Preview

Antibiot Khimioter = Antibiotics and Chemotherapy

Advanced search

Microbiological Monitoring of Purulent Complications in Burn Patients and Molecular Genetic Features of Methicillin-Resistant Staphylococcus aureus (MRSA)

Abstract

The aim of the study was to research the microflora of suppurative complications, its antibiotic resistance, and the molecular genetic features of MRSA in burn patients. Material and methods. The microflora of biopsy specimens, wound fluid from 145 patients with thermal burns was investigated on the first day and on the 10-50th days of stay in the burn center of the Regional Clinical Hospital in 2013-2016. The molecular genetic features of 12 strains of MRSA isolated from different burn patients have been studied. Methods used: bacteriological, PCR, M-PCR, sequencing, PFGE, agglutination reaction. Results. On the first day of hospitalization, when biopsy specimen and wound fluid were taken, microbial growth was detected in 25.5% of cases, gram-positive microorganisms, in particular MSSA (37.8%), dominated. On the 10-50th days of hospitalization, growth was obtained in 93.2% of cases, Gram-negative microflora (53.4%) dominated, with a significant role played by Pseudomonas spp. and Acinetobacter spp. (38.0%), characterized by a high degree of resistance to antimicrobial drugs: XDR - 18%, PDR - 67%. On the 10-50th days of hospitalization, a significant role was played by staphylococci (38.7%), while the proportion of MRSA was 62.2%. Circulation of one MRSA clone in burn patients - ST239/spa3(t037)/a§r//SCCmecIII.1.1.2(IIIA)/CoaIy, characterized by multiple resistance to antimicrobial agents, was established.

About the Authors

O. E. Khokhlova
Krasnoyarsk State Medical University named after Prof. V.F.Voino-Yasenetski; Russia-Japan Center of Microbiology, Metagenomics and Infectious Diseases
Russian Federation


O. V. Peryanova
Krasnoyarsk State Medical University named after Prof. V.F.Voino-Yasenetski; Russia-Japan Center of Microbiology, Metagenomics and Infectious Diseases
Russian Federation


I. V. Vladimirov
Regional Clinical Hospital
Russian Federation


V. A. Matskevich
Regional Clinical Hospital
Russian Federation


N. K. Potkina
Russia-Japan Center of Microbiology, Metagenomics and Infectious Diseases
Russian Federation


D. N. Kapshuk
Krasnoyarsk State Medical University named after Prof. V.F.Voino-Yasenetski
Russian Federation


L. N. Kopytko
Regional Clinical Hospital
Russian Federation


V. V. Gostev
Children's Scientific and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency
Russian Federation


S. V. Sidorenko
Children's Scientific and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency
Russian Federation


Ya. .. Iwao
International Medical Educational Research Center (IMERC)
Russian Federation


T. .. Yamamoto
Russia-Japan Center of Microbiology, Metagenomics and Infectious Diseases; International Medical Educational Research Center (IMERC)
Russian Federation


References

1. Church D, Elsayed S., Reid O., Winston B., Lindsay R. Burn wound infections. Clin Microbiol Rev 2006; 19: 403-434.

2. Alexander J.W. Mechanism of immunologic suppression in burn injury. J Trauma 1990; 30 (12 Suppl): S70-75.

3. Griswold J.A. White blood cell response to burn injury. Semin Nephrol 1993; 13: 409-415.

4. Hansbrough J.F., Field T.O. Jr, Gadd M.A., Soderberg C. Immune response modulation after burn injury: T cells and antibodies. J Burn Care Rehabil 1987; 8: 509-512.

5. Heideman M, Bengtsson A. The immunologic response to thermal injury. World J Surg 1992; 16: 53-56.

6. Lederer J.A., Rodrick M.L., Mannick J.A. The effects of injury on the adaptive immune response. Shock 1999; 11: 153-159.

7. Jason P. Heard J.P., McDonald K.M., Xing Y., Kluesner K.M, Liao J. et al. Regional and National Review of Factors Associated With Burn Wound Cellulitis. Journal of Burn Care & Research 2015; 36: 1: 23-32.

8. Винник Ю.С., Маркелова H.M., Тюрюмин B.C. Современные методы лечения гнойных ран. Сибирское медицинское обозрение. - 2013. - № 1. - С. 18-24.

9. Jeschke M.G., Pinto R., Kraft R., Nathens A.B., Finnerty C.C., Gamelli R.L. et al. Morbidity and survival probability in burn patients in modern burn care. Crit CareMed 2015; 43: 808-815.

10. Mann E.A., Baun M.M., Meininger J.C, Wade C.E. Comparison of mortality associated with sepsis in the burn, trauma, and general intensive care unit patient: A systematic review of the literature. Shock 2012; 37: 4-16.

11. Alp E., Coruh A., Gunay G.K., Yontar Y., Doganay M. Risk factors for nosocomial infection and mortality in burn patients: 10 years of experience at a university hospital. J Burn Care Res 2012; 33: 379-385.

12. Collier J., Gottlieb L.J., Alverdy J.C. Stochasticity among Antibiotic-Resistance Profiles of Common Burn-Related Pathogens over a Six-Year Period Zachary. Surgical infections 2017; 18: 3: 327-335.

13. Сабирова Е.В., Гординская Н.А., Абрамова Н.В., Некаева Е.С. Антибиотикорезистентность нозокомиальных штаммов Staphylococcus spp., выделенных в ожоговом центре в 2002-2008 гг. Клин микробиол антимикроб химиотер. - 2010. - Т. - 12. - №1. - С. 77-81.

14. Воробьева О.Н., Денисенко Л.И., Жилина Н.М. Этиология гнойно-септических процессов у ожоговых больных Бюллетень СО РАМН. - 2010. - Т. 30. - № 6. - С. 57-63

15. Самарцев В.А., Еньчева Ю.А., Кузнецова М.В., Карпунина Т.И. Особенности инфицирования ожоговых ран Новости хирургии. - 2014. - Т. 22. - № 2. - С. 199-206

16. Туркутюков В.Б., Ибрагимова Т.Д., Шмагунова Е.В. Этиология гнойно-септических осложнений при ожоговой травме и мониторинг чувствительности микроорганизмов к антибиотикам. Тихоокеанский медицинский журнал. - 2012. - № 4. - С. 70-72

17. Takano T., Hung W.C., Shibuya M. et al. A new local variant (ST764) of the globally disseminated ST5 lineage of hospital-associated methicillin-resistant Staphylococcus aureus (MRSA) carrying the virulence determinants of community-associated MRSA. Antimicrob Agents Chemother 2013; 57: 1589-1595.

18. International working group on the classification of staphylococcal cassette chromosome elements (IWG-SCC). Classification of Staphylococcal Cassette Chromosome mec (SCCmec): guidelines for reporting novel SCCmec elements. Antimicrob Agents Chemother 2009; 53: 4961-4967.

19. Kondo Y., Ito T., Ma X.X., Watanabe S., Kreiswirth B.N., Etienne J., Hiramatsu K. Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. Antimicrob Agents Chemother 2007; 51: 264-274.

20. Iwao Y., Khokhlova O.E., Takano T., Hung W.C., Isobe H., Peryanova O.V. et al. Fatal pneumonia in HIVinfected patients from a novel ST239 methicillin-resistant Staphylococcus aureus carrying the toxic shock syndrome toxin-1 gene in Krasnoyarsk, Siberian Russia. Jpn J Infect Dis 2012; 65: 184-186.

21. Kado and Liu Kado C.I., Liu S.T. Rapid procedure for detection and isolation of large and small plasmids. J Bacteriol 1981; 145: 1365-1373.

22. Гостев В.В., Калиногорская О.С., Попенко Л.Н., Черненькая Т.В., Науменко З.С., Ворошилова Т.М. и др. Антибиотикорезистентность метициллинорезистентных Staphylococcus aureus, циркулирующих в Российской Федерации. Антибиотики и химиотер. - 2015. - Т. 60. - № 1-2. - С. 3-9.

23. Романов А.В., Чернов E.A., Эйдельштейн М.В. Молекулярная эпидемиология внутрибольничных золотистых стафилококков в стационарах различных регионов России. Молекулярная медицина. - 2013. - № 4. - С. 55-64

24. Khokhlova O.E., Hung W-C, Wan T-W. et al. Healthcare- and Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) and Fatal Pneumonia with Pediatric Deaths in Krasnoyarsk, Siberian Russia: Unique MRSA's Multiple Virulence Factors, Genome, and Stepwise Evolution. PloS ONE 2015; 1: 1-30


Review

For citations:


Khokhlova O.E., Peryanova O.V., Vladimirov I.V., Matskevich V.A., Potkina N.K., Kapshuk D.N., Kopytko L.N., Gostev V.V., Sidorenko S.V., Iwao Ya..., Yamamoto T... Microbiological Monitoring of Purulent Complications in Burn Patients and Molecular Genetic Features of Methicillin-Resistant Staphylococcus aureus (MRSA). Antibiot Khimioter = Antibiotics and Chemotherapy. 2017;62(9-10):27-33. (In Russ.)

Views: 408


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 0235-2990 (Print)