Results of Epidemiological and Microbiological Monitoring of Healthcare- Associated Infections in the Republic of North Ossetia–Alania

Abstract

Introduction: The complex of exogenous and endogenous risk factors in multidisciplinary hospitals creates conditions for the development of nosocomial infections induced by ESKAPE pathogens. Objective: To establish epidemiological features and etiological significance of antibiotic resistant strains of the leading pathogens inducing hospital-acquired infections and to determine their prevalence in multidisciplinary clinics of the Republic of North Ossetia–Alania. Materials and methods: We analyzed the incidence of nosocomial infections and results of the microbiological monitoring of antimicrobial drug resistance in leading pathogens for the years 2012–2021. Detection of genes encoding the production of metallo-β-lactamases was performed in P. aeruginosa strains, extended-spectrum β-lactamases and PFGE profiles of E. coli and K. pneumoniae strains. Results: In the Republic of North Ossetia–Alania, the average long-term incidence rate of hospital-acquired infections in the study period was 0.74 per 1,000 inpatients. We established that 44.2 % of all such cases were diagnosed in surgical departments, 32.4 % – in maternity departments, 6.6 % – in pediatric departments, and 16.8 % – in other clinical departments. The average long-term incidence rate of nosocomial infections was the highest (0.85 per 1,000 patients) in departments of surgery, the most prevalent being surgical and injection site infections, lower respiratory tract and urinary tract infections. The leading pathogens in the etiological structure were Enterobacteriaceae spp., P. aeruginosa and Staphylococcus spp. The incidence rates estimated based on microbiological monitoring results were on average 2.5 times higher than those registered within the routine surveillance system. Conclusions: Incidence rates of healthcare-associated infections in the Republic of North Ossetia–Alania are comparable to those in the Russian Federation. Patients of surgery departments are at higher risk for nosocomial infections. Optimization of preventive measures requires a risk-based approach that takes into account in-depth microbiological monitoring data on the most common pathogens resistant to drugs of choice in local hospitals.