EPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS

The aim of the study was to identify the epidemiological features of bacterial infections in patients and circulation of epidemiologically significant microorganisms in the bone marrow transplant (BMT) units. Materials and methods. The study was conducted in three BMT departments. To identify the ep...

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Autores principales:	A. V. Lyubimova, S. A. Ryakhovskikh, N. A. Shalyapina, T. V. Brodina, M. Yu. Averyanova, B. I. Aslanov, V. V. Nechaev
Formato:	article
Lenguaje:	RU
Publicado:	Sankt-Peterburg : NIIÈM imeni Pastera 2018
Materias:	hospital-acquired infections risk factors vancomycin-resistant enterococci prevalence molecular typing bone marrow tranplantation Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/f715728b8ace431b95b2f95977d5f899
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spelling	oai:doaj.org-article:f715728b8ace431b95b2f95977d5f8992021-11-22T07:09:48ZEPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS2220-76192313-739810.15789/2220-7619-2017-4-350-358https://doaj.org/article/f715728b8ace431b95b2f95977d5f8992018-01-01T00:00:00Zhttps://www.iimmun.ru/iimm/article/view/592https://doaj.org/toc/2220-7619https://doaj.org/toc/2313-7398The aim of the study was to identify the epidemiological features of bacterial infections in patients and circulation of epidemiologically significant microorganisms in the bone marrow transplant (BMT) units. Materials and methods. The study was conducted in three BMT departments. To identify the epidemiological features of bacterial infections, a prospective observational study was conducted from 01 April 2014 to 31 August 2014 (91 patients) which included active detection of cases of infection and microbiological examination of patients. In order to detect the circulation of epidemiologically significant microorganisms, point prevalence studies (59 patients, 170 environmental samples) were conducted. To study the role of colonization, microbiological monitoring of patients on admission to the department was carried out, and repeated every week before discharge. Swab samples from skin and mucous membrane of the oral cavity and stool sampleswere included in the monitoring. In total, 639 samples from 50 patients were tested. Results. The study revealed a high incidence of infectious complications in BMT patients (100 cases of bacterial infections in 57 patients: sepsis 30.8 per 100 patients, pneumonia 26.4 per 100 patients, urinary tract infections 32.9 per 100 patients, soft tissue infection 9.9 per 100 patients, catheter-associated bloodstream infection 9.9 per 100 patients). Most infections were caused by Gram-negative bacteria, in particular K. pneumoniae. The onset of disease manifestation was preceded by colonization of the patient with these microorganisms. Fatal outcomes were observed from sepsis and pneumonia caused by K. pneumoniae and/or P. aeruginosa. Sepsis and pneumonia were often associated with cytopenia, RR 2.63 [95% CI 1.52–4.57] p = 0.004 and RR 3.97 [95% CI 2.19–7.19] p < 0.001 respectively. In course of observation, the frequency of colonization of patients with microorganisms susceptible to antibiotics decreased, and colonization with resistant pathogens increased. A series of prevalence studies revealed a constant circulation of VRE in the BMT units with a contacttransmission via household objects. Multidrug-resistant gram-negative microorganisms did not have a constant circulation and appeared sporadically against the background of the constant circulation of susceptible strains of these pathogens. Conclusions. Prospective epidemiological surveillance and microbiological monitoring are required in the BMT units. Widespread contamination of household objects in the environment indicates the need to strengthen the hygienic education of patients and visitors as well as disinfection of these facilities. In addition, we recommend introduction of weekly fecal screening cultures to monitor intestinal colonization of patients with MDRO.A. V. LyubimovaS. A. RyakhovskikhN. A. ShalyapinaT. V. BrodinaM. Yu. AveryanovaB. I. AslanovV. V. NechaevSankt-Peterburg : NIIÈM imeni Pasteraarticlehospital-acquired infectionsrisk factorsvancomycin-resistant enterococciprevalencemolecular typingbone marrow tranplantationInfectious and parasitic diseasesRC109-216RUInfekciâ i Immunitet, Vol 7, Iss 4, Pp 350-358 (2018)
institution	DOAJ
collection	DOAJ
language	RU
topic	hospital-acquired infections risk factors vancomycin-resistant enterococci prevalence molecular typing bone marrow tranplantation Infectious and parasitic diseases RC109-216
spellingShingle	hospital-acquired infections risk factors vancomycin-resistant enterococci prevalence molecular typing bone marrow tranplantation Infectious and parasitic diseases RC109-216 A. V. Lyubimova S. A. Ryakhovskikh N. A. Shalyapina T. V. Brodina M. Yu. Averyanova B. I. Aslanov V. V. Nechaev EPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS
description	The aim of the study was to identify the epidemiological features of bacterial infections in patients and circulation of epidemiologically significant microorganisms in the bone marrow transplant (BMT) units. Materials and methods. The study was conducted in three BMT departments. To identify the epidemiological features of bacterial infections, a prospective observational study was conducted from 01 April 2014 to 31 August 2014 (91 patients) which included active detection of cases of infection and microbiological examination of patients. In order to detect the circulation of epidemiologically significant microorganisms, point prevalence studies (59 patients, 170 environmental samples) were conducted. To study the role of colonization, microbiological monitoring of patients on admission to the department was carried out, and repeated every week before discharge. Swab samples from skin and mucous membrane of the oral cavity and stool sampleswere included in the monitoring. In total, 639 samples from 50 patients were tested. Results. The study revealed a high incidence of infectious complications in BMT patients (100 cases of bacterial infections in 57 patients: sepsis 30.8 per 100 patients, pneumonia 26.4 per 100 patients, urinary tract infections 32.9 per 100 patients, soft tissue infection 9.9 per 100 patients, catheter-associated bloodstream infection 9.9 per 100 patients). Most infections were caused by Gram-negative bacteria, in particular K. pneumoniae. The onset of disease manifestation was preceded by colonization of the patient with these microorganisms. Fatal outcomes were observed from sepsis and pneumonia caused by K. pneumoniae and/or P. aeruginosa. Sepsis and pneumonia were often associated with cytopenia, RR 2.63 [95% CI 1.52–4.57] p = 0.004 and RR 3.97 [95% CI 2.19–7.19] p < 0.001 respectively. In course of observation, the frequency of colonization of patients with microorganisms susceptible to antibiotics decreased, and colonization with resistant pathogens increased. A series of prevalence studies revealed a constant circulation of VRE in the BMT units with a contacttransmission via household objects. Multidrug-resistant gram-negative microorganisms did not have a constant circulation and appeared sporadically against the background of the constant circulation of susceptible strains of these pathogens. Conclusions. Prospective epidemiological surveillance and microbiological monitoring are required in the BMT units. Widespread contamination of household objects in the environment indicates the need to strengthen the hygienic education of patients and visitors as well as disinfection of these facilities. In addition, we recommend introduction of weekly fecal screening cultures to monitor intestinal colonization of patients with MDRO.
format	article
author	A. V. Lyubimova S. A. Ryakhovskikh N. A. Shalyapina T. V. Brodina M. Yu. Averyanova B. I. Aslanov V. V. Nechaev
author_facet	A. V. Lyubimova S. A. Ryakhovskikh N. A. Shalyapina T. V. Brodina M. Yu. Averyanova B. I. Aslanov V. V. Nechaev
author_sort	A. V. Lyubimova
title	EPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS
title_short	EPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS
title_full	EPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS
title_fullStr	EPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS
title_full_unstemmed	EPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS
title_sort	epidemiological features of bacterial infections in bone marrow transplant units
publisher	Sankt-Peterburg : NIIÈM imeni Pastera
publishDate	2018
url	https://doaj.org/article/f715728b8ace431b95b2f95977d5f899
work_keys_str_mv	AT avlyubimova epidemiologicalfeaturesofbacterialinfectionsinbonemarrowtransplantunits AT saryakhovskikh epidemiologicalfeaturesofbacterialinfectionsinbonemarrowtransplantunits AT nashalyapina epidemiologicalfeaturesofbacterialinfectionsinbonemarrowtransplantunits AT tvbrodina epidemiologicalfeaturesofbacterialinfectionsinbonemarrowtransplantunits AT myuaveryanova epidemiologicalfeaturesofbacterialinfectionsinbonemarrowtransplantunits AT biaslanov epidemiologicalfeaturesofbacterialinfectionsinbonemarrowtransplantunits AT vvnechaev epidemiologicalfeaturesofbacterialinfectionsinbonemarrowtransplantunits
_version_	1718418016697319424

EPIDEMIOLOGICAL FEATURES OF BACTERIAL INFECTIONS IN BONE MARROW TRANSPLANT UNITS

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