Monitoring of the risk of healthcare-associated infections in healthcare facilities of the Rostov Region
Objective. Determination of the risk criteria for healthcare-associated infections (HAI) in healthcare facilities (HF) of Rostov-on-Don and the Rostov Region.Goloshva E.V., Aleshukina A.V., Markova K.G., Berezinskaya I.S.
Materials and methods. From 2012 to 2024, 2,709 cultures of non-fermenting gram-negative bacteria (NFGNB) were isolated from healthcare facilities. Their species, antibiotic sensitivity, and biofilm-forming capacity were studied. Bacteriological studies and antibiotic susceptibility testing were conducted using the disk diffusion method. Biofilm formation of NFGNB was assessed using the authors’ method. To identify loci of antibiotic resistance, 13 randomly selected Pseudomonas aeruginosa strains isolated from various sources were analyzed.
Results. The detection rate of NFGNB in city hospitals ranged from 5% to 28%. The most frequently detected bacteria were Pseudomonas aeruginosae, Stenotrophomonas maltophilia, and Acinetobacter baumannii. A high, stable incidence and prevalence of pan-antibiotic-resistant NFGNB, along with increasing antibiotic resistance and biofilm formation potential, were noted. A pilot study of Pseudomonas antibiotic resistance loci showed that the number of identified clinically significant R-AB genes in Pseudomonas can be arranged in descending order: tetO > aadA2 > blaVIM > ermB > vanA > sul2.
Conclusion. The identification of dominant potentially dangerous microbial cultures, the presence of strains resistant to multiple antibiotic groups among isolates, and lack of susceptibility to disinfectants should be considered criteria for the risk of developing HAIs in medical institutions. Monitoring the antibiotic resistance of NFGNB strains can allow for adjustments to antibacterial prescribing regimens in medical institutions, assess the risk of developing HAIs, and develop appropriate anti-epidemic measures.
Keywords
healthcare facilities
healthcare-associated infections
opportunistic microorganisms
non-fermenting gram-negative bacteria
antibiotics
resistance
antibiotic resistance loci
References
1. Зубков М.Н. Неферментирующие бактерии: классификация, Общая характеристика, роль в патологии человека. Идентификация Pseudomonas spp. и сходных микроорганизмов. Инфекции и антимикробная терапия 2003; 5(1): 55–59. (Zubkov M.N. Non-fermenting bacteria: classification, General characteristics, role in human pathology. Identification of Pseudomonas spp. and similar microorganisms. Infektsii i antimikrobnaya terapiya 2003; 5(1): 55–59. (In Russ.)).
2. Шагинян И.А., Чернуха М.Ю. Неферментирующие грамотрицательные бактерии в этиологии внутрибольничных инфекций: клинические, эпидемиологические и микробиологические особенности. Клиническая микробиология и антимикробная химиотерапия 2005; 7(3): 271–285. (Shaginyan I.A., Chernuha M.Yu. Non-fermenting gram-negative bacteria in the etiology of nosocomial infections: clinical, epidemiological and microbiological features. Clinical Microbiology and Antimicrobial Chemotherapy 2005; 7(3): 271–285. (In Russ.))
3. Чернуха М.Ю., Шагинян И.А., Капранов Н.И. Персистенция Burkholderia cepacia у больных муковисцидозом. Журнал микробиологии, иммунологии и эпидемиологиии 2012; (4): 93–98. (Chernuha M.Yu., Shaginyan I.A., Kapranov N.I. Persistence of Burkholderia cepacia in patients with cystic fibrosis. Journal of microbiology, epidemiology and immunology 2012; (4): 93–98. (In Russ.)).
4. Воропаева Н.М., Немченко У.М., Григорова Е.В., Белькова Н.Л., Чемезова Н.Н., Савилов Е.Д. Этиологическая структура инфекций, связанных с оказанием медицинской помощи, и антибиотикорезистетность основных возбудителей инфекций. Эпидемиология и Вакцинопрофилактика 2023; 22(1): 68–73. (Voropaeva N.M., Nemchenko U.M., Grigorova E.V., Bel’kova N.L., Chemezova N.N., Savilov E.D. Etiological structure of medical care-related infections and antibiotic resistance of the main infectious agents. Epidemiology and Vaccinal Prevention 2023; 22(1): 68–73. (In Russ.)). DOI: 10.31631/2073-3046-2023-22-1-68-73
5. Алешукина А.В., Голошва Е.В., Твердохлебова Т.И. Неферментирующие бактерии: влияние биотических и абиотических факторов на биопленкообразование. Ростов-на-Дону, 2019; 98 с.(Aleshukina A.V., Goloshva E.V., Tverdohlebova T.I. Non-fermenting bacteria: the influence of biotic and abiotic factors on biofilm formation. Rostov-on-Don, 2019; 98 р. (In Russ.)).
6. Алешукина А.В., Голошва Е.В., Маркова К.Г., Алешукина И.С., Полищук И.С., Твердохлебова Т.И. и др. Мониторинг устойчивости к антибиотикам неферментирующих бактерий, циркулирующих в г. Ростове-на-Дону. Главный врач Юга России 2020; (2): 4–8. (Aleshukina A.V., Goloshva E.V., Markova K.G., Aleshukina I.S., Polishchuk I.S., Tverdohlebova T.I. et al. Monitoring of antibiotic resistance of non-fermenting bacteria circulating in Rostov-on-Don. Glavnyy vrach Yuga Rossii 2020; (2): 4–8. (In Russ.)).
7. Носкова О.А., Савилов Е.Д., Чемезова Н.Н. Антибиотикорезистентность возбудителей генерализованных гнойно-септических инфекций у детей. Эпидемиология и Вакцинопрофилактика 2020; 19(6): 56–61. (Noskova O.A., Savilov E.D., Chemezova N.N. Antibiotic resistance of pathogens of generalized purulent-septic infections in children Epidemiology and Vaccinal Prevention 2020; 19(6): 56–61 (In Russ.)). DOI: 10.31631/2073-3046-2020-19-6-56-61
8. Ажогина Т.Н., Воропина Д.С., Хмелевцова Л.Е., Лицевич А.Р., Чернышенко Е.Р. Гены антибиотикорезистентности и бактериоценоз донных отложений озера Маныч-Гудило. Живые и биокосные системы 2024; (50). (Azhogina T.N., Voropina D.S., Khmelevtsova L.E., Litsevich A.L., Chernyshenko E.R. Antibiotic resistance genes and bacteriocenosis of Manych-Gudilo Lake bottom sediments. Live and bio-abiotic systems 2024; (50). (In Russ.)). DOI: 10.18522/2308-9709-2024-50-1
9. Тапальский Д.В. Чувствительность к комбинациям антибиотиков продуцирующих карбапенемазы нозокомиальных штамммов грамотрицательных бактерий, выделенных в Беларуси. Клиническая микробиология и антимикробная химиотерапия 2018; 20(3): 182–191. (Tapal’sky D.V. Sensitivity to combinations of antibiotics of carbapenemase-producing nosocomial strains of gram-negative bacteria isolated in Belarus. Clinical Microbiology and Antimicrobial Chemotherapy 2018; 20(3): 182–191. (In Russ.)). DOI: 10.36488//cmac.2018.3.182-191
10. Azhogina T., Sazykina M., Konstantinova E., Khmelevtsova L., Minkina T. Antonenko E. et al. Bioaccessible PAH influence on distribution of antibiotic resistance genes and soil toxicity of different types of land use. Environ. Sci. Pollut. Res. Int. 2023; 30(5): 12695–12713. DOI:10.1007/s11356-022-23028-2
11. Mafiz A.I., Perera L.N., He Y., Zhang W., Xiao S., Hao W. et al. Case study on the soil antibiotic resistome in an urban community garde. Int. J. Antimicrob. Agents 2018; 52(2); 241–250. DOI: 10.1016/j.ijantimicag.2018.05.016
12. Louca S., Parfrey L.W., Doebeli M. Decoupling function and taxonomy in the global ocean microbiome. Science 2016; 353(6305): 1272–1277. DOI: 10.1126/science.aaf4507
13. Wang C., Mao Y., Zhang L., Wei H., Wang Z. Insight into environmental adaptability of antibiotic resistome from surface water to deep sediments in anthropogenic lakes by metagenomics. Water Res. 2024; 256: 121583. doi: 10.1016/j.watres.2024.121583
14. Gillings M., Boucher Y., Labbate M., Holmes A., Krishnan S., Holley M. et al. The Evolution of Class 1 Integrons and the Rise of Antibiotic Resistance. J. Bacteriol. 2008; 190(14): 5095–5100.
15. Hossain A., Habibullah-Al-Mamun M., Nagano I., Masunaga S., Kitazawa D., Matsuda H. Antibiotics, antibiotic-resistant bacteria, and resistance genes in aquaculture: risks, current concern, and future thinking. Environ. Sci. Pollut. Res. Int. 2022; 29: 11054–11075. DOI: 10.1007/s11356-021-17825-4
About the Authors
Elena V. Goloshva, Leading Researcher, Laboratory of Virology, Microbiology, and Molecular Biological Research Methods, Rostov Research Institute of Microbiology and Parasitology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Rostov-on-Don, Russia; elena_goloshva@mail.ru; http://orcid.org/0000-0002-4149-9333Anna V. Aleshukina, Chief Researcher, Laboratory of Virology, Microbiology, and Molecular Biological Research Methods, Rostov Research Institute of Microbiology and Parasitology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Rostov-on-Don, Russia; aaleshukina@mail.ru; http://orcid.org/0000-0002-9797-2441
Kristina G. Markova, Researcher, Laboratory of Virology, Microbiology, and Molecular Biological Research Methods, Rostov Research Institute of Microbiology and Parasitology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Rostov-on-Don, Russia; syomchenko@rambler.ru; http://orcid.org/0000-0001-5154-1171
Iraida S. Berezinskaya, Junior Researcher, Laboratory of Sanitary Microbiology of Water Bodies and Human Microbial Ecology, Rostov Research Institute of Microbiology and Parasitology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Rostov-on-Don, Russia; aleshukina@yandex.ru, http://orcid.org/0000-0001-7503-6465
Similar Articles
