Etiology and efficacy of anti-microbial treatment for community-acquired pneumonia in adults requiring hospital admission in Ukraine

Background and aim: Empiric therapy of community-acquired pneumonia (CAP) remains the standard care and guidelines are mostly based on published data from the United States or Europe. In this study, we determined the bacterial etiology of CAP and evaluated the clinical outcomes under antimicrobial treatment of CAP in Ukraine. Methods: A total of 98 adult subjects with CAP and PORT risk II-IV were recruited for the study. The sputum diagnostic samples were obtained from all patients for causative pathogen identification. Subjects were randomly assigned in a 1:1 ratio to receive delafloxacin 300 mg (n=51) or moxifloxacin 400 mg (n=47) with a blinding placebo. The switch to oral treatment was after a minimum of 6 IV doses according to clinical criteria. The total duration of antibacterial treatment was 5-10 days. In vitro susceptibility of pathogens to delafloxacin and other comparator antibiotics was determined. Results: The most frequently isolated pathogens in adults with CAP were S. pneumoniae – 19.5%, M. pneumoniae – 15.3%, H. influenzae – 13.2%, S. aureus – 10.5%, K. pneumoniae – 10.1%, and H. parainfluenzae – 6.4%. All isolates of S. pneumoniae, S. aureus, M. pneumoniae had sufficient susceptibility to appropriate antibiotics. 9.0% of H. influenzae strains were susceptible to azithromycin. 94.8 % of patients had a successful clinical response to delafloxacin at the end of treatment and 93.9 % – at test-of-cure. Conclusions: In Ukraine, the major bacterial agents that induced CAP in adults were S. pneumoniae, M. pneumoniae, H. influenzae, S. aureus, K. pneumoniae, H. parainfluenzae, E. cloacae, L. pneumophila. Delafloxacin is a promising effective antibiotic for monotherapy of CAP in adults and could be used in cases of antimicrobial-resistant strains. (www.actabiomedica.it

Agro-Environmental Evaluation of Irrigation Water from Different Sources, Together with Drainage and Escape Water of Rice Irrigation Systems, According to its Impact on Maize

Water supply deficit requires agro-environmental rationale for the use of alternative water sources to feed agricultural crops, viz.: industrial wastes, municipal drains, farm animal waste, drainage and escape water of rice irrigation systems. We have analyzed the quality of irrigation water from different sources, with regard to the content of cations, anions, water-soluble salts, power of hydrogen (рН), sodium adsorption ratio (SAR), etc. in it. In the course of greenhouse trial, we diagnosed its impact on the indicator crop (maize) (Zea mays L.) with its herbage crop stage of 10 leaves, supplied with water of varied quality. We proved the viability of improved drainage and escape water of rice irrigation systems in irrigated agriculture, owing to which maize herbage had been diminished, at an average, by 5.82 %. We verified the negative impact of irrigation water, which contains effluent disposals of metallurgical production, on croppers – it had contributed to diminishing the watered maize herb, at an average, by 39.27 %. Correlation analysis of the test data proved the closely interrelated feedback between the maize herbage amount and the content of cations, anions and water-soluble salts in irrigation water (coefficient of correlation r varied between 0.88 and 0.98). The worked-out linear regressive model for maize herbage, based on the content of water-soluble salts in irrigation water, together with SAR index (Y=2342.71-1.82×x1+366.78×x2), affirmed the validity of the pattern, discovered by means of correlation analysis