Abstract
Relevance. The absence of a system of epidemiological surveillance of chronic lung infection (CLI) in patients with cystic fibrosis (CF) led to the spread of Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia cepacia complex and Achromobacter spp. among patients with CF during hospitalizations, that is proved by numerous cases of infection in patients with CF treated in various Russian clinics. Aims. Determine the directions of epidemiological surveillance (ES) for CLI in patients with CF and preventive measures necessary to counteract the cross-infections among patients with CF and the spread of the dominant pathogens of CLI in the hospital. Materials and methods. A complex of epidemiological, microbiological and molecular genetic methods was used. Results and discussion . Based on the results of studies of the epidemiological and microbiological features of infections caused by the above-mentioned pathogens, the directions of ES and preventive measures for CF were determined. The tasks of the information-analytical unit, including the monitoring of morbidity and microbiological monitoring, are substantiated. It has been established that in the framework of microbiological monitoring, it is necessary to conduct bacteriological examination of biomaterial from the respiratory tract of patients with CF not less than 1 time per quarter, as well as at each outpatient visit and at hospitalization. The necessity of studying the phenotypic properties of pathogens contributing to long-term persistence in the patient's body of the CF, the definition and monitoring of the antibiotic sensitivity of microorganisms isolated from the patient over time, and the study of hypermutability was shown. One of the main tasks of monitoring is molecular genetic analysis of pathogens by PCR for the purpose of intraspecies identification, typing of pathogens and detection of epidemic markers and clones (including international ones), identification of genetic determinants of antibiotic resistance. Conclusion. The introduction of ES for chronic lung infection will improve the quality of etiological diagnosis, will contribute early identification of the sources of infections and prevent the spread of CLI pathogens among patients with CF in hospitals and in non-hospital conditions, as well as optimize the tactics of CLI antimicrobial therapy. The main directions of preventing the spread of CLI pathogens should be the separation of patients with various infections during outpatient examination and isolation during hospitalization.
Highlights
Эпидемиологический надзор за хроническими инфекциями легких, вызванными бактериями Burkholderia cepacia complex, бактериями рода Achromobacter, Pseudomonas аeruginosa и метициллинрезистентным Staphylococcus aureus, у больных муковисцидозом
Directions of Epidemiological Surveillance of Chronic Lung Infections Caused by Burkholderia cepacia Complex, Achromobacter spp., Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus in Patients with Cystic Fibrosis LR Avetisyan**1, IA Shaginyan1, MYu Chernukha1, EM Burmistrov1, OS Medvedeva1, EV Rusakova1, EA Siyanova1, EI Kondrateva2, AG Chuchlin3, AL Ginzburg1 1 N ational Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya, Moscow, Russian Federation 2 Research Centre of Medical Genetics, Moscow, Russian Federation 3 Pirogov Russian National Research Medical University, Moscow, Russian Federation Abstract Relevance
The absence of a system of epidemiological surveillance of chronic lung infection (CLI) in patients with cystic fibrosis (CF) led to the spread of Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia cepacia complex and Achromobacter spp. among patients with CF during hospitalizations, that is proved by numerous cases of infection in patients with CF treated in various Russian clinics
Summary
Эпидемиологический надзор за хроническими инфекциями легких, вызванными бактериями Burkholderia cepacia complex, бактериями рода Achromobacter, Pseudomonas аeruginosa и метициллинрезистентным Staphylococcus aureus, у больных муковисцидозом. Цель исследования – определить направления эпидемиологического надзора (ЭН) за ХИЛ у больных муковисцидозом и профилактических мероприятий, необходимых для противодействия перекрестному инфицированию больных МВ и распространению доминирующих возбудителей хронической инфекции легких в стационаре. For citation: Avetisyan LR, Shaginyan IA, Chernukha MYu et al Directions of Epidemiological Surveillance of Chronic Lung Infections Caused by Burkholderia cepacia complex, Achromobacter spp., Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus in Patients with Cystic Fibrosis. В связи с этим для предупреждения распространения бактерий Bсс, Achromobacter spp., P. aeruginosa и метициллинрезистентный золотистый стафилококк (MRSA) среди больных МВ как в стационарах, так и во внегоспитальных условиях, необходимо внедрить постоянный эпидемиологический надзор (ЭН), который позволил бы управлять эпидемическим процессом инфекций, вызванных этими бактериями. Цель – определить направления эпидемиологического надзора за хронической инфекцией легких у больных муковисцидозом и профилактических мероприятий, необходимых для противодействия перекрестному инфицированию больных МВ и распространению доминирующих возбудителей ХИЛ в стационаре. В исследованиях использовались эпидемиологические, бактериологические и молекулярно-генетические (ПЦР, мультилокусное секвенирование, секвенирование полного генома) методы [3,4,5]
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