candida albicans constituted 49.4%. The most common species of the Candida non albicans, were C.parapsilosis (25.3%), C.glabrata (12.0%) and C.krusei (4.8%). Analysis of antifungal susceptibility testing of the recovered strains was found that 95.2% Candida spp. were susceptible to 5-fuorocytosine and 94.0% to ketoconazole and intermediate susceptibility to miconazole 34.9%, itraconazole 15.7%. Candida species were resistant to miconazole in 15.7% of the cases, and in 14.5% of cases each to amphotericin B and fluconazole, 9.6% to itraconazole. Conclusion. C.albicans is the most frequently isolated fungal species, but there is also an increase share of non-albicans Candida species such as C.parapsilosis. Introducere. Infecțiile oportuniste de origine fungică sunt o provocare a secolului XXI. Identificarea corectă a speciilor Candida implicate în dezvoltarea micozelor umane, determinarea sensibilității la antifungice sunt elemente cheie în gestionarea acestor infecții, în special în cazul rezistenței antifungice. Scopul lucrării. Analiza distribuţiei și patternurilor de sensibilitate la antifungice a speciilor de Candida izolate din diverse prelevate patologice pe parcursul anilor 2017-2018. Material și Metode. A fost realizat un studiu descriptiv al distribuției speciilor de Candida și al profilului de sensibilitate la antifungice. Identificarea speciilor de Candida izolate a fost realizată prin sistemul MALDI-TOF, iar profilurile de susceptibilitate antifungică prin Fungitest (Bio-Rad SDP Paris, Franta). Rezultate. Din 83 tulpini recuperate, au predominat speciile Candida non albicans cu 50,6%, iar Candida albicans a constituit 49,4%. Din speciile de Candida non albicans, cele mai frecvente au fost C.parapsilosis (25,3%), C.glabrata (12,0%) şi C.krusei (4,8%). Analizând rezultatele testării către preparatele antifungice a tulpinilor recuperate, s-a observat că 95,2% izolatele au fost sensibile la 5- fuorocytosina și 94,0% la ketoconazol. Speciile de Candida au fost rezistente la miconazol în 15,7% cazuri, iar în câte 14,5% din cazuri fiecare la amfotericină B și fluconazol, 9,6% la itraconazol. Concluzii. C.albicans reprezintă specia fungică cel mai frecvent izolată, însă se observă și creșterea ponderii speciilor de Candida non-albicans, precum C.parapsilosis. Speciile de Candida au fost rezistente la miconazol, amphotericină B și fluconazol

VIRULENT FACTORS OF PATHOLOGIC FUNGI: CLINICAL MEANING AND PHENOTIPICAL DETECTION

The article represents the review based on the analysis of literary sources, selected through documentary research into Web of Science, PubMed/MedLine, EMBASE, Scopus, and HINARI databases containing the most recent and relevant information. Studies concerning the fungi virulent factors and the methods of their detection. In the paper, data on the following pathogenicity factors are presented: adhesion mechanisms, synthesis of hydrolytic enzymes responsible for host tissue lesions, immunomodulatory effects, deterioration of the antimicrobial resistance of the host, mechanisms of biofilm formation are presented. The in vitro research methodologies of these factors are listed. The ability of fungi to cause disease is due to virulence factors that help the survival of fungi and persistence in the host, resulting in tissue damage and disease. Detection of virulence and persistence factors allows microbiologists and clinicians to distinguish between colonization and fungal infection.</p

Antifungal susceptibility patterns and virulence factors of clinical Candida spp. isolates

Public Health Laboratory Diagnostic Department, National Agency of Public Health, State University of Medicine and Pharmacy "Nicolae Testemițanu", Chișinău, Republic of MoldovaObjective. The global emergence of antifungal resistance among Candida spp. is a growing threat to public health. Candida infections may resist antifungal drugs actions resulting in their therapeutic deficiency. Considering the increase rate of Candida infections and resistance to antifungal agents in the last decades, this study was conducted to evaluate the in vitro expression of different virulence factors among clinical isolates of Candida species, as well as to assay their susceptibility patterns against antifungal agents. Material and methods. Chromogenic media was used for Candida isolation. A total of 127 Candida isolates were identified by conventional methods, Vitek 2 system. The antifungal susceptibility test was carried out by Vitek-2 system. Candida species were tested for virulence factors such as extracellular enzymes and biofilm formation by the standard phenotypic methods. Results. C. albicans continues to remain one of the most common opportunistic pathogenic fungi in humans. The authors highlighted the importance of research on understanding the mechanisms of antifungal resistance and its pathogenicity. The study demonstrates that C. albicans isolates were the most virulent and produce the highest number of extracellular enzymes: hemolysin, phospholipase, protease, esterase and catalase. The study showed the most effective antifungal agent was fucitozin (98.4%), while 29.4% isolates were resistant to fluconazole and 11.8% to voriconazole. Conclusion. C. albicans were the most virulent and produce the highest number of extracellular enzymes compared to non-albicans Candida isolates. The study showed the most effective antifungal agent was fucitozin. In conclusion, more locally relevant studies should be carried out to monitoring of the distribution and susceptibility profile

The evolution of antibiotic resistance - urgent global

Centrul Naţional de Sănătate PublicăThe evolution of antibiotic resistance - urgent global Evolution of resistance to antimicrobial preparations is an alarming phenomenon in recent decades. Multidrug-resistant bacteria do not know boundaries and thus the risk of spread of untreatable infections. After a certain period since the introduction of a new antibiotic, employing them incorrect and imprudently occur quickly bacterial strains resistant to it. Until recently, antibiotics are the most important arsenal in the fight against pathogenic microorganisms but since bacteria have developed mechanisms of their inactivation. To counter this phenomenon is urgently needed international cooperation of politicians, patients, doctors. Key words: antibiotics, resistance, mechanisms, Beta Lactamases. Evoluţia rezistenţei la preparatele antimicrobiene este un fenomen alarmant în ultimile decenii. Bacteriile multirezistente nu cunosc graniţe şi astfel există riscul de răspîndire al infecţiilor netratabile. După o anumită perioadă de timp de la introducerea unui antibiotic nou, utilizîndul nejudicios şi imprudent foarte repede apar tulpini bacteriene rezistente la acesta. Pînă nu demult, antibioticele reprezintau cel mai important arsenal în lupta cu microorganismele patogene dar la moment bacteriile dezvoltă diferite mecanisme de inactivare a lor. Pentru stoparea fenomenului dat este necesar cooperare internaţională urgentă a politicienilor, pacienţilor, medicilor. Cuvinte cheie: antibiotice, rezistenţă, mecanisme, beta-lactamaz

Фенотипический и генотипический мониторинг маркеров устойчивости к антибиотикам у кишечной палочки

Centrul Naţional de Sănătate PublicăSummary: In the current context of the rapid increase in the prevalence of resistant strains of Enterobacteriaceae, the need to use methods of molecular biology is becoming increasingly stringent. These methods are far more sensitive than phenotypic testing, surveillance and epidemiological monitoring of strains producing CTX-M, and are important in determining treatment tactics for reviewing the empirical treatment protocols. Our study is new for our country thanks to the molecular analysis of plasmid genes that have great potential for communities.Резюме: В нынешних условиях быстрого роста и распространения резистентных штаммов Enterobacteriaceae, необходимо использовать методы молекулярной биологии, которые более чувствительныe, чем фенотипическое тестирование. Эпидемиологический мониторинг штаммов, продуцирующих CTX-М, играeт важную роль для рассмотрения эмпирических протоколов лечения в определении тактики лечения. Проводимые нами исследования являются новшеством для нашей республики, а именно молекулярный анализ генов плазмиды с большим потенциалом распространения в обществе

Феномен резистентности к антибиотикам – серьезная проблема общественного здравоохранения

Centrul Naţional de Sănătate PublicăAntibiotic resistance is a global problem alarming to public health. Since the discovery of antibiotics, because of their abuse and misuse of bacterial resistance the phenomenon of bacterial resistance, was recorded. Currently observed evolution of antibiotic resistance, and bacteria through mutation and selective pressure are becoming increasingly resistant. Humanity is likely to lose the most important conquest-the antibiotics. Combating antimicrobial resistance is a priority public health.Устойчивость к антибиотикам является тревожной, глобальной проблемой для общественного здравоохранения. С момента открытия антибиотиков, из-за их злоупотребления и неправильного использования было зафиксировано явление резистентности бактерий к антибиотикам. В настоящее время наблюдается эволюция устойчивости и бактерии, в результате мутации и селективного давления, становятся все более устойчивыми. Человечество может потерять одно из важнейших завоеваний – антибиотики. Борьба с устойчивостью к противомикробным препаратам является приоритетом общественного здравоохранения

Producent of EBLS Enterobacteriaceae – issues contemporary a diagnostic laborator

Centrul Naţional de Sănătate PublicăOne of the main research problems in clinical microbiology is currently acquired resistance of bacteria to antibiotics. Currently inactivation by beta-lactam beta-lactamase is the most common mechanism. The rapid spread of this type of resistance is because coding genes found on transmissible plasmids or movable. At this point it is important to mitigate the social impact of the phenomenon of multiple resistance to antibacterial preparations, with detailed knowledge of the mechanisms of bacterial resistance. Correct detection of strains producing ESBLs Enterobacteriacea family, remains a challenge for the microbiology laboratory Key words: antibiotics, resistance, mechanisms, Beta Lactamases. Una din problemele prioritare de cercetare în microbiologia clinică la ora actuală reprezintă rezistenţa dobândită a bacteriilor la antibiotice. Actualmente inactivarea betalactaminelor de către beta-lactamaze este mecanismul cel mai frecvent întâlnit. Răspândirea rapidă a acestui tip de rezistență se datorează faptului că genele codante se găsesc pe plasmidele transmisibile sau mobilizabile. În acest moment este important să diminuăm impactul social al fenomenului de rezistenţă multiplă la preparatele antibacteriene, prin cunoaşterea detailată a mecanismelor de rezistenţă bacteriană. Detectarea corectă a tulpinilor familiei Enterobacteriacea producătoare BLSE, rămâne o provocare pentru laboratorul de microbiologie. Cuvinte cheie: antibiotice, rezistenţă, mecanisme, beta-lactamaz

Актуальные тенденции в диагностике инвазивных грибковых инфекций

Agenţia Naţională pentru Sănătate Publică, IP Universitatea de Stat de Medicină şi Farmacie Nicolae TestemiţanuActualmente, infecţiile fungice invazive (IFI) sunt întâlnite tot mai frecvent şi decurg mult mai difi cil, fi ind însoțite de un şir de dificultăţi de diagnostic și tratament şi de o mortalitate înaltă. Constatarea unor deficienţe în diagnosticul IFI şi subraportarea lor din biosubstraturi sterile a fost premisa acestui articol de sinteză. Lucrarea prezintă rezultatele analizei celor mai relevante studii din ultimele două decenii, selectate din bazele de date Google, Academic şi Pubmed cu referire la infecţiile fungice invazive şi oferă date bazate pe dovezi privind tendinţele actuale ale epidemiologiei, clinicii și terapiei acestor infecţii. Lucrarea sumarizează datele cercetărilor ştiinţifice publicate privind IFI şi sensibilitatea la antimicotice. Studiul dat confi rmă domeniul dinamic al infecţiilor fungice care prezintă permanenta schimbare a speciilor de fungi implicate în dezvoltarea acestora. Totodată, se menţionează şi îngrijorarea privind spectrul de sensibilitate la antimicotice a acestor specii de fungi, care manifestă rezistenţă în majoritatea cazurilor. IFI reprezintă o problemă majoră pentru comunitatea medicală prin consecinţele clinice, scăderea duratei de supravieţuire a pacienţilor afectaţi, precum și prin creşterea costurilor necesare unui diagnostic specific timpuriu şi terapiei ţintite. Așadar, există o preocupare permanentă a societăţii ştiinţifi ce pentru elaborarea metodologiilor de diagnostic al infecţiilor fungice invazive.Invasive fungal infections (IFIs) are currently an increasingly common and challenging problem in intensive care units, and are burdened with a number of difficulties: diagnosis, treatment, and very high mortality. The detection of some deficiencies in the diagnosis of invasive fungal infections as well as them underreport from sterile biological samples was the premise of this review of the literature. The paper presents the results of the analysis of studies of the last two decades on some particularities of invasive fungal infections and provides evidence-based data on current trends in epidemiology, clinics and their diagnostic principles. The paper summarizes the published scientific research data on invasive fungal infections and susceptibility to antimycotics. This study confirms that fungal infections represent a dynamic area with a permanent change in the fungal species involved in their development. Also, worrying is the antimycotic susceptibility spectrum of these fungal species that is resistant in most cases. Therefore, there is a permanent concern of the scientific society regarding the elaboration of diagnostic methodologies for invasive fungal.Инвазивные грибковые инфекции в настоящее время становятся все более распространенной и более сложной проблемой в отделениях интенсивной терапии и сопровождаются рядом трудностей диагностики, лечения и очень высокой долей смертности. Обнаружение некоторых недостатков в диагностике инвазивных грибковых инфекций, а также выделение их из стерильных биосубстратов стало предпосылкой написания этой работы. В статье представлены результаты анализа исследований некоторых особенностей инвазивных грибковых инфекций за последние два десятилетия и приведены данные, основанные на фактических знаниях о современных тенденциях в эпидемиологии, клинических и диагностических принципах. В статье обобщены данные опубликованных научных исследований по инвазивным грибковым инфекциям и их восприимчивости к антимикотикам. Это исследование подтверждает, что грибковые инфекции представляют собой динамическую область с постоянной измененчивостью видов грибов, участвующих в их развитии. Также вызывает беспокойство спектр антимикотической чувствительности этих видов грибов, которые в большинстве случаев резистентны. Поэтому научное общество постоянно беспокоится о разработке методологий диагностики инвазивных грибковых инфекций

Monitorizarea infecției COVID -19 prin secvențierea intregului genom și analiza filogenetică a izolatelor SARS-COV-2

Background. Coronavirus genome-wide sequencing and publication of data obtained are essential for evaluating the performance of PCR test systems used, tracking the spread of the virus, determining its genetic variability, and developing the vaccine. Objective of the study. Identification of mutation variants of SARS-CoV-2 virus with phylogenetic analysis of circulating isolates on the territory of the Republic of Moldova. Material and Methods. The identification of genetic variants and the determination of the type of mutations was performed by the method of sequencing the fragments using the Ion Torrent Genexus tool and using the Pangolin and GISAID programs. Results. In the Republic of Moldova, the first sequencing of the SARS-CoV-2 virus was performed at the end of 2021 – 47 biological samples were investigated. According to the results of the investigations, the Delta variant was identified in all 47 samples. Moreover, during 2022, 144 biological samples were sequenced, selected according to all clinical, epidemiological and laboratory diagnostic criteria. Following the sequencing, the following results were obtained: in 141 biological samples the Omicron variant was identified, of them 57 presented the BA.2 line and 84 samples the BA.1 line, and in 3 samples the Delta variant was identified. Conclusion. Following the study, it was found that the Delta version circulated on the territory of the Republic of Moldova in the second half of 2021. At the beginning of 2022, the Omicron version begins to appear. At the beginning of the Omicron variant, line BA.1 predominated.Introducere. Secvențierea întregului genom al coronavirusurilor și publicarea datelor obținute sunt esențiale pentru evaluarea performanței sistemelor de testare PCR utilizate, urmărirea răspândirii virusului, determinarea variabilității sale genetice și dezvoltarea vaccinului. Scopul lucrării. Identificarea variantelor de mutație a virusului SARS-CoV-2 cu analiza filogenetică a izolatelor circulante pe teritoriul Republicii Moldova. Material și Metode. Identificarea variantelor genetice și determinarea tipului de mutații a fost efectuată prin metodă de secvențierea fragmentelor cu ajutorul instrumentului Ion Torrent Genexus și folosind programele Pangolin și GISAID. Rezultate. În Republica Moldova au fost realizate primele secvențieri ale virusului SARSCoV-2 la finele anului 2021 – au fost investigate 47 de probe biologice. Potrivit rezultatelor obținute în urma investigațiilor, în toate cele 47 de probe a fost identificată varianta Delta. Iar în perioada anului 2022 au fost secvențiate 144 probe biologice selectate după toate criteriile clinice, epidemiologice și diagnostic de laborator. În urma secvențierii au fost obținute următoarele rezultate: în 141 probe biologice a fost identificată varianta Omicron, din ele 57 au prezentat linia BA.2 și 84 probe linia BA.1, iar în 3 probe a fost identificată varianta Delta. Concluzii. În urma studiului s-a constatat că varianta Delta au circulat pe teritoriul Republicii Moldova în a doua jumătate a anului 2021. La începutul anului 2022, începe să apară varianta Omicron. La începutul circulației variantei Omicron a predominat linia BA.1