Monitoring of opportunistic and pathogenic microorganisms in surgical departments of Dniprodzerzhynsk
AbstractThe paper presents monitoring results of the spread of opportunistic and pathogenic microorganisms in patients of surgical departments of the Dniprodzerzhynsk city hospital No 7. 1464 strains of bacteria isolated from biological material of the patients from January to December 2012 were studied. Relevant standard methods of research and data interpretation in accordance with the regulatory guidelines were used. The microorganisms’ sensitivity to antibiotics was determined by the disk diffusion method. Assessment of the resistance of isolated microorganisms to antibiotics was made with the software Whonet 5.1. At the first stage of investigation sampling biological material and inoculation in the culture medium were made. The discharges of wounds, throat, nose, ears, vagina and urethra, and also urine from patients of surgical departments were sampled for bacteriological analysis. The main substratum was 5% blood agar. There may additionally be used the selective growth media (yolk-salt agar, Endo, and Saburo). At the second stage we identify microorganisms with bacterioscopic, bacteriological and biochemical methods. Identifying microorganisms of the genus Staphylococcus was made by the reaction of lecithinase presence, plasma-coagulation reaction and the mannitol oxidation reaction. For the identification of bacteria of the family Streptococcaceae the growth pattern in 0.5% sugar medium was used. It was differentiated from bacteria of the genus Enterococcus by plating onto egg yolk agar base and milk with 0.1% methylene blue. Identification of bacteria of the Enterobacteriaceae family was made by studying their colonies on dense differential diagnostic media. Suspicious colonies were transferred on a combined medium for primary identification (Olkenitsky's medium). Then the biochemical signs of enterobacteria were studied in the minimum number of tests. The third phase of the study included the determination of the sensitivity of microorganisms to antibiotics. To do that, we use the disc diffusion method. The antibiogram tests of isolated bacterial strains used Mueller-Hinton agar. According to the data obtained we assign of microorganisms to certain category of sensitivity: sensitive, moderately resistant or resistant. Monitoring of prevalent microorganisms showed that 61% (893 of 1464) isolates were gram-positive bacteria, 696 strains of them are staphylococci. 477 of these are identified as S. aureus, representing 68.5% of all Staphylococcus. We found coagulase negative staphylococci in 192 patients, and the strains of S. haemolyticus are dominated. Strains of the family Streptococcaceae isolated from 197 patients. Among them the E. faecalis accounted for 66% of the total number of Streptococcus. Gram negative bacteria were presented by the families Enterobacteriaceae and Pseudomonaceae. Enterobacteriaceae accounted for 90.7% (518 of 571). E. coli plays the leading role and accounted for 42% of all Enterobacteriaceae. The strains of P. aeruginosa were identified in 53 patients. S. haemolyticus has played an important role as a pathogen as well as S. aureus. Its resistance to antibiotics is much higher than that of S. aureus. Although S. haemolyticus is opportunistic coagulase negative, it can be isolated from patients not only with chronic, but with acute infection. Thus nowadays the strains of S. haemolyticus gained high pathogenic and virulent properties.
Aboelela, S.W., Stone, P.W., Larson, E.L., 2007. Effectiveness of bundled behavioural interventions to control healthcareassociated infections: A systematic review of the literature. J. Hosp. Infect. 66(2), 101–108. >>doi: 10.1016/j.jhin.2006.10.019
Bacteriology. Regulatory, legislative and legal documents, 2003. [Normatyvni, derectyvni, pravovi documenti]. Kyiv, Medinform (in Ukrainian).
Bearman, G.M., Munro, C., Sessler, C.N., Wenzel, R.P., 2006. Infection control and the prevention of nosocomial infections in the intensive care unit. Semin. Respir. Crit. Care Med. 27(3), 310–324. >>doi: 10.1055/s-2006-945534
Bertin, M.L., Vinski, J., Schmitt, S., 2006. Outbreak of methicil-linresistant Staphylococcus aureus colonization and infection in a neonatal intensive care unit epidemiologically linked to a healthcare worker with chronic otitis. Infect. Control Hosp. Epidemiol. 27(6), 581–585. >>doi: 10.1086/504933
Bishop, M.C., 2004. Uncomplicated urinary tract infection. EAU Update Series. 2, 143–150. >>doi: 10.1016/j.euus.2004.08.003
Bryskin, B.C., 2000. [Vnutrybolnichnaja infekcija i posleoperacionnije oslozhnenyja s pozicii chirurga]. Moscow, Consilium Medicum (in Russian).
Byloborodov, V. B., Mitrohin, S.D., 2002. Staphylococcus infection. Infekcii ta Antybacterialna Terapija 5(1), 45–49 (in Ukrainian).
Bycov, A.S., Vorobjov, A.A., Pashkov, E.P., 2009. Microbiology and Immunology. Moscow, Academia (in Russian).
Calzolai, L., Ansorge, W., Calabrese, E., Denslow, N., Part, P., Lettieri, T., 2007. Transcriptomics and proteomics. Applications to ecotoxicology. Comparative Biochemistry and Physiology 2D(3), 245–249.
Carrico, R., 2005. APIC Text of Infection Control and Epidemiology. Washington, DC, APIC Press.
Church, D., Elsayed, S., Reid, O., Winston, B., Lindsay, R., 2006. Burn wound infections. Clin. Microbiol. Rev. 19(2), 403–434. >>doi: 10.1128/CMR.19.2.403-434.2006
Centers for Disease Control and Prevention (CDC), 2003. Update: Outbreak of severe acute respiratory syndrome – world-wide. MMWR Morb. Mortal. Wkly Rep. 52(13), 269–272.
DeFranco, D.B., 2002. Navigating steroid hormone receptors through the nuclear compartment. Molecular Endocrinology 76, 1449–1455. >>doi: 10.1210/mend.16.7.0880
Deleo, F.R., Otto, M., Kreiswirth, B.N., Chambers, H.F., 2010. Community-associated meticillin-resistant Staphylococcus aureus. Lancet 375: 1557–1568. >>doi: 10.1016/S0140-6736(09)61999-1
De Jong, M.D., Tran, T.T., Truong, H.K., Vo, M.H., Smith, G.J., Nguyen, V.C., 2005. Oseltamivir resistance during treatment of influenza A (H5N1) infection. Engl. J. Med. 353, 2667–2672. >>doi: 10.1056/NEJMoa054512
DiSalvo, H., Haiduven, D., Johnson, N., 2006. Who let the dogs out? Infection control did: Utility of dogs in health care settings and infection control aspects. Am. J. Infect. Control 34(5), 301–307. >>doi: 10.1016/j.ajic.2005.06.005
Eertmans, F., Dhooge, W., Stuyvaert, S., Comhaire, F., 2003. Endocrine disruptors: Effects on male fertility and screening tools for their assessment. Toxicology In Vitro 17, 515–524. >>doi: 10.1016/S0887-2333(03)00121-8
Fanci, R., Pecile, P., Casalone, E., Mengoni, A., Tamburini, E., Guidi, S., 2006. Pseudomonas aeruginosa sepsis in stem cell transplantation patients. Infect. Control Hosp. Epidemiol. 27, 767–770. >>doi: 10.1086/504449
Hien, T.T., de Jong, M., Farrar, J., 2004. Avian influenza – a challenge to global health care structures. N. Engl. J. Med. 351, 2363–2365. >>doi: 10.1056/NEJMp048267
James, L., Gorwitz, R.J., Jones, R.C., 2008. Methicillin-resistant Staphylococcus aureus infections among healthy full-term newborns. Arch. Dis. Child. Fetal. Neonatal. Ed. 93, 40–44. >>doi: 10.1136/adc.2006.104026
John, L.D., 2006. Nosocomial infections and bath water: Any cause for concern? Clin. Nurse Spec. 20, 119–123.
Johnston, C.P., Cooper, L., Ruby, W., Carroll, K.C., Cosgrove, S.E., Perl, T.M., 2006. Epidemiology of community-acquired methicillin-resistant Staphylococcus aureus skin infections among healthcare workers in an outpatient clinic. Infect. Control Hosp. Epidemiol. 27, 1133–1136. >>doi: 10.1086/507970
Korotaev, A.I., 2008. Medical microbiology. S.Pb, Speclyt (in Russian).
Kramer, A., Schwebke, I., Kampf, G., 2006. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect. Dis. 6, 130. >>doi: 10.1186/1471-2334-6-130
Loeffler, J., Stevens, D.A., 2003. Antifungal drug resistance. Clin. Infect. Dis. 36, 31–41. >>doi: 10.1086/344658
Marfin, A.A., Petersen, L.R., Eidson, M., Miller, J., Hadler, J., Farello, C., 2007. ArboNET Cooperative Surveillance Group. Widespread West Nile virus activity, eastern United States. Emerg. Infect. Dis. 7, 730–735.
McBryde, E.S., Bradley, L.C., Whitby, M., McElwain, D.L., 2004. An investigation of contact transmission of methicil-linresistant Staphylococcus aureus. J. Hosp. Infect. 58(2), 104–108. >>doi: 10.1016/j.jhin.2004.06.010
McGowan, J.E. Jr., 2006. Resistance in nonfermenting gram-negative bacteria: Multidrug resistance to the maximum. Am. J. Infect. Control. 34, 29–37. >>doi: 10.1016/j.ajic.2006.05.226
Mitrohin, S.N., 2008. [Infekcionnije oslozhnenija v chirurgii: Antibiotikoterapija practica i terapija]. Moscow, Consilium Medicum (in Russian).
Mitchell, R.J., Gu, M.B., 2004. An Escherichia coli biosensor capable of detecting both genotoxic and oxidative damage. Appl. Microbiol. Biotechnol. 64, 46–52. >>doi: 10.1007/s00253-003-1418-0
Nadal, A., Alonso-Magdalena, P., Ripoll, C., Fuentes, E., 2005. Disentangling the molecular mechanism of action of natural and environmental estrogens. Pflugers Arch. 449, 335–343. >>doi: 10.1007/s00424-004-1343-9
NCCLS: Perfomance standarts antimicrobial susceptibility testing, 2004. Twelfth information supplement. NCCLS document, 100, 14.
Parvez, S., Venkataraman, C., Mukherji, S., 2006. A review on advantages of implementing luminescence inhibition test (Vibrio fischeri) for acute toxicity prediction of chemicals. Environmental International 32(2), 265–268. >>doi: 10.1016/j.envint.2005.08.022
Pozdeev, O.K., 2008. Medical Microbiology. Moscow, Geotar-Media (in Russian).
Pronovost, P., Needham, D., Berenholtz, S., 2006. An intervention to decrease catheter-related bloodstream infections in the ICU. N. Engl. J. Med. 355(26), 272–273. >>doi: 10.1056/NEJMoa061115
Said-Salim, B., Mathema, B., Kreiswirth, B.N., 2007. Community-acquired methicillin-resistant Staphylococcus aureus: An emerging pathogen. Infect. Control Hosp. Epidemiol. 24, 451–455.
Schelonka, R.L., Scruggs, S., Nichols, K., Dimmitt, R.A., Carlo, W.A., 2006. Sustained reductions in neonatal nosocomial infection rates following a comprehensive infection control intervention. J. Perinatol. 26(3), 176–179. >>doi: 10.1038/sj.jp.7211411
Simon, A., Khurana, K., Wilkesmann, A., 2006. Nosocomial respiratory syncytial virus infection: Impact of prospective surveillance and targeted infection control. Int. J. Hyg. Environ. Health. 209(4), 317–324. >>doi: 10.1016/j.ijheh.2006.02.003
Stewart, P.S., Costerton, J.W., 2001. Antibiotic resistance of bacteria in biofilms. Lancet 358, 135–138. >>doi: 10.1016/S0140-6736(01)05321-1
Van’t Veen, A., van der Zee, A., Nelson, J., Speelberg, B., Kluytmans, J.A., Buiting, A.G., 2005. Outbreak of infection with a multiresistant Klebsiella pneumoniae strain associated with contaminated roll boards in operating rooms. J. Clin. Microbiol. 43, 4961–4967.
Vonberg, R.P., Gastmeier, P., 2006. Nosocomial aspergillosis in outbreak settings. J. Hosp. Infect. 63(3), 246–254.
Warren, J.W., 2010. Catheter-associated urinary tract infection. Int. J. Antimicrob. Agents 45, 299–303.
Wongworawat, M.D., Jones, S.G., 2007. Influence of rings on the efficacy of hand sanitization and residual bacterial contamination. Infect. Control Hosp. Epidemiol. 28(3), 351–353. >>doi: 10.1086/510790
Yoon, H.J., Choi, J.Y., Park, Y.S., Kim, C.O., Kim, J.M., Yong, D.E., 2005. Outbreaks of Serratia marcescens bacteriuria in a neurosurgical intensive care unit of a tertiary care teaching hospital: A clinical, epidemiologic, and laboratory perspective. Am. J. Infect. Control 33, 595–601. >>doi: 10.1016/j.ajic.2005.01.010
Zanetti, G., Blanc, D.S., Federli, I., Raffoul, W., Petignat, C., Maravic, P., 2007. Importation of Acinetobacter baumannii into a burn unit: A recurrent outbreak of infection associated with widespread environmental contamination. Infect. Control Hosp. Epidemiol. 28, 723–725. >>doi: 10.1086/517956
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