Transcription of NOSOCOMIAL INFECTIONS: TRENDS IN AMR - …
1 E. P. Barantsevich,Head, Department of Microbiology, Cell Technologies and Molecular Biology, Head, Unit of NOSOCOMIAL InfectionsFederal Almazov North-West Medical Research Centre, Saint-Petersburg, RussiaNOSOCOMIAL infections : TRENDS IN AMRFEDERAL ALMAZOV NORTH-WEST MEDICAL RESEARCH CENTRE THE LEADING MEDICAL RESEARCH INSTITUTION IN THE NORTH-WEST FEDERAL DISTRICTCOLLECTION OF NOSOCOMIAL STRAINS: 11,274 strainsPRECLINICAL TRANSLATIONAL RESEARCH CENTERS mall LargeFrogs (Xenopus laevis) MonkeysFish (Danio rerio) Pigs and minipigsRats and miceSheep and dogs MEDICAL RESEARCH CENTER: 6 institutes Heart and Vessels, Hematology, Perinatology and Pediatrics, Endocrinology, Experimental Medicine, Molecular Biology and GeneticsEDUCATIONAL CENTER: Institute of Medical EducationCLINICAL FACILITIES.
2 1,525 bedsCardiology and Cardiosurgery, Hematology, Heart and Stem Cell Transplantation, Rheumatology, Neurosurgery, Endocrinology, TRANSLATIONAL RESEARCH CENTER FACILITIES: SPF animalsFEDERAL ALMAZOV NORTH-WEST MEDICAL RESEARCH CENTRE UNIQUE MEDICAL RESEARCH INSTITUTIONR. Streefkerk et al., 2014 MEAN: 8,1%RATE OF NOSOCOMIAL INFECTIONSSURVIVAL RATE IN SEPTIC SHOCK AND TIME OF ADEQUATE ANTIMICROBIAL THERAPY survival fraction of patients, % time (hrs) following first documentation of septic shock-associated 1-2 2-3 3-4 5-6 6-9 9-12 12-24 24-36 >361 HOUR DELAY DECREASES SURVIVAL BY 7% 10%Kumar A.
3 Et al, Crit Care, 2006 SURVIVAL IN SEPTIC SHOCK AND TIME OF EFFECTIVE ANTIMICROBIAL THERAPYANTIBACTERIAL THERAPY OF NOSOCOMIAL INFECTIONSEMPIRIC THERAPY - resistance surveillanceCAUSAL TREATMENT fast and correct identification of causative agent and ASTTIME!IDENTIFICATION OF MICROBIAL PATHOGENS MALDI-TOF mass spectrometry SEQUENCING (16S rRNA gene, ITS, D1/D2 regions)AMR AND MECHANISMS Disc diffusion (Oxoid) Broth dilution (SensiTitre) PCR and real-time PCR Sequencing NGSROUTINE STUDIES IN TO ANTIBIOTICS IN GRAM-POSITIVES, 2015-2016 RESISTANCE TO ANTIFUNGAL AGENTSIN CANDIDA ALBICANS, 20160%10%20%30%40%50%60%70%80%90%100%0%9 1%63%32%30%10%RATE OF MDR AND CR IN K.
4 PNEUMONIAE, 2013-20141,367 consecutive strains of K. pneumoniae:7 hospitals in Saint-Petersburg2 hospitals in the Leningrad region34%27%24%4%4%3%3%Respiratory samples (BAL, lungs, sputum)Postoperative woundsUrinePeritoneal fluidBloodFaecesOthers (pleural fluid, cerebrospinal fluid etc.)MULTIDRUG RESISTANCE and CARBAPENEM RESISTANCE in K. PNEUMONIAE in SAINT-PETERSBURG and LENINGRAD REGION0%10%20%30%40%50%60%70%80%0%0%0%1% 1%1%1%1%2%2%2%MDR K. pneumoniae in 2 neighboring subjects:CR K. pneumoniae in 2 neighboring subjects: 956 ( ) MDR K. pneumoniae, 21 ( ) CR K. pneumoniaeNDM - 1 OXA - 48 KPC - 2 RESISTANCE GENES IN K.
5 PNEUMONIAE:CARBAPENEMASESESBL: СTX-M-150%10%20%30%40%50%60%70%80%90%100 % RESISTANCE TO ANTIBIOTICS IN CARBAPENEMASE-PRODUCING K. PNEUMONIAEST 340ST 307ST 147ST 101ST 11 SEQUENCE TYPES OF CR K. PNEUMONIAE IN SAINT-PETERSBURG, TO CARBAPENEMS IN GRAM-NEGATIVES, 2015- 2016 THANK YOU!
