Clinical Microbiology and Antimicrobial Chemotherapy

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ISSN / EISSN : 1684-4386 / 2686-9586
Total articles ≅ 137
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, Nikolay I. Briko, G.R. Galstyan, Andrey V. Dekhnich, L.Y. Drozdova, , , T.V. Nikonova, , , et al.
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.2.161-165

Abstract:
The purpose of the meeting is to obtain an opinion on approaches and recommendations for vaccine prevention of pneumococcal infections in adults.
Barantsevich N.E., Levanova V.V., Barantsevich Elena P.
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.2.117-125

Abstract:
The geographical routes and time schedule of spread of C. auris – the fungus first identified in 2009 are discussed. Data on the increasing frequency of C. auris infections and rapid dissemination of the fungus from the regions of origin – southern Asia, eastern Asia, southern Africa and southern America – towards different regions of all continents except Antarctica, especially after 2016, are presented. Three different clades are encountered in Great Britain, all four clades – in the USA. South Asian clade is currently present in Russia: the introduction was associated with labor migration from Middle Asia. The necessity of C. auris surveillance, essential for the establishment of sources and routes of transmission and dissemination of different clades is emphasized. A window of possibilities is still present to prevent further spread of the fungus with the ability to cause outbreaks of hospital infections including intensive care departments. Rapid implementation of preventive measures during the pandemic of COVID-19 are needed taking into account introduction of fungus in new countries and clinics, as well as increased frequency of C. auris infections in some hospitals for patients infected with SARS-CoV-2 virus.
Anastasia N. Vaganova, S.V. Borisenko, E.V. Nesterova, N.N. Trofimova, I.V. Litvinenko, Y.G. Petunova, W.V. Roca, V.N. Verbov
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.2.205-211

Abstract:
Objective. To evaluate frequency and intensity of cefazolin inoculum effect among methicillin-susceptible staphylococci isolated from patients with skin infections. Materials and Methods. A total of 80 methicillin susceptible isolates of Staphylococcus aureus were identified by cefoxitin disk-diffusion test and negative results of real-time PCR for mecA gene. Inoculum effect was measured by broth microdilution test with two inocula with concentrations of 5 × 105 CFU/mL and 5 × 107 CFU/mL. The disk-diffusion test with cefoxitin was also performed. Penicillin susceptibility was determined by disk-diffusion method. Beta-lactamase blaZ gene was identified by real-time PCR. Results. The frequency of cefazolin inoculum effect in tested isolates was 30% which is consistent with data from different countries. The MIC values for concentrated inoculum reached CLSI breakpoint for cefazolin resistance in 2.5% of isolates. The isolates with inoculum effect and those without it had the similar MIC values for cefazolin in broth microdilution test for standard inocula and similar diameters of inhibition zone in disk-diffusion test with cefazolin. Penicillin resistance was more frequent in inoculum effect-positive isolates. Beta-lactamase activity is considered as a main cause of cefazolin inoculum effect in staphylococci. The beta-lactamase blaZ gene was identified in the majority of isolates with cefazolin inoculum effect, but it was also prevalent among inoculum effect-negative isolates. Conclusions. Up to 30% of MSSA isolates from skin lesions in dermatological patients from SaintPetersburg are positive for cefazolin inoculum effect. Those isolates are usually characterized by penicillin resistance. Most of the cefazolin inoculum effect-positive isolates also carry beta-lactamase blaZ gene.
, , Aida N. Chagaryan, , Anastasia A. Kurkova, Alexey Yu. Kuzmenkov, Ivan V. Trushin, Marina V. Sukhorukova, «SPECTRUM» Study Group
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.2.127-137

Abstract:
Objective. To estimate prevalence and antimicrobial susceptibility of circulated S. pneumoniae serotypes in adult population in different regions of the Russian Federation. Materials and Methods. A total of 500 isolates of S. pneumoniae obtained from patients with invasive pneumococcal disease (IPD), community-acquired pneumonia (CAP), sinusitis/acute otitis media (AOM) and healthy carriers from 29 centers were included in the study from 01 June 2019 to 15 January 2020. Re-identification, typing using real-time PCR with 27 primer pairs and antimicrobial susceptibility testing were performed in the central laboratory by standardized methods. Results. Among 50 isolates from patients with IPD, the following serotypes were detected: 3 (20.0%), 23F (10.0%), 6ABCD (8.0%), 19F (6.0%), 12ABF, 4, 7AF, 8, 9NL, 9VA, 15B (4.0% each), 1, 10A, 11AD, 14, 15AF, 18ABCF, 22AF, 33F/33A/37 (2.0% each). PCV-13 and PPV-23 covered 62.0% and 86.0% of those serotypes, respectively. Among 357 isolates from patients with CAP, the following serotypes were detected: 19F (12.3%), 6ABCD (11.5%), 3 (10.1%), 23F (5.9%), 14 (5.3%), 22AF (5.0%), 11AD (4.8%), 9NL (3.4%), 15AF (2.8%), 9VA (2.2%), 18ABCF (2.0%), 19A (1.7%), 12ABF (1.4%), 17F (0.8%), 16, 33F/33A/37, 7AF and 8 (0.6% each), 10A and 4 (0,3% each); serotypes were not specified due to the PCR typing protocol limitations for 106 (29.8%) isolates. PCV-13 and PPV-23 covered 51.9% and 68.7% of those serotypes, respectively. In patients with sinusitis/AOM (n = 48), serotypes were: 19F (18.8%), 6ABCD (16.7%), 23F (12.5%), 3 (12.5%), 18ABCF (6.3%), 11AD (4.2%), 14 (4.2%), 22AF (4.2%), 15AF, 4, 9VA (2.1% each). PCV-13 and PPV-23 covered 75.0% and 83.3% of those serotypes, respectively. In healthy nasopharyngeal carriers (n = 45), the following serotypes were detected: 19F (24.4%), 3 (17.8%), 6ABCD (17.8%), 11AD (13.3%), 23F (8.9%), 22AF (6.7%), 14 and 15AF (2.2% each). PCV-13 and PPV-23 covered 71.1% and 91.1% of those serotypes, respectively. Serotypes 14, 19F, and 19A were frequently resistant to three antibiotics – penicillin, erythromycin, and tetracycline. Resistance to respiratory quinolones was very low (0.7%) and detected among serotypes 14 and 9NL only. The majority of non-vaccine serotypes did not have substantial antimicrobial resistance problems. Conclusions. Despite the relatively low number of isolates in all but CAP group and limitations of PCR typing protocol, results of our study support the use of pneumococcal vaccines (PPV-23 and PCV-13) in Russian adult population, with some advantages of PPV-23 over PCV-13.
, T.I. Garashchenko, N.A. Geppe, I.A. Dronov, , Nataly V. Ivanchik, L.I. Ilenko, E.P. Karpova, , Ludmila V. Kozlova, et al.
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.2.195-196

Abstract:
Currently, there is a steady growth antimicrobial resistance (AMP) worldwide. This is especially true now when antibiotic use has become uncontrolled due to its use in COVID-19 treatment regimens. Antibiotics do not have antiviral effect, their appointment is justified only with complicated forms of COVID-19. Moreover, such a massive use antibiotics creates the prerequisites for the formation antibiotic resistance, including among the causative agents of community-acquired infections. Due to the relentless the growth of antibiotic resistance of community-acquired pathogens of respiratory diseases, it becomes necessary to revise approaches to antibacterial therapy (ABT) and assessing the potential use of thiamphenicol for the treatment of community-acquired infections caused by respiratory pathogens.
, Vladimir A. Bagin, D.V. Belsky, Maria N. Astafyeva, N.N. Nevskaya, G.B. Kolotova, S.M. Rosanova, T.I. Bykova
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.1.17-25

Abstract:
Objective. To review a literature published over the past 5 years and our own data on the etiology of lower respiratory tract infections (LRTI), antimicrobial resistance and its relationships between sepsis and choice of appropriate antibiotic therapy. Materials and Methods. National Nosocomial Infections Surveillance (NNIS) criteria were used to diagnose LRTI. A review of the articles regarding LRTI from the Russian and international English language journals published over 6 years was performed. Identification of microorganisms was performed by culture over the period of 2003–2013; since 2014, MALDI-TOF MS method was used for this purpose. Results. Despite the ongoing policy to limit the use of antimicrobial therapy in the ICUs, there is an increase in carbapenemase-producing isolates in the ICUs from 2.2% (2018) to 11.7% (2020, 9 months). Along with the trend to increase in carbapenemase-producing pathogens causing LRTI, their variability is also increasing. In particular, it applies to strains producing carbapenemases OXA-48 or combination of OXA-48 with KPC; with the trend to combined production of carbapenemase beginning at 2019. Conclusions. Carbapenemase producers are becoming more widespread in the ICU settings, including the lower respiratory tract in mechanically ventilated patients. Practitioners didn’t get used to associate VAP with the Sepsis-3 criteria. The changes in etiology include the increased rate of carbapenem-resistant Enterobacterales and non-fermenting Gram-negative bacteria, primarily Acinetobacter spp., in Russia. It’s due to improved quality of respiratory support and increased consumption of carbapenems, tigecycline and polymyxins. Significant increase of OXA-48-producing pathogens is likely to be associated with a poor compliance with temporary guidelines on COVID-19 with regard to antibiotic therapy.
Dmitry Y. Ruzanov, A.M. Skriagina, I.V. Buinevich, S.V. Goponiako, G.S. Balasaniantc, E.S. Khimova
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.1.27-42

Abstract:
Rapid tests detecting Mycobacterium tuberculosis and drug resistance which are universally implemented in medical practice has dramatically improved the diagnosis of rifampicin-resistant tuberculosis and shortened turnaround time thus enabling early etiotropic therapy. However, permanently increasing drug resistance of M. tuberculosis makes treatment less effective. Furthermore, long treatment courses are required due to low sterilizing activity of treatment regimens used for drug-resistant tuberculosis which leads to greater toxic effects, reduces patients’ adherence to treatment and consumes resources of medical care systems. Current phthisiology needs new effective medications and short treatment regimens, otherwise elimination of tuberculosis by 2050 is impossible. This review summarizes the information about treatment of drugresistant TB, including repurposed drugs, new medications and treatment regimens.
A.V. Zhestkov, , D.D. Ismatullin, A.A. Martinovich, E.V. Haykina
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.1.66-91

Abstract:
Non-tuberculous mycobacteria (NTM) include more than 190 species and subspecies. Some NTM species can cause human diseases of the lungs or extrapulmonary infections. The guidelines focus on pulmonary mycobacteriosis in adult patients without cystic fibrosis or HIV infection caused by the most common NTMs, such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among slow-growing NTMs and Mycobacterium abscessus complex among fast-growing species. Experts of American Thoracic Society (ATS), European Respiratory Society (ERS), European Society for Clinical Microbiology and Infectious Diseases (ESCMID), and American Society for Infectious Diseases (IDSA) contributed to the development of the guidelines. A total of 31 evidence-based recommendations are provided for the diagnosis and treatment of NTM-induced lung infections.
, Мarina V. Sukhorukova, Аida N. Chagaryan, Ivan V. Trushin, Andrey V. Dekhnich,
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.1.92-99

Abstract:
Objective. To determine in vitro activity of thiamphenicol and other clinically available antimicrobials against clinical isolates of Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes. Materials and Methods. We included in the study 875 clinical isolates from 20 Russian cities during 2018–2019. Among tested strains, 126 were H. influenzae, 389 – S. pneumoniae, 360 – S. pyogenes. Antimicrobial susceptibility testing was performed using broth microdilution method according to ISO 20776-1:2006. AST results were interpreted according to EUCAST v.11.0 clinical breakpoints. Results. The minimum inhibitory concentrations (MICs) of thiamphenicol did not exceed 2 mg/L for 94.4% of H. influenzae strains (MIC50 and MIC90 were 0.5 and 1 mg/L, respectively). Thiamphenicol was active against 76.9% of ampicillin-resistant H. influenzae strains (MIC of thiamphenicol < 2 mg/L). The MIC of thiamphenicol was in the range of 0.06–2 mg/L for 96.7% of S. pneumoniae strains (MIC50 and MIC90 were 0.5 and 2 mg/L, respectively). The MIC of thiamphenicol for 90.6% of S. pneumoniae strains with reduced susceptibility to penicillin (MIC of penicillin > 0.06 mg/L) did not exceed 2 mg/L. A total of 88.1% of S. pneumoniae strains resistant to erythromycin were highly susceptible to thiamphenicol (MIC < 2 mg/L). The MIC of thiamphenicol did not exceed 8 mg/L for 96.1% of S. pyogenes strains (MIC50 and MIC90 were 2 and 4 mg/L, respectively). Conclusions. Thiamphenicol was characterized by relatively high in vitro activity, comparable to that of chloramphenicol, against tested strains of H. influenzae, S. pneumoniae and S. pyogenes, including S. pneumoniae isolates with reduced susceptibility to penicillin.
, , А.U. Lekmanov, Еlena V. Haykina
Clinical Microbiology and Antimicrobial Chemotherapy, Volume 23; https://doi.org/10.36488/cmac.2021.2.173-183

Abstract:
The increasing number of infections caused by multidrug-resistant gram-negative bacteria in children is a serious problem all over the world. Ceftazidim-avibactam is a promising antimicrobial drug recently approved in Russia for use in pediatric practice. This review provides information on the possible use of ceftazidime-avibactam in children with complicated intraabdominal infections (in combination with metronidazole); complicated urinary tract infections, including pyelonephritis; hospital-acquired pneumonia, including ventilator-associated pneumonia; infections caused by aerobic gram-negative microorganisms in patients with limited choice of antibacterial therapy. Based on the data on the in vitro activity of the drug, the results of clinical studies of pharmacokinetics, safety and efficacy of ceftazidimeavibactam for the treatment of infections in children the main clinical cases in which the use of ceftazidimeavibactam in pediatric practice is most justified and appropriate are identified.
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