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Presentations from NW Russian regions: St. Petersburg

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Presentations from NW Russian regions – gaps and challenges, opportunities and strengths: St. Petersburg

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Presentations from NW Russian regions: St. Petersburg

  1. 1. Current issues of microbiological resistance in St. Petersburg - the view of a clinician Thematic Programme for Health Promotion and prevention: Nordic – Russian Cooperation on Antimicrobial Resistance (AMR) Containment, 2019-2020» A. Yakovlev, V.Musatov Botkin Infectious Disease Hospital 28th February, 2019
  2. 2. Number of inpatients trend 28 537 35 146 33 395 36 827 35 531 39 141 39 718 44 717 45 999 47 782 57 313 1420 1210 1210 1149 1149 1147 1147 1000 1200 1400 1600 1800 2000 2200 2400 0 10000 20000 30000 40000 50000 60000 70000 1994 2004 2005 2006 2012 2013 2014 2015 2016 2017 2018 Number of beds
  3. 3. Inpatients in the Botkin Infectious Disease Hospital Indications Years 2014 2015 2016 2017 2018 Total inpatients in the hospital 39 718 44 717 45741 47 782 57 313 Acute Intestinal Infection 10506 10 446 11 452 10432 13 434 Acute and chronic viral hepatitis 4038 4070 3342 4894 5187 Flu 648 680 1447 703 1042 ARVI 7617 3687 11 093 10262 9056
  4. 4. Microbiological monitoring (according to the Botkin Hospital laboratory)
  5. 5. Isolation of cultures from feces Potentially pathogenic flora 835 1865 1384 2350 224 792 1510 1374 1749 1490 1440 663 1067 2785 1067 666 1535 1518 1047 1778 1027 687 978 2810 1845 653 678 0 2000 4000 6000 8000 10000 12000 St. aureus Proteus Candida (др) Citrobacter Klebsiella Enterobacter EHEC Pseudomonas Others Pathogenic microorganisms 1429 938 1057 961 148 135 227 209 152 142 216 142 44 59 34 20 17 4 8 6 3 0 500 1000 1500 2000 2014 2015 2016 2017 Salmonella spp EPEC Shigella spp Campilobacter Typhus, paratyphoid Yersinia spp 1341 1542 1278 1790 76,600 83,200 83,500 78,500 # of tests 10279 11373 9052 6932 «+» tests«+» проб
  6. 6. Isolation of cultures from blood 361 511 344 99 67 52 248 219 206 0 200 400 600 800 1000 2015 2016 2017 Staph. coagulase «-» Staph. aureus Other m/о 17 35 3 29 3 37 34 19 18 15 4 37 6 169 119 128 0 100 200 300 K. pneumonia Klebsiella spp E. coli Enterococcus faecalis Enterococcus spp Other m/о > 15 various m/о > 15 various m/о ≈ 40 various m/о 6108 5217 5211 Number of samples 602 797 708 Total «+» tests 57,1% 64,1% 51,0% 9,5% 8,4% 13,9%
  7. 7. Culture isolation from CSF 65 78 105 62 20 18 16 18 3 10 4 11 8 3 5 3 4 4 2 7 3 7 3 3 9 11 13 8 0 20 40 60 80 100 120 140 160 2014 2015 2016 2017 Cr. neoformans S. pneumonia Listeria monocytogenes N. meningitidis S. aureus S. coagulase«-» Others 907 1716 1186 Number of samples 1375 112 «+» 131 «+» 148 «+» 112 «+»
  8. 8. Comparison of resistance of a number of pathogens • Data from Botkin Hospital (2015-2017 ) • MRSA 9,1 – 8,9 – 5,8%, MRSA mean level 8,3% • K. рneumonia having ESBL, mean value– 32,1% • E.coli, having ESBL, mean value– 28,9% • In December 2018 and in February 2019 впервые в of vancomycin resistant enterococcus (VRE) cultures were isolated for the first time • ECDC data (2016) • MRSA 13.7%. In 2013-2016 there was statistically significant decrease in the level of MRSA in all countries • K. Pneumonia - 34.5% were resistant to at least one antimicrobial agent - Fq, 3rd generation Cs, carbapenems, aminoglycosides • E.coli - 58.6% were resistant to at least one antimicrobial agent - aminopenicillins, Fq, III generation Cs, carbapenems, aminoglycosides Мусатов В.Б. с соавт., Вестник Российской военно-медицинской академии, 2018, 4 (64) пр. 2 с. 63
  9. 9. Monitoring of the microorganisms resistance in St. Pet. • Since 2008, microorganisms isolated in the city hospitals are being monitored, the analysis is performed with the help of the WHONET program database • In 2008 - 2014 information on more than 250,000 cultures has been entered. • Most important pathogens – S. aureus 17% – E coli 12% – K.pneumonia 8–10% • The proportion of microorganisms with established resistance (2014 ) – MRSA 19,6% – Resistance to Cs of III generation • E. coli 30,9% – Resistance to carbopenems • K. pneumonia 67,2% • P. aeruoginosa 37,5% Резистентность микроорганизмов в Санкт-Петербурге» Зуева Л.П., с соавт., 2015
  10. 10. MBT multiple drug resistance 14,0% 13,7% The proportion of patients discharging bacteria 148 165Number of primary detected patients with MDR 2017 2016 42,2% 26,0% %% of all isolated cultures 143 131Number of detected patients with MDR 2017 2011-2012SPb Botkin Hospital
  11. 11. PROPOSALS • To continue monitoring, to organize a system for obtaining information on the entire range of microbiological resistance data available in St. Petersburg • To discuss the issues of pathogenic viruses resistance (herpes group, HIV) • To discuss the feasibility of developing protocols for clinical use of antimicrobial agents.
  12. 12. V. Musatov Botkin Infectious Disease Hospital Тел 717 77 61, 409 79 99 doctormusatov@gmail.com

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