Microbiological monitoring as a component of efficient prevention and treatment of purulent-septic infections in an orthopedics and traumatology department

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.3.229667

Keywords:

bacterial multiple drug resistance, purulent-septic infections, antibacterial therapy, biological monitoring

Abstract

Efficient monitoring of circulating purulent-septic infectious agents in a clinical setting and a study on antibiotic susceptibility of isolated strains of microorganisms allows identifying changes in the pathogen structure and trends in antibiotic resistance development, which helps to determine the tactics of antibacterial therapy and elaborate appropriate measures.

The aim of the study. Retrospective analysis of the results of microbiological monitoring of purulent-septic infectious (PSI) agents in the Orthopedics and Traumatology Department (OTD) of the Zaporizhzhia Central Ambulance and Emergency Care Hospital over the period 2017–2020 to determine the main antibacterial drugs for empirical therapy.

Materials and methods. We analyzed the bacteriological test results of 664 clinical material samples obtained from OTD patients using bacteriological examination statistical reporting and analytical data of the WHONET 5.6 software.

Results. The main PSI pathogens in the OTD were from the ESKAPE group: E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa and S. epidermidis, P. mirabilis, C. amycolatum. Isolates of E. faecalis were sensitive to vancomycin, linezolid, S. aureus – to linezolid, tigecycline, netilmicin, A. baumannii – to tigecycline. All P. aeruginosa strains were resistant to ticarcillin/clavulanate, cefepime, chloramphenicol, imipenem, meropenem, aztreonam, ciprofloxacin. E. coli and K. pneumoniae were resistant to ampicillin, ticarcillin/clavulanate, aztreonam, ceftriaxone, cefepime. The number of isolates sensitive to piperacillin/tazobactam, carbapenems, levofloxacin, gentamicin, amikacin, chloramphenicol ranged from 37 % to 65 %.

Conclusions. E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa, S. epidermidis, P. mirabilis, C. amycolatum play an important role in the structure of PSI pathogens in the Orthopedics and Traumatology Department of Zaporizhzhia Central Ambulance and Emergency Care Hospital. The antibiotics of choice as the antibacterial empirical therapy for enterococcal infections are vancomycin, linezolid, for staphylococcal infections – vancomycin, linezolid, tigecycline, netilmicin. PSI pathogens continually evolve developing antibiotic resistance, and it is of particular importance to monitor antibiotic susceptibility of microorganisms within the OTD.

Author Biographies

N. M. Polishchuk, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Head of the Department of Microbiology, Virology and Immunology

D. L. Kyryk, Shupyk National Healthcare University of Ukraine, Kyiv

MD, PhD, DSc, Professor, Head of the Department of Microbiology, Epidemiology and Infection Control

I. Ye. Yurchuk, MNE “City Zaporizhzhia Clinical Hospital of Emergency and Critical Care Medicine”, Zaporizhzhia, Ukraine

Bacteriologist of the second qualification category

References

Shanmuga Vadivoo, N., & Usha, B. (2018). ESKAPE pathogens: Trends in antibiotic resistance pattern. MedPulse International Journal of Microbiology, 7(3), 26-32. https://doi.org/10.26611/1008732

World Health Organization. (‎2017, February 27)‎. WHO publishes list of bacteria for which new antibiotics are urgently needed. https://www.who.int/news/item/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed

Terekhova, R. P., Mitish, V. A., Paskhalova, Yu. S., Skladan, G. E., Prudnikova, S. A., & Blatun, L. A. (2016). Vozbuditeli osteomielita dlinnykh kostei i ikh rezistentnost' [Osteomyelitis agents of the long bones and their resistance]. Rany i ranevye infektsii. Zhurnal imeni prof. B. M. Kostyuchenka, 3(2), 24-30. https://doi.org/10.17650/2408-9613-2016-3-2-24-30 [in Russian].

Semak, M. V. (2014). Problemy lecheniya khronicheskogo posleoperatsionnogo osteomielita konechnostei v usloviyakh gnoinosepticheskogo otdeleniya mnogoprofil'nogo statsionara i puti ikh resheniya. (Avtoref. dis. … kand. med. nauk). [Problems of treatment of chronic postoperative osteomyelitis of the extremities in the conditions of purulent septic department of a multidisciplinary hospital and ways to solve them]. (Extended abstract of candidate’s thesis). Sankt-Petersburg. http://medical-diss.com/docreader/585763/a#?page=1 [in Russian].

Bozhkova, S. A., Kasimova, A. R., Tikhilov, R. M., Polyakova, E. M., Rukina, A. N., Shabanova, V. V., & Liventsov, V. N. (2018). Neblagopriyatnye tendentsii v etiologii ortopedicheskoi infektsii: rezul'taty 6-letnego monitoringa struktury i rezistentnosti vedushchikh vozbuditelei [Adverse Trends in the Etiology of Orthopedic Infection: Results of 6-Year Monitoring of the Structure and Resistance of Leading Pathogens]. Travmatologiya i ortopediya Rossii, 24(4), 20-31. https://doi.org/10.21823/2311-2905-2018-24-4-20-31 [in Russian].

Sllamniku, S., Raka, L., Haxhija, E. Q., & Murtezani, A. (2017). Subacute Acetabular Osteomyelitis Caused by Proteus Mirabilis. A Case Study. Ortopedia Traumatologia Rehabilitacja, 19(3), 297-300. https://doi.org/10.5604/15093492.1241409

Thorpe, M. A., & Buckwalter, J. A. (1983). Hematogenous Proteus Mirabilis Osteomyelitis. Orthopedics, 6(7), 865-867. https://doi.org/10.3928/0147-7447-19830701-09

Nuraliyev, N. A., & Suvonov, K. Z. (2015). Fenomen bakterial'noi translokatsii - mikrobiologicheskie aspekty [Microbiological Aspects of Bacterial Translocation Phenomenon: Review]. Visnyk problem biolohii i medytsyny, 1(2), 41-46. [in Russian].

Kalt, F., Schulthess, B., Sidler, F., Herren, S., Fucentese, S. F., Zingg, P. O., Berli, M., Zinkernagel, A. S., Zbinden, R., & Achermann, Y. (2018). Corynebacterium Species Rarely Cause Orthopedic Infections. Journal of Clinical Microbiology, 56(12), Article e01200-18. https://doi.org/10.1128/JCM.01200-18

Bayram, S., Bilgili, F., Anarat, F. B., & Saka, E. (2019). Subacute Osteomyelitis of the Fibula due to Corynebacterium striatum in an Immunocompetent Child. A Case Report. JBJS Case Connector, 9(2), Article e0220. https://doi.org/10.2106/JBJS.CC.18.00220

Sengupta, M., Naina, P., Balaji, V., & Anandan, S. (2015). Corynebacterium amycolatum: An Unexpected Pathogen in the Ear. Journal of Clinical and Diagnostic Research, 9(12), DD01-DD3. https://doi.org/10.7860/JCDR/2015/15134.7002

Liubimova, A. V., Shalyapina, N. A., Kolodzhieva, V. V., Riachovskich, S. A., Dmitrieva, O. V., Brodina, T. V., & Shishmakov, A. A. (2016). Epidemiologiya vankomitsin-rezistentnykh enterokokkov v otdeleniyakh razlichnogo profilya [Epidemiology of Vancomycin-Resistant Enterococci in Various Medical Wards]. Epidemiologiya i Vaktsinoprofilaktika, 15(4), 48-52. https://doi.org/10.31631/2073-3046-2016-15-4-48-52 [in Russian].

Winkler, T., Trampuz, A., Renz, N., Perka, C., & Bozhkova, S. A. (2016). Klassifikatsiya i algoritm diagnostiki i lecheniya periproteznoi infektsii tazobedrennogo sustava [Сlassification and algorithm for diagnosis and treatment of hip periprosthetic infection]. Travmatologiya i ortopediya Rossii, (1), 33-45. https://doi.org/10.21823/2311-2905-2016-0-1-33-45 [in Russian].

Shekarabi, M., Hajikhani, B., Chirani, A. S., Fazeli, M., & Goudarzi, M. (2017). Molecular characterization of vancomycin-resistant Staphylococcus aureus strains isolated from clinical samples: A three year study in Tehran, Iran. PLOS ONE, 12(8), Article e0183607. https://doi.org/10.1371/journal.pone.0183607

Salmanov, A. G. (2017). Antibiotikorezistentnost' nozokomial'nykh shtammov Acinetobacter spp. v khirurgicheskikh statsionarakh Ukrainy: rezul'taty mnogotsentrovogo issledovaniya (2009 - 2015 gg.) [Antimicrobial resistance of nosocomial strains of Аcinetobacter spp. in surgical departments in Ukraine: results of prospective multicenter study (2009 - 2015)]. International journal of antiibiotics and probiotics, (1), 70-82. https://doi.org/10.31405/ijap.1-1.17.05 [in Russian].

Salmanov, A. G., Verner, O. M., & Slepova, L. F. (2018). Epidemiolohiia ta antymikrobna rezystentnist Acinetobacter [Epidemiology and antimicrobial resistance of Acinetobacter]. International Journal of Antibiotics and Probiotics, 4-5(4), 46-59. https://doi.org/10.31405/ijap.4-5.18.05 [in Ukrainian].

Salmanov, A. G., & Verner, O. M. (2017). Antybiotykorezystentnist nozokomialnykh shtamiv Rseudomonas aeruginosa v khirurhichnykh statsionarakh Ukrainy: rezultaty bahatotsentrovoho doslidzhennia (2011 - 2015 rr.) [Antibiotic resistance nosocomial strains of Pseudomonas aeruginosa in Ukrainian surgical department: results of prospective multicenter study (2011 - 2015)]. International Journal of Antibiotics and Probiotics, (1), 49-63. https://doi.org/10.31405/ijap.1-1.17.03 [in Ukrainian].

Potochilova, V., Rudneva, K., Pokas, O., & Vishnyakova, G. (2020). Chutlyvist do antybakterialnykh preparativ ta fenotypove vyznachennia faktoriv rezystentnosti u mikroorhanizmiv rodyny Enterobacteriaceae - zbudnykiv ranovykh infektsii [Sensitivity to antibacterial drugs and phenotypic determination of resistance factors in microorganisms of the Enterobacteriaceae family - pathogens of wound infections]. Visnyk problem biolohii i medytsyny, (3), 208-213. https://doi.org/10.29254/2077-4214-2020-3-157-208-213 [in Ukrainian].

Maxson, B., Serrano-Riera, R., Bender, M., & Sagi, C. (2015). Vancomycin and Cefepime Antibiotic Prophylaxis for Open Fractures Reduces the Infection Rates in Grade III Open Fractures Compared to Cefazolin and Gentamicin, Avoids Potential Nephrotoxicity, and Does Not Result in Antibiotic Resistance with MRSA. Orthopaedic Trauma Association Infection & General Interest II: Orthopaedic Trauma Association’s 31st Annual Meeting (p. 296). Rosemont. https://ota.org/education/meetings-and-courses/abstracts/vancomycin-and-cefepime-antibiotic-prophylaxis-open

Hrytsai, M. P., Kolov, H. B., & Tsokalo, V. M. (2016). Infektsiini uskladnennia pislia nakistkovoho ta vnutrishnokistkovoho osteosyntezu [Infectious complications after external fixation and internal fixation]. Zdorovia Ukrainy, (3. Khirurhiia. Ortopediia. Travmatolohiia), 36-38. https://health-ua.com/wp-content/uploads/2016/11/Book_hirurg3-optimiz.pdf [in Ukrainian].

Polishchuk, N. M., Kyryk, D. L., Yurchuk, I. Ye., Filippova, O. M., Lishchenko, T. M., & Yehorovа, S. V. (2020). Biolohichni vlastyvosti osnovnykh zbudnykiv hniino-zapalnykh zakhvoriuvan u khirurhichnykh khvorykh Zaporizkoi likarni shvydkoi dopomohy [Biological properties of the major causes factors of purulently inflammatory diseases of surgical patients in Zaporizhzhia Clinical Hospital of Emergency and Critical Care Medicine]. Current issues in pharmacy and medicine: science and practice, 13(2), 271-277. https://doi.org/10.14739/2409-2932.2020.2.207203 [in Ukrainian].

Published

2021-06-07

How to Cite

1.
Polishchuk NM, Kyryk DL, Yurchuk IY. Microbiological monitoring as a component of efficient prevention and treatment of purulent-septic infections in an orthopedics and traumatology department. Zaporozhye Medical Journal [Internet]. 2021Jun.7 [cited 2024Dec.25];23(3):381-7. Available from: http://zmj.zsmu.edu.ua/article/view/229667

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Section

Original research