Cases Of Nosocomial Infection Research Articles

The experience of using a bacteriophages-based complex antibacterial and analgesic drug in gel formulation in women who underwent various instrumental and diagnostic and treatment interventions

During the spread of bacterial infections with extensive drug resistance, the potential of existing antibacterial drugs is significantly reduced. The medical community is seeking opportunities for the rational use of antibacterial drugs, the development of new drugs, as well as the use of alternative treatments for these infections.
 Aim. The objective of this study was to evaluate the effectiveness of the use of a complex antibacterial and analgesic drug based on bacteriophages in gel form during various instrumental studies and diagnostic procedures in order to minimize the risk of the urinary system infections complications.
 Materials and methods. The study included 235 women aged 18 to 75 years who underwent treatment at the Moscow State Clinical Hospital named after Spasokukotsky and in the clinic of urology of Moscow State University of Medicine and Dentistry from September 2019 to January 2020. During the manipulation, all patients of the main group (n=120) used a developed preparation based on bacteriophages, and in the control group (n=115), a topical gel based on chlorhexidine dihydrochloride and lidocaine hydrochloride was used. All patients before the manipulation, as well as 10 days after the manipulation, underwent bacteriological analysis of urine. Efficiency assessment was carried out on the basis of laboratory data obtained, as well as according to the visual analogue scale of the pain syndrome severity.
 Results. None of the patients in the main group showed intolerance, side effects and allergic reactions of the developed drug based on bacteriophages. Bacteriological analysis of urine received before manipulation in both groups showed the absence of clinically significant titers of pathogenic bacteria, while 1 week after manipulation the number of titers of pathogenic bacteria (104) was significantly higher in the control group (p0.04). In patients of the main group, the incidence of dysuria was lower compared with the control group (p0.05).
 Conclusion. The study showed good tolerance of the developed drug and its clinical effectiveness in reducing the number of symptomatic bacteriuria; severity of pain after undergoing manipulation was relatively lower in the main group of patients. Conducting multicenter studies with the inclusion of a larger number of patients in the future will reduce the economic costs associated with treating patients by reducing the number of cases of nosocomial infections and reducing postoperative time spent by patients in the hospital.

Magnetic Resonance Imaging and Health Analysis Applied to Nursing Strategies for Clinical Management

Objective: To explore the medical imaging features of lung cancer brain metastases, and to explore the application effect of health informatics process reengineering on nursing management. Methods: Retrospective analysis of the medical data of patients admitted, including the number of cases of nosocomial infections in the two years, and analysis and summary of the reasons for the hospital patients were divided into the control group and the observation group. The control group was treated with traditional care, and the observation group was re-engineered in the basic upward process of the control group. The nursing quality scores, the occurrence of nursing errors and the satisfaction of nursing were compared between the two groups. Results: The nursing quality score of the observation group was better than that of the control group. The incidence of nursing errors was lower than that of the control group. The patient’s nursing satisfaction was higher than that of the control group (P > 0.05). Conclusion: The implementation of process reengineering in nursing management can effectively improve the quality of indoor nursing work, reduce the incidence of error events in the nursing work process, and improve the satisfaction of patients and their families.

Bactericidal Capacity of a Heterogeneous TiO2/ZnO Nanocomposite against Multidrug-Resistant and Non-Multidrug-Resistant Bacterial Strains Associated with Nosocomial Infections.

The surge of medical devices associated with nosocomial infection (NI) cases, especially by multidrug-resistant (MDR) bacterial strains, is one of the pressing issues of present health care systems. Metal oxide nanoparticles (MNPs) have become promising antibacterial agents against a wide range of bacterial strains. This work study is on the bactericidal capacity of heterogeneous TiO2/ZnO nanocomposites with different weight percentages and concentrations against common MDR and non-MDR bacterial strains. The profiles on disk diffusion, minimum inhibitory concentration, minimum bactericidal concentration, tolerance determination, time-kill, and biofilm inhibition assay were determined after 24 h of direct contact with the nanocomposite samples. Findings from this work revealed that the heterogeneous TiO2/ZnO nanocomposite with a 25T75Z weight ratio showed an optimal tolerance ratio against Gram-positive and -negative bacteria, indicating their bactericidal capacity. Further observation suggests that higher molar ratio of Zn2+ may possibly involve generation of active ion species that enhance bactericidal effect against Gram-positive bacterial strains, especially for the MDR strains. Nano-based technology using MNPs may provide a promising solution for the prevention and control of NIs. Further work on biocompatibility and cytotoxicity profiles of this nanocomposite are needed.

Implementation of a Comprehensive Preoperative Screening Process for Elective and Emergency Surgeries During the Peak of the COVID-19 Outbreak

Background: Amidst the COVID-19 pandemic, recent guidelines suggest that any surgery that may be delayed should be postponed to prevent the nosocomial spread of COVID-19. However, real-world data on the outcomes of implementing preoperative screening processes during the COVID-19 pandemic are lacking. We report the outcomes of implementing a comprehensive preoperative screening process for COVID-19 in a large-sized tertiary medical center for 72 days during the first peak of the outbreak. Methods: We reviewed the medical records of patients who underwent elective or emergency surgery at Asan Medical Center (Seoul, South Korea) during the first peak of the COVID-19 outbreak in South Korea (February 23–May 5, 2020). The preoperative screening process for COVID-19 included a chest X-ray and a detailed questionnaire on symptoms and epidemiological correlations to COVID-19. RT-PCR for SARS-CoV-2 and imaging studies were performed according to the presence of symptoms and epidemiological risks. Findings: During the peak of the COVID-19 outbreak, 140 scheduled surgeries were postponed through the preoperative screening process, of which one patient was confirmed with COVID-19 two days before the surgery. Including 611 cases of emergency surgeries, a total of 13,792 surgeries were performed during the study period, which is equivalent to approximately 5800 surgeries/month. Eighty-eight surgeries were performed in negative-pressure operating rooms with full personal protective equipment because RT-PCR results for SARS-CoV-2 could not be confirmed in time. All surgeries were successfully carried out, and there were no cases of nosocomial infection during the study period. Interpretation: By implementing a comprehensive preoperative screening process, a large number of elective and emergency surgeries (5800 surgeries/month) were safely performed even during the peak of the COVID-19 outbreak. Funding: There was no specific funding source for this study.Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: The protocols of this study were approved by the institutional review board of Asan Medical Center (protocol number 2020-0914).

Sensitivity of Staphylococcus aureus Isolated from Nasal and Throat of Pre-Clerkship Students to Antibiotics

Background: Cases of nosocomial infection are many caused by the bacteria of S.aureus. Bacteria infection caused by S.aureus may result in various skin and soft tissue infections. The infection may become difficult to treat if the strain of S.aureus responsible is the methicillin resistant strain or methicillin-resistant Staphylococcus aureus (MRSA). Currently there are two known types of MRSA: Hospital Acquired MRSA/HA-MRSA and Community Acquired MRSA/CA-MRSA. Transmission of the bacteria from one patient to another may be caused by unsterile medical equipment or from the hospital staff, especially pre-clinical students who will work in a hospital. The purpose of this study was to obtained the difference of bacteria colonisations S.aureus from nasal and throat swabs, and the sensitivity patterns of S.aureus when exposed to antibiotics (methicillin, vancomycin, imipenem, penicillin, ofloxacin, ciprofloxacin) and the prevalence of MRSA carriers and also to obtain an understanding of the characteristics of medical drug use through Islamic views. Metodes: This study used descriptive analysis method with samples taken from nasal and throat swabs applied to healthy pre-clinic student from Universitas YARSI. Statistical analysis using Mann-Whitney test in the program SPSS for windows. Results: The results bacteria colonisations S.aureus from nasal swabs was positive (23,3%), while from the throat sample was positive (10%). The results of statistical analysis (Sig. = 0.051 > 0.05) shows that there is no significant difference between the bacterial colonies of S.aureus originating from the nasal swabs and throat swabs of the pre-clinical students. From 60 samples a positive prevalence of (1.7%) was obtained for MRSA carriers. The result of the sensitivity test shows that the isolated sample of the bacteria S.aureus shows the highest sensitivity to the antibiotic imipenem and almost all the isolated samples show resistance to the antibiotic penicillin. Conclusion: There are more S.aureus bacteria colonies on nasal swabs compared to throat swabs. There was no significant difference between S.aureus bacteria colonization of nose and throat swabs in pre-clinical-students. The positive prevalence of MRSA carrier among pre-clinical-students of Yarsi University was (1.7%). In nasal swabs all isolates were still sensitive to the antibiotics methicillin, imipenem, ofloxacin and ciprofloxacin. But on the nasal swab there were three VISA isolates. In the throat swab, there was one MRSA isolate and one isolate that was resistant to ofloxacin. The inhibition zone of the highest sensitivity was obtained for imipenem antibiotics. Almost all isolates showed resistance to penicillin antibiotics. In Islamic medicine, drugs or antibiotics must not contain unclean and haram objects for human consumption.

Characteristics and Influencing Factors of Pathogenic Bacteria in Lung Cancer Chemotherapy Combined with Nosocomial Pulmonary Infection

背景与目的本研究旨在探讨肺癌患者化疗期间并发院内肺部感染的病原菌类型、分布、耐药性及影响因素。方法本研究回顾性分析2017年1月-2018年12月于浙江大学医学院附属第一医院住院治疗的411例肺癌化疗患者的临床资料，统计患者院内肺部感染发生率、病原体、耐药性及影响因素。结果411例肺癌患者在化疗期间发生院内肺部感染184例次，感染率达44.77%，分离的病原体包括革兰阴性菌、革兰阳性菌、病毒、真菌和结核，其中以革兰阴性菌为主，占37.25%，其次为病毒感染，占15.69%。革兰阴性菌以铜绿假单胞菌和肺炎克雷伯菌为主，革兰阳性菌以金黄色葡萄球菌和肺炎链球菌常见，病毒以乙型流感病毒为主，真菌以念珠菌和曲霉菌多见。铜绿假单胞菌对亚胺培南的耐药率偏高，达26.67%，而肺炎克雷伯菌对亚胺培南的耐药率仍保持低水平，为12.50%；主要革兰阳性菌对万古霉素的耐药率均为0.00%。低蛋白血症、化疗周期长、高强度化疗及合并有慢性阻塞性肺疾病、支气管扩张基础疾病者是肺癌患者在化疗期间合并院内肺部感染的高危因素（P < 0.05）。结论肺癌患者化疗期间合并院内肺部感染的病原菌分布和耐药性具有一定的特征，临床医生应加强对病原菌及其耐药性检测，在对症治疗的基础上，以达到保障治疗效果、延长患者生存期的目的，对高危患者应做好预防措施，尽可能降低化疗周期及强度，以减少感染的发生。

PREPARASI DISPERSI ANTIBAKTERI BERBAHAN DASAR TITANIUM DIOKSIDA (TIO2) SERTA APLIKASINYA PADA KAIN DENGAN METODA DIP COATING

Cases of nosocomial infections in Indonesia are increasing every year. One of the reasons is hospital equipment that is not sterile and poorly maintained in public facilities used in hospitals such as sheets, pillowcases, blankets, curtains, towels, and patient clothes. Everything made from fabrics can be contaminated by bacteria causing infections. In this research, the preparation of antibacterial based on titanium dioxide (TiO2) and its application to the fabric using a simple methodology. Cross-linking using Maleic Acid and catalyst using sodium hypophosphite. The dip-coating method is used to coat the fabric. Then, fabric washing is carried out to see the decrease in the amount of TiO2. Plate Count Method is carried out to see the antibacterial activity on the fabric. Fabric characterization was carried out using SEM and FTIR. SEM shows that TiO2 particles distributed throughout the fabric surface. After washing 10 times, there is a reduction in the amount of TiO2 in the fabric. FTIR aims at cross-linking between TiO2 and fabric. Meanwhile, testing for antibacterial activity showed that no bacteria appeared in all samples.

Concerning the discovery of mechanism for enterovirus B infection published in Cell.

Concerning the discovery of mechanism for enterovirus B infection published in Cell.

Vancomycin-resistant enterococcal infection in a Thai university hospital: clinical characteristics, treatment outcomes, and synergistic effect.

PurposeThe incidence of infections with vancomycin-resistant enterococci (VRE) is increasing, with associated high mortality rates and limited therapeutic choices. We investigated the clinical characteristics and treatment outcomes of VRE infection and also determined the in vitro effect of monotherapy and combined antimicrobials against clinical VRE isolates.Patients and methodsClinical data and bacterial isolates obtained from patients with VRE infections between January 2014 and April 2018 at Phramongkutklao Hospital were reviewed. The clinical outcomes included in-hospital mortality, 30-day mortality, and microbiological eradication. Clonal relationships were assessed by random amplified polymorphic DNA analysis. In vitro activity of linezolid, tigecycline, fosfomycin, gentamicin, chloramphenicol, and ampicillin were determined by minimum inhibitory concentration (MIC) values. Tests of synergy of fosfomycin- or gentamicin-based combinations by the checkerboard method were reported with the fractional inhibitory concentration index or MIC reduction, respectively.ResultsAmong 26 cases of VRE infection, nosocomial and gastrointestinal infections were the most common. There were various treatment regimens, but linezolid-containing regimens were generally used. In-hospital and 30-day mortality were 73.1% and 57.7%, respectively. Higher mortality was significantly associated with illness severity. The VRE isolates tested were universally susceptible to linezolid and tigecycline. A synergistic or additive effect was observed for fosfomycin combined with linezolid (100%) and with tigecycline (83.3%). Fourfold or greater MIC reduction was observed for linezolid or fosfomycin plus gentamicin at concentrations 1 (58.3%, 62.5%), 2 (83.3%, 62.5%), and 4 μg/mL (91.6%, 62.5%).ConclusionIn-hospital mortality among patients with VRE infection was high. Linezolid remains a treatment of choice. However, combination therapy such as linezolid plus fosfomycin and linezolid plus gentamicin should be considered in cases of serious infection.

Nosocomial Infections among Patients with Intracranial Hemorrhage: A Retrospective Data Analysis of Predictors and Outcomes

ObjectiveIntracranial hemorrhage is a critical medical emergency. Nosocomial infections may promote worse outcomes in these vulnerable patients. This study investigated microbial features, predictors, and clinical outcomes of nosocomial infections among patients with multiple subtypes of intracranial hemorrhage. Patients and methodsWe conducted a retrospective cohort study of patients that were hospitalized with intracranial hemorrhage between January 2015 and October 2018, and divided them into two groups based on the development of nosocomial infection. Within the cohort of patients with nosocomial infections, microbiology and resistance patterns were established across multiple sites of infection. Moreover, consequences of nosocomial infection such as mortality and length of hospital stay were determined. ResultsA total of 233 cases were identified that met our inclusion and exclusion criteria out of which were 94 cases of nosocomial infection (40.3%) versus 139 cases with no nosocomial infection (59.7%). The most common infections were pneumonia, urinary tract infections, and bacteremia. Resistance accounted for 70.2% of cultures. Multivariable analysis revealed significant association of nosocomial infections with hypertension (OR: 2.62, 95% CI: 1.11–6.16, p = 0.027), hospital LOS (OR: 1.08, 95% CI: 1.05–1.12, p < 0.001), levetiracetam (OR: 3.6, 95% CI: 1.41–0.922, p = 0.007), and GCS category (OR: 5.42, 95% CI: 1.67–17.55, p = 0.005 and OR: 7.63, 95% CI: 2.44–23.87, p < 0.001 for moderate and severe, respectively). Patients with nosocomial infections witnessed a significant increase in the length of hospital stay (23 versus 8 hospital days, p < 0.001). This finding was significant across most types of brain hemorrhage. Mortality was significantly associated with GCS category (OR: 10.1, 95% CI: 4–25.7, p < 0.001) and percutaneous endoscopic gastrostomy tube insertion (OR: 19.6, 95% CI: 4.1–91, p < 0.001). ConclusionsCollectively, these findings suggest that nosocomial infections are common among patients with intracranial hemorrhage and can be predictable by considering certain risk factors. Future studies are warranted to evaluate the efficacy of implementing infection control strategies or protocols on these patients to achieve better therapeutic outcomes.

Novel Sequence Type in Bacillus cereus Strains Associated with Nosocomial Infections and Bacteremia, Japan.

Bacillus cereus is associated with foodborne illnesses characterized by vomiting and diarrhea. Although some B. cereus strains that cause severe extraintestinal infections and nosocomial infections are recognized as serious public health threats in healthcare settings, the genetic backgrounds of B. cereus strains causing such infections remain unknown. By conducting pulsed-field gel electrophoresis and multilocus sequence typing, we found that a novel sequence type (ST), newly registered as ST1420, was the dominant ST isolated from the cases of nosocomial infections that occurred in 3 locations in Japan in 2006, 2013, and 2016. Phylogenetic analysis showed that ST1420 strains belonged to the Cereus III lineage, which is much closer to the Anthracis lineage than to other Cereus lineages. Our results suggest that ST1420 is a prevalent ST in B. cereus strains that have caused recent nosocomial infections in Japan.

Nosocomial bloodstream infection and the emerging carbapenem-resistant pathogen Ralstonia insidiosa

BackgroundRalstonia picketti, Ralstonia mannitolilytica, and Ralstonia insidiosa have recently been regarded as emerging pathogens of infectious diseases, in particular as the pathogens responsible for nosocomial infection in immunocompromised patients. R. insidiosa differs from R. picketti and R. mannitolilytica, and its related infections are rarely reported.MethodsClinical data from two nosocomial bloodstream infection cases were extracted and analyzed. The causable isolates were identified by the VITEK 2 Compact system, matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and molecular identification methods using PCR with universal and species-specific primers. Antimicrobial susceptibility testing was performed using the broth microdilution method. Both of the isolates were subjected to whole genome sequencing using a HiSeq X10 Sequencer. Antimicrobial resistance genes, virulence factors, and plasmid replicons were identified from assembled genomes. A real-time RT-PCR experiment and a cloning experiment were conducted to explore the related class D β-lactamase-encoding genes.ResultsBoth patients recovered under therapy with antibiotics. Isolates were initially misidentified as R. mannitolilytica by the VITEK 2 Compact system rather than R. insidiosa, as identified by both MALDI-TOF MS and 16S rRNA gene sequencing. Both isolates were resistant to aminoglycosides, β-lactams, and polymyxin B. One isolate harboring blaOXA-570 was resistant to carbapenems. The whole genome sequencing data confirmed species identification based on average nucleotide identity (ANI) and revealed two variants of class D β-lactamase-encoding gene blaOXA (blaOXA-573 and blaOXA-574). The real-time RT-PCR experiment showed no difference in gene expression between blaOXA-570 and blaOXA-573 in our strains. The cloning experiment showed that variant OXA-573 had no carbapenem hydrolase activity.ConclusionsWe described two cases of nosocomial bloodstream infection caused by R. insidiosa strains. MALDI-TOF MS was cost-effective for rapid species identification. Clinicians should be aware that R. insidiosa can be resistant to commonly used antibiotics, even carbapenems.

The 2017 human monkeypox outbreak in Nigeria-Report of outbreak experience and response in the Niger Delta University Teaching Hospital, Bayelsa State, Nigeria.

BackgroundIn September 2017, Nigeria experienced a large outbreak of human monkeypox (HMPX). In this study, we report the outbreak experience and response in the Niger Delta University Teaching Hospital (NDUTH), Bayelsa state, where the index case and majority of suspected cases were reported.MethodsIn a cross-sectional study between September 25th and 31st December 2017, we reviewed the clinical and laboratory characteristics of all suspected and confirmed cases of HMPX seen at the NDUTH and appraised the plans, activities and challenges of the hospital in response to the outbreak based on documented observations of the hospital’s infection control committee (IPC). Monkeypox cases were defined using the interim national guidelines as provided by the Nigerian Centre for Disease Control (NCDC).ResultsOf 38 suspected cases of HMPX, 18(47.4%) were laboratory confirmed, 3(7.9%) were probable, while 17 (18.4%) did not fit the case definition for HMPX. Majority of the confirmed/probable cases were adults (80.9%) and males (80.9%). There was concomitant chicken pox, syphilis and HIV-1 infections in two confirmed cases and a case of nosocomial infection in one healthcare worker (HCW). The hospital established a make-shift isolation ward for case management, constituted a HMPX response team and provided IPC resources. At the outset, some HCWs were reluctant to participate in the outbreak and others avoided suspected patients. Some patients and their family members experienced stigma and discrimination and there were cases of refusal of isolation. Repeated trainings and collaborative efforts by all stakeholders addressed some of these challenges and eventually led to successful containment of the outbreak.ConclusionWhile the 2017 outbreak of human monkeypox in Nigeria was contained, our report reveals gaps in outbreak response that could serve as lessons to other hospitals to strengthen epidemic preparedness and response activities in the hospital setting.

Russia-wide epidemiological survey of congenital and nosocomial infections in newborns

High prevalence and great socio-economic impact of nosocomial infections is documented in obstetric hospitals. Objective: to uncover Russia-wide epidemiological features for congenital and nosocomial infections in newborns. Material and Methods: the data covering 20082016 period were retrieved from the Federal Statistical Monitoring Form No. 2 Report on Infectious and Parasitic Diseases, via the Unified Interdepartmental Information Statistical System. During 20082016, incidence of congenital and nosocomial infections in newborns was analyzed in various constituents of the Russian Federation, which were divided into quartile groups including confidence interval. Results: It was found that the increased/decreased/unchanged incidence of congenital infections in newborns was shown in 30, 31 and 13 subjects, respectively. In case of nosocomial infections in newborns, its incidence was increased/decreased/unchanged in 7, 41 and 26 subjects, respectively. Moreover, a congenital/nosocomial infection ratio in newborns was increased/decreased/ unchanged in 40, 15 and 19 subjects, respectively. Based on the morbidity pattern, 9 major groups might be distinguished. In particular, the most abundant (16 subjects) was the group with increased incidence of congenital infections, decreased incidence of nosocomial infections and increased congenital/nosocomial infection ratio in newborns. However, it is worth mentioning that recording of nosocomial infection cases is incomplete in the vast majority of the subjects of the Russian Federation: as few as seven subjects may be highlighted providing a proper registration of nosocomial and congenital infections in newborns such as: Vologda Region, Trans-Baikal Territory, Nizhny Novgorod Region, Omsk Region, Orenburg Region, Penza Region, and Sverdlovsk Region. Conclusion: to fully assess an objective status on nosocomial and congenital infections in newborns, it is necessary that a hospital epidemiologist investigates every single case; ensure applying a standard approach to determine a case of healthcare-associated infection, congenital infections; official recording of all cases; responsibility of all staff members involved in recording healthcare-associated infection cases; regularly reviewed data by using science-based methods. Key words: congenital infections, nosocomial infections, healthcare associated infections, registration, incidence, mortality.

Аспергиллезное поражение органов как один из случаев внутрибольничной инфекции

Аспергиллезное поражение органов как один из случаев внутрибольничной инфекции

Aspergillus diversity in the environments of nosocomial infection cases at a university hospital.

Aspergillus species (sp.) that causes opportunistic infections have been increasingly found in human mainly immunosuppressive patients around the world every year. The main objective was to use a rapid and cheap molecular method for monitoring Aspergillus infections and epidemiological approaches. In order to identity Aspergilli species (spp.), a number of molecular methods including restriction fragment length polymorphism (RFLP) have been employed in accordance with ribosomal RNA amplification. The focus of this study — a group of hospitalized patients with clinical and subclinical signs of infection. All of the collected clinical specimens were transported to the medical mycology lab and examined for Aspergillus identification. The environmental specimens were collected from air and surfaces inspected for the Aspergillus within the hospital sources. At first, growth characteristics and microscopic features on mycological media for the identification of Aspergillus sp. were performed. For the confirmation of Aspergillus isolates which similarly found in clinical and environmental sources, molecular method polymerase chain reaction/restriction fragment length polymorphism was carried out. From the mentioned specimens, 102 fungal isolates included Candida spp., Aspergillus spp. and other fungi. Aspergillus flavus (47%), Aspergillus fumigatus (29.4%) and Aspergillus niger (23.5%) all were found as the most common clinical isolates. In addition, Aspergillus isolates from environmental were Aspergillus niger (43.7%), Aspergillus flavus (41.7%), Aspergillus fumigatus (14.6%). Therefore, polymerase chain reaction-restriction fragment length polymorphism with a single restriction enzyme can be very useful in the identification of Aspergillus spp., because of its facility in use, speed, robust, and high sensitivity of diagnosis.

Оценка бактериологического анализа мочи у пациентов с длительным дренированием мочевого пузыря

The experience of comparative evaluation of the effectiveness of various types of urethral catheters in prevention of catheter-associated infection is described in this article. The study included 69 patients treated at the CCH n.a. S.I. Spasokukotsky in the period from December 2017 to March 2018. The average age of patients was 67.5 years. In all patients, the bladder was drained by a two-way Foley catheter No. 16-18 Ch (100% silicone). In the 1st group (n=18), the bladder was drained with a standard urethral uncoated catheter, in the 2nd (n=16) - with a silver impregnated urethral catheter, in the 3rd (n=15) - with an urethral catheter coated with nitrofuran, in the 4th (n=20) urethral catheter with the possibility of controlled irrigation of the bladder and urethra with antiseptic solutions and (a new model of the urethral catheter developed during cooperative work of the Moscow State University of Medicine and Dentistry n.a. A.I. Evdokimov Urology Department and National Medical Research Center of Obstetrics, Gynecology and Perinatology n.a. V.I. Kulakov). The bladder was drained by Foley urethral catheter for more or equal 15 days. A microbiological study of urine (on the example of clinical isolates of conditionally pathogenic microorganisms) with preparation of an inoculum, inoculation of nutrient media, counting cultures of pathogenic bacteria and determining the sensitivity of pathogenic bacteria to antibiotics was carried out. The study showed the effectiveness of the new urethral catheter model in patients with long-term bladder drainage. Conducting multicenter studies evaluating the effectiveness of the proposed urethral catheter model with the inclusion of a larger number of patients will reduce the economic costs, associated with treating patients with prolonged bladder drainage in the long term by reducing the number of nosocomial infection cases and reducing postoperative day.

Ukrainian Strategy and Action Plan for the Prevention of Healthcare Association Infections (HAIs) and Antimicrobial Resistance

The Ukrainian Strategy and Action Plan for the Prevention of Healthcare Association Infections (HAIs) and An- timicrobial Resistance defines the purpose, principles and main directions of the improvement of the National system for control and prevention of HAI and AMR pathogens of these infections, mechanisms of its functioning, as well as expected socio-economic impact.&#x0D; Action plan underscores the need for an effective «One Health» approach involving coordination among numer- ous international sectors and actors, including human and veterinary medicine, agriculture, environment, and well-informed consumers. The Action Plan recognizes and addresses both the variable resources nations have to combat antimicrobial resistance.&#x0D; The main objectives of the Ukrainian Action Plan is to improve the regulatory, legal and methodological support system of prevention of Healthcare-associated Infections (HAI), laboratory diagnosis and monitoring of AMR pathogens infections, training system for medical personnel in these fields. We are talking about the introduction of modern approaches and optimization of controls and prevention of HAI, preventing of transmission of multi re- sistance pathogens in healthcare institutions, improving the effectiveness of disinfection and sterilization measures.&#x0D; It is planned to create a unified system of laws and regulations that will ensure effective control and prevention of HAI and AMR, and investigation of outbreaks when they occur and ensuring of adequate compensation to victims; to prepare a standard on infection control with the compliance of mandatory requirements aimed at preventing HAI and AMR in healthcare institutions based on their profile; to create in healthcare institutions the methods of epidemiological diagnostic, based on standard criteria for determining of nosocomial infection cases by anatomic localization of infection.&#x0D; In addition, it is necessary to optimize the list of indications for microbiological and clinical research material and objects of hospital environment, rules of sampling and shipping of samples of biological material in the laboratory. And to develop target prevention programs for HAI and AMR at the national (country), regional and municipal levels. To implement modern technologies on infection control and monitoring of AMR in health care institutions.&#x0D; As a result of the Ukrainian Action Plan is expected to reduce the number of infections caused by resistant strains of microorganism’s mortality, disability and complications from infections associated with medical care, increase the employment potential of the nation by reducing temporary and permanent loss of working ability as a result of population diseases. Also, it is necessary to increase safety of patients and staff while providing medical care.

Clinical value of blood analysis in diagnosis and differential diagnosis of patients with acute and chronic leukemia

Objective To explore the clinical value of related indicators of blood analysis in the differential diagnosis of acute and chronic leukemia. Methods From January 2015 to June 2017, 15 patients with acute leukemia (A group) and 10 patients with chronic leukemia (B group), and 20 healthy volunteers(C group), 20 cases of nosocomial infection(D group) in Jiaocheng People's Hospital of Lyuliang were selected.The differences of WBC, RBC, PLT, HB in four groups were analyzed, and the differences of WBC, immature granulocyte percentage(IG%), immature granulocyte(IG), the percentage of naive cells, immature cells count between A group and B group were further analyzed. Results The count of WBC from high to low was B group [(120.3±39.2)×109/L], A group[(81.4±29.2)×109/L], D group[(26.3±10.3)×109/L], C group [(5.4±1.9)×109/L], there was statistically significant difference among the four groups(P B group [(1.4±0.7)×109/L] > A group [(0.6±0.1)×109/L](P C group [(264.3±84.2)×109/L] > B group [(12.3±6.5)×109/L] ≈A group [(5.9±1.7)×109/L](P<0.05). Through the analysis of bone marrow AML 11 cases, 54.55% was M2, followed by M1, M3, M5.ALL in 4 cases, CML in 10 cases.The IG%, IG count, WBC, percentage of naive cells, immature cells count in A group and B group were increased, but in the different types of leukemia increased in amplitude had significant difference, AML was characterized by the increase of IG% and percentage of naive cells, ALL was characterized by the significant increase of WBC, CML was characterized by the significant increase of WBC, IG%, IG count. Conclusion Blood analysis is of high value in the differential diagnosis of acute and chronic leukemia.It can provide a reliable basis for the initial diagnosis and classification of leukemia, and can be used to guide clinical treatment. Key words: Leukaemia; Blood chemical analysis; Leukocyte; Immature granulocyte; Immature cell

Bacteriophages for the control of Klebsiella outbreak in the neonatal intensive care unit

Background: Healthcare-associated infections (HAI) are the most frequent adverse event in health-care delivery worldwide. Antibiotic resistance threatens the effective prevention and treatment of an ever-increasing range of HAI caused by bacteria. There is an urgent need to investigate alterative preventive and treatment options while there are still a few antibiotics left. Bacteriophage (phage) therapy, the use of viruses that infect bacteria as antimicrobials, has been championed as a promising alternative to antibiotics. Methods & Materials: Commercial bacteriophage cocktail targeting Klebsiella pneumoniae was orally given over 5 days to patients hospitalized in the neonatal intensive care unit in Saint-Petersburg, Russia. Results: In July 2013 the incidence of nosocomial infections caused by K. pneumoniae in the neonatal ICU began to increase. The outbreak started with two cases of pneumonia caused by K. pneumoniae. 4 cases of nosocomial infections were identified in July. The number of cases of K. pneumoniae infection increased to 11 cases in August. Totally, HAI caused by K. pneumonia were occurred in 15 patients, the rate was 19.0% (95% CI = 11,0-29,4) during the outbreak period. Common measures to control the outbreak had been unsuccessful. After application of the phage cocktail among newborns, the rate of nosocomial K. pneumoniae infections decreased to zero and remained at this level for more than a month of surveillance in the ICU. Conclusion: Presented results clearly demonstrate high efficiency of bacteriophages. Phages have several features that make them potentially attractive antibacterial agents. Bacteriopahges are highly specific and very effective in destroying targeted bacteria, safe and rapidly modifiable to combat the emergence of newly arising bacterial threats.