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Pskov Region
Challenges
Key Tasks
Potential
Tamara Nyunyushkina, Pskov Regional Clinical Hospital,
epidemiologist; senior ...
Challenges
• 1.Lack of access to bacteriological tests for the majority of
medical institutions.
• 2.Staff shortage: lack ...
Major pathogens antibiotic resistance profiles 2018г.
• Acinetobacteria 111 isolates E.coli 226 isolates
Klebsiella 355 isolates Pseudomonas Aureginosa 125 isolates
Key Tasks
1. We are in need of a concept of state-of-the-art
microbiological service to be established in the region.
2. R...
Potential
• 1. A new bacteriological laboratory is equipped in the new
prenatal center, but there is no personnel.
• 2. Th...
Major Pathogens Antibiotic Resistance
in Purulent Septic Infections
Data from Pskov Regional Hospital
• WalkAway automatic analyzer is used to
identify isolated pathogens
• WHONET program is used for resistance data
analysis.
Сomparative analysis of epidemiologically relevant opportunistic
pathogenic bacteria: their proportion in all isolates rec...
Of 355 Klebsiella Isolates
• - 90 (25%) – multiresistant to 6 main AB,
• - 14 (4%) – pandrug resistant to 26 AB.
• Such ch...
Etiological structure of the clinical and bacteriological analyses –
aggregate numbers for the hospital in 2018г. (%)
Tota...
Antibiotic resistance profiles of the key epidemiologically
significant pathogens, 2018
Acinetobacteria 111 isolates E.col...
Antibiotic resistance profiles of the key epidemiologically
significant pathogens, 2018
Klebsiella spp 355 isolates Ps. Ae...
Klebsiella spp. resistance to antibiotics in PSI patients,
2017-2018 (% resistant isolates)
0
20
40
60
80
100
120
cefopera...
Acinetobacter spp. resistance to antibiotics in PSI
patients, 2017-2018 (% of resistant isolates)
0
20
40
60
80
100
120
ce...
E.coli resistance to antibiotics in PSI patients, 2017-
2018 (% of resistant isolates)
0
10
20
30
40
50
60
70
80
90
100
ce...
P.aeruginosa resistance to antibiotics in PSI
patients, 2017-2018 (% of resistant isolates)
0
20
40
60
80
100
120
ceftazid...
• 133 pathogen isolates were identified with
WalkAway; the following microorganisms were
discovered:
• ESBL producers:
• -...
Conclusions
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Presentations from NW Russian regions: Pskov region

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Presentations from NW Russian regions – gaps and challenges, opportunities and strengths: Pskov region

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Presentations from NW Russian regions: Pskov region

  1. 1. Pskov Region Challenges Key Tasks Potential Tamara Nyunyushkina, Pskov Regional Clinical Hospital, epidemiologist; senior external expert at Pskov Regional Committee for Healthcare
  2. 2. Challenges • 1.Lack of access to bacteriological tests for the majority of medical institutions. • 2.Staff shortage: lack of bacteriologists • 3. Insufficient training of clinicians in antimicrobial therapy. • 4. Inefficient use of antibiotics. • 5. Lack of clinical pharmacologists even in large inpatient facilities. • 6.Lack of hospital epidemiologists. • 7.Development of resistance to antibiotics.
  3. 3. Major pathogens antibiotic resistance profiles 2018г. • Acinetobacteria 111 isolates E.coli 226 isolates
  4. 4. Klebsiella 355 isolates Pseudomonas Aureginosa 125 isolates
  5. 5. Key Tasks 1. We are in need of a concept of state-of-the-art microbiological service to be established in the region. 2. Recruitment and staffing. 3. Introduction of modern methods of microbiological diagnostics (automatic analyzers, blood incubators, MALDI- TOF mass spectrometry) 4. Provision of modern equipment. 5. Improving the quality of clinicians training in antibiotic therapy 5. Staffing more hospital epidemiologists into inpatient medical facilities
  6. 6. Potential • 1. A new bacteriological laboratory is equipped in the new prenatal center, but there is no personnel. • 2. The Center for the Prevention of AIDS and Infectious Diseases conducts PCR diagnostics of most infections and an up-to-date bacteriological laboratory will be commissioned there soon. • 3.Training in "Laboratory work" and "Epidemiology“ residency under target training assignments from the region.
  7. 7. Major Pathogens Antibiotic Resistance in Purulent Septic Infections Data from Pskov Regional Hospital
  8. 8. • WalkAway automatic analyzer is used to identify isolated pathogens • WHONET program is used for resistance data analysis.
  9. 9. Сomparative analysis of epidemiologically relevant opportunistic pathogenic bacteria: their proportion in all isolates recovered from patients with PSI (% of all isolated opportunistic pathogenic bacteria) Klebsiella Ps. Aureginosa Acinetobacteria
  10. 10. Of 355 Klebsiella Isolates • - 90 (25%) – multiresistant to 6 main AB, • - 14 (4%) – pandrug resistant to 26 AB. • Such change in the etiological structure of PSI causes new problems in antibiotic therapy and jeopardizes infectious safety.
  11. 11. Etiological structure of the clinical and bacteriological analyses – aggregate numbers for the hospital in 2018г. (%) Total number of isolates:1378 26 16 1115 15 8 9 8 Inpatientdepartment Klebsiella spp E.Coli Other Coliforms Staphylococci Enterococci Acinetobacteria Ps. aeroginosa Fungi
  12. 12. Antibiotic resistance profiles of the key epidemiologically significant pathogens, 2018 Acinetobacteria 111 isolates E.coli 226 isolates
  13. 13. Antibiotic resistance profiles of the key epidemiologically significant pathogens, 2018 Klebsiella spp 355 isolates Ps. Aeroginosa 125 isolates
  14. 14. Klebsiella spp. resistance to antibiotics in PSI patients, 2017-2018 (% resistant isolates) 0 20 40 60 80 100 120 cefoperazone/sulbactamertapenem am picillin/sulbactamceftriaxone m eropenem am ikacincefazolinecefotaxim e levofloxacin gentam ycine 2017 2018
  15. 15. Acinetobacter spp. resistance to antibiotics in PSI patients, 2017-2018 (% of resistant isolates) 0 20 40 60 80 100 120 cefoperazone/sulbactamertapenem am picillin/sulbactamceftriaxone m eropenem am ikacincefazolinecefotaxim e levofloxacin gentam ycine 2017 2018
  16. 16. E.coli resistance to antibiotics in PSI patients, 2017- 2018 (% of resistant isolates) 0 10 20 30 40 50 60 70 80 90 100 ceftazidim e am picillin/sulbactamceftriaxonem eropenem am ikacin cefazolinecefotaxim elevofloxacinceftazidim egentam ycine im ipenem am picillin 2017 2018
  17. 17. P.aeruginosa resistance to antibiotics in PSI patients, 2017-2018 (% of resistant isolates) 0 20 40 60 80 100 120 ceftazidim e ceftriaxone m eropenem am ikacin cefepim e cefoperazone cefotaxim e levofloxacin 2017 2018
  18. 18. • 133 pathogen isolates were identified with WalkAway; the following microorganisms were discovered: • ESBL producers: • -K.pneumoniae - 21 isolates • -E.coli - 9 isolates • IB isolates (resistant to all betalactam antibiotics): • P.aeruginosa - 7 isolates
  19. 19. Conclusions

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