Epidemiology of septic infections caused by methicillin-resistant strains of Staphylococcus aureus

The purpose of the work is to reveal the patterns of methicillin-resistant strains of Staphylococcus aureus (MRSA) spread in medical institutions and to develop the approaches to the epidemiological surveillance and control in health care institutions, depending on the level of MRSA spread. Methods. The study of 193.869 samples of biological material has been carried out. We have used standard microbiological techniques, molecular-genetic and statistical methods. Results. Due to the epidemiological monitoring of the circulation of MRSA in Kemerovo region the heterogeneity of distribution of strains in certain territories (from 2.63% to 60.12%; χ2 = 40.97; p = 0.000) has been revealed. The incidence of infections caused by MRSA in patients of health care organizations has been 10.97 per 1000 patients. The differences of circulation intensity of MRSA in patients of hospitals of different profiles (from 219.4 to 131.8 per 1000 patients; c2 = 755, p = 0.0003) has been revealed. The belonging of the cultures to the clonal complex CC8/239 has been determined. The dependence of MRSA circulation on the frequency of disinfection processing of medical personnel hands has been established, the sensitivity of the cultures to disinfectant preparations and the preparations for local treatment of wounds has been investigated. Conclusions. 1. The circulation of MRSA in Kemerovo region in a population of people without pathological processes, in hospital patients and in closed institutions has been unequal. 2. The sources of MRSA in outpatient medical institutions are mostly patients with purulent infections of skin and soft tissues, infections of respiratory tract, ENT-organs and eyes. 3. The strains of MRSA, identified in surgical hospitals, have a significant pathogenic potential due to the genes embodying the synthesis of pathogenicity factors, that provide the immunosuppressive properties. 4. The dynamics of infections caused by MRSA remains stable; however, it is necessary to differentially develop the approaches to the surveillance of the given group of infections and correction of anti-epidemic measures depending on the prevalence of MRSA

Modern trends of Salmonella epidemic process

Modifications in the technology of foodstuff producing, storage and realization, the change of eating behavior along with the endless globalization process are followed by the intensive growth of salmonellosis, thus the permanent epidemiologic monitoring of this group of infections is necessary. The manifestations of the epidemic process of salmonellosis have been studied by an epidemic retrospective analysis and a random retrospective survey of “case – control” type. This article illustrates the analyzed data from Kemerovo region: 41820 cases of salmonellosis disease (1992-2012 г.г.), 1759 cards of the epidemiological study from the disease center (2011-2012 г.г.), the results of bacteriological monitoring (94790 samples of materials of animal origin and objects of the environment). Two periods of salmonellosis morbidity have been identified, which had significant differences in the intensity of epidemic process (the first one – from 1995 to 2004, the second one – from 2005 to 2012). During the first period the morbidity sharply decreased (Тпр. = 9.24%), in the second period, on the contrary, it raised (Тпр. = 9.60%). The growth of the number of the disease cases provoked by salmonella of serogroup D (Salmonella enteritidis) has been discovered. The maximum rate of the salmonellosis morbidity in the annual dynamics has been detected in August, the minimum one – in December. The special group of high risk is babies from 0 to 2 years old. It has been discovered that the majority of morbidities have been caused by a nutritional factor. There is a high rate of correlation between salmonella diseases and eating eggs and poultry products (OR = 4.27). It is obvious that the preventive measures for salmonellosis should be improved

Occurence of common dolphins (Delphinus delphis) in the Gulf of Trieste and the northern Adriatic Sea

1. The Mediterranean common dolphin (Delphinus delphis), considered to have been very common in the past, had undergone a dramatic decline across most of the basin by the end of 1970s. In the northern Adriatic Sea, one of the regions with most available historical information, the common dolphin is thought to have been the most common and abundant cetacean throughout most of the 20th century. However, by the end of 1970s, it had virtually disappeared from the region and is now considered generally absent from the entire Adriatic Sea. 2. This contribution summarizes the occurrence of common dolphins in the Gulf of Trieste and provides a brief review of published records in other parts of the Adriatic Sea. 3. Systematic boat surveys in the wider area of the Gulf of Trieste between 2002 and 2019 confirmed that the common bottlenose dolphin (Tursiops truncatus) is the only regularly occurring cetacean species in this area. Despite this, several records of common dolphins were documented in the Gulf of Trieste between 2009 and 2012, through sightings of live animals or recovery of dead stranded animals. 4. Dorsal fin markings allowed the photo‐identification of some of these, suggesting that at least four different live individuals (three adults and one calf) occurred here in recent times. Most cases involved single adult individuals, but one included a mother‐calf pair that was temporarily resident in a port for several months, a behaviour atypical for this species. Photo‐identification showed that the presumed mother had previously been sighted in the Ionian Sea in Greece, over 1,000 km from the Gulf of Trieste, making this the longest documented movement for this species worldwide. 5. At present, the common dolphin continues to be rare in the region.Publisher PDFPeer reviewe

Lymnaea schirazensis, an Overlooked Snail Distorting Fascioliasis Data: Genotype, Phenotype, Ecology, Worldwide Spread, Susceptibility, Applicability

BACKGROUND: Lymnaeid snails transmit medical and veterinary important trematodiases, mainly fascioliasis. Vector specificity of fasciolid parasites defines disease distribution and characteristics. Different lymnaeid species appear linked to different transmission and epidemiological patterns. Pronounced susceptibility differences to absolute resistance have been described among lymnaeid populations. When assessing disease characteristics in different endemic areas, unexpected results were obtained in studies on lymnaeid susceptibility to Fasciola. We undertook studies to understand this disease transmission heterogeneity. METHODOLOGY/PRINCIPAL FINDINGS: A ten-year study in Iran, Egypt, Spain, the Dominican Republic, Mexico, Venezuela, Ecuador and Peru, demonstrated that such heterogeneity is not due to susceptibility differences, but to a hitherto overlooked cryptic species, Lymnaea schirazensis, confused with the main vector Galba truncatula and/or other Galba/Fossaria vectors. Nuclear rDNA and mtDNA sequences and phylogenetic reconstruction highlighted an old evolutionary divergence from other Galba/Fossaria species, and a low intraspecific variability suggesting a recent spread from one geographical source. Morphometry, anatomy and egg cluster analyses allowed for phenotypic differentiation. Selfing, egg laying, and habitat characteristics indicated a migration capacity by passive transport. Studies showed that it is not a vector species (n = 8572 field collected, 20 populations): snail finding and penetration by F. hepatica miracidium occur but never lead to cercarial production (n = 338 experimentally infected). CONCLUSIONS/SIGNIFICANCE: This species has been distorting fasciolid specificity/susceptibility and fascioliasis geographical distribution data. Hence, a large body of literature on G. truncatula should be revised. Its existence has henceforth to be considered in research. Genetic data on livestock, archeology and history along the 10,000-year post-domestication period explain its wide spread from the Neolithic Fertile Crescent. It is an efficient biomarker for the follow-up of livestock movements, a crucial aspect in fascioliasis emergence. It offers an outstanding laboratory model for genetic studies on susceptibility/resistance in F. hepatica/lymnaeid interaction, a field of applied research with disease control perspectives

Risk Factors of Klebsiella pneumoniae Infections in Pediatric Healthcare Settings

Relevance. Klebsiella pneumoniae is a major cause of severe healthcare-associated infections in children, representing one of the six most widespread multidrug-resistant microorganisms worldwide and requiring the implementation of population-wide treatment strategies.Aim. To study the risk factors for Klebsiella spread in pediatric healthcare settings.Materials and Methods. Here we performed a descriptive retrospective epidemiological study of Klebsiella spp. cases in pediatric units across the entire Kemerovo region (2012–2019). In total, we documented 27,852 treatment outcomes. We further selected 52 confirmed cases and assessed their risk profiles in comparison with 738 condition-matched control children.Results. Average incidence of Klebsiella spp. detection in pediatric healthcare settings was 78.52 per 1,000 patients (95% CI = 75.42–81.74). We revealed a declining incidence of Klebsiella pneumoniae infection in the region, with notable 4-year cyclicity. The proportion of Klebsiella pneumoniae-infected patients increased 2-fold after 5 days of antibiotic therapy. Among the risk factors of Klebsiella pneumonia infection were artificial feeding (OR = 9,21, 95% = 3,31–35,45, р = 0,0001), assisted ventilation (OR = 7,36, 95% CI = 3,92–14,0], р = 0,0001), use of nebulizers (OR = 5,34, 95% CI =2,49 – 10,9], р=0,0001), airway management (OR = 4,62, 95% CI =2,49–8,56, р = 0,0001), preterm birth (OR = 2,55, 95% CI =1,38 – 4,69, р=0,001), low body weight (OR = 2,48, 95% CI = 1,34–4,56, р = 0,002), enema administration (OR = 1,80, 95% CI = 0,78–3,81, р = 0,088), and nasogastric intubation (OR = 1,79, 95% CI = 0,85–3,54, р = 0,065).Conclusions. The incidence of Klebsiella pneumoniae infections is currently lowering and has 4-year cyclicity. Antimicrobial treatment is associated with 2-fold increased risk if administered for ≥ 5 days. A number of healthcare-associated risk factors of Klebsiella pneumoniae infections have been found

Evaluation Effectiveness of Decolonization Nasal Carriage Staphylococcus aureus the Medical Staff

Methicillin-resistant Staphylococcus aureus (MRSA) is the most common multiresistant agent of hospital acquired infections in Europe. Health care-associated infections caused by MRSA described of severe course, epidemic dissemination, often with fatal outcome, accompanied by considerable economic damage. The prevention of such diseases is devoted to many publications of research results. However, developed and implemented by some preventive measures demanded evaluation of their effectiveness. Thus, the sanitation of MRSA nasal carriers among medical staff, as a measure of prevention strategies hasn’t unique estimate. In the article presents the results, we conducted a meta-analysis to assess the effectiveness of intranasal decolonization of Staphylococcus aureus among medical staff. In the study materials includes the results of four randomized clinical trial, installed total relative risk (RR = 0.20; [95% ДИ = 0.06 - 0.66], = 22.72; df = 3; p = 0.0001),shows the effectiveness of decolonization nasal carriers Staphylococcus aureus, a reduction in the frequency of the carrier and the number sources of infection among medical staff within a 6 month period from the date of its holding