Decreasing Prevalence of Multidrug-Resistant Acinetobacter Baumannii in Rīga East University Hospital

Publisher Copyright: © 2016 by Maris Liepiņš. Copyright: Copyright 2016 Elsevier B.V., All rights reserved.There has been an increasing tendency of infections caused by multidrug-resistant organisms (MDRO), including multidrug-resistant Acinetobacter baumannii (MDRAB), in the Rīga East University Hospital (REUH) during the last decade. Over the last two years (2014-2015), this tendency has reversed and the prevalence of MDRAB has decreased considerably. In this study we assessed the prevalence of MDRAB in intensive care units (ICUs), internal medicine, surgery units and analysed antibiotic sensitivity profiles. In addition, we determined if current infection control measures are preventing further increase of infections caused by MDRAB in REUH. Retrospective Acinetobacter baumannii prevalence data were collected for the period from 2009 until 2012. For the time period from the beginning of 2013 until 2015, after implementing such infection control measures as control of compliance to hand hygiene guidelines, a review of central venous catheter insertion protocols and regular search for sources of MDRAB in hospital environment, prospective follow-up of new cases was conducted. Antimicrobial sensitivity profiles were assessed for the period from 2013 until 2015. Data were processed with the statistical software WHONET 5.5. Bacteria identification and antibiotic susceptibility testing were performed by VITEK 2 compact, BioMerieux, France. The prevalence of MDRAB in the period 2009 to 2013 increased from 71 to 217 cases per year, but from between 2013 (time of implementing infection control measures) and 2015 it decreased to 113 cases in 2015. In the three year period (2013-2015), the proportion of MDRAB causing bloodstream infections (BSI) and central nervous system infections (CNSI) was 15.85% from all identified MDRAB cases. Of the 113 MDRAB infections diagnosed in 2015, BSI was found in 16.81% cases (n = 19). Antibiotic resistance testing showed that colistin is the most effective drug against MDRAB. The majority of Acinetobacter baumannii isolates were resistant to Ampicillin/Sulbactam, Piperacillin/Tazobactam, Ceftazidime, Cefepime, Imipenem, Meropenem, Amikacin, Gentamicin, Tobramycin, and Ciprofloxacin. Over the last two years (2014-2015), prevalence of MDRAB infections decreased considerably. In the time period from 2013 to 2014, resistance of Acinetobacter baumannii increased to imipenem, ciprofloxacin and colistin, while decreased slightly to amikacin. Rigorous infection control measures, such as identification and elimination of new MDRAB sources in environment, review of the central venous catheter insertion protocol and improvements in hand hygiene, are crucial for decreasing distribution of and invasive infections caused by MDRAB in the hospital environment.publishersversionPeer reviewe

Epidemiological Characterization of Clinical Fungal Isolates from Pauls Stradins Clinical University Hospital, Latvia: : A 4-year Surveillance Report

Funding Information: The authors are extremely grateful of the management of Pauls Stradin? Clinical University Hospital (PSCUH) and the supporting hospital and laboratory staff for their support in the present study. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Nosocomial fungal infections are an emerging global public health threat that requires urgent attention and proper management. With the limited availability of treatment options, it has become necessary to understand the emerging epidemiological trends, mechanisms, and risk factors. However, very limited surveillance reports are available in the Latvian and broader European context. We therefore conducted a retrospective analysis of laboratory data (2017–2020) from Pauls Stradinš Clinical University Hospital (PSCUH), Riga, Latvia, which is one of the largest public multispecialty hospitals in Latvia. A total of 2278 fungal isolates were analyzed during the study period, with Candida spp. comprising 95% of the isolates, followed by Aspergillus spp. and Geotrichum spp. Amongst the Candida spp., C. albicans and C. glabrata made up about 75% of the isolates. The Department of Lung Diseases and Thoracic Surgery had the highest caseload followed by Intensive Care Department. Majority of the fungal isolates were collected from the bronchoalveolar lavage (37%), followed by urine (19%) and sputum (18%) samples. A total of 34 cases of candidemia were noted during the study period with C. albicans being the most common candidemia pathogen. Proper surveillance of emerging epidemiological trends serve as the most reliable and powerful cornerstone towards tackling this emerging threat.publishersversionPeer reviewe

Towards the Goal of Hepatitis C Elimination in Latvia — Using Patient Survey Results

The success of global strategies to eliminate hepatitis C as a public threat by 2030 depends on local country-wide activities of all involved stakeholders, the most important being general practitioners (GP) and the entire country population. The opinion of currently diagnosed patients can help stakeholders to plan further actions such as addressing new target groups. Our aim was to determine the experiences, opinions, and attitudes of viral hepatitis C (VHC) patients towards the hepatitis C virus (HCV) infection and corresponding healthcare services in Latvia. Questionnaires were distributed by nurses in hospitals of major cities in Latvia. The survey results highlighted the importance of the role of the general practitioner and time from diagnosis to specialist consultation. The majority of respondents were not aware of VHC symptoms, although they were informed about possible complications such as liver cirrhosis and hepatocellular carcinoma. The major VHC patient pool was not composed of drug users, but people who never used narcotics, highlighting the importance to increase VHC awareness in other risk groups and in the general population. Consequently, targeted VHC screening programmes are essential tools in achieving elimination of HCV infection as a public threat in Latvia. The action plans should be updated regularly aiming to strengthening of the GP role and shortening time to consultation with a specialist.publishersversionPeer reviewe