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Directions of Epidemiological Surveillance of Chronic Lung Infections Caused by Burkholderia cepacia Complex, Achromobacter spp., Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus in Patients with Cystic Fibrosis

https://doi.org/10.31631/2073-3046-2020-19-1-14-23

Abstract

Relevance. The absence of a system of epidemiological surveillance of chronic lung infection (CLI) in patients with cystic fibrosis (CF) led to the spread of Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia cepacia complex and Achromobacter spp. among patients with CF during hospitalizations, that is proved by numerous cases of infection in patients with CF treated in various Russian clinics.

Aims. Determine the directions of epidemiological surveillance (ES) for CLI in patients with CF and preventive measures necessary to counteract the cross-infections among patients with CF and the spread of the dominant pathogens of CLI in the hospital.

Materials and methods. A complex of epidemiological, microbiological and molecular genetic methods was used.

Results and discussion. Based on the results of studies of the epidemiological and microbiological features of infections caused by the above-mentioned pathogens, the directions of ES and preventive measures for CF were determined. The tasks of the information-analytical unit, including the monitoring of morbidity and microbiological monitoring, are substantiated. It has been established that in the framework of microbiological monitoring, it is necessary to conduct bacteriological examination of biomaterial from the respiratory tract of patients with CF not less than 1 time per quarter, as well as at each outpatient visit and at hospitalization. The necessity of studying the phenotypic properties of pathogens contributing to long-term persistence in the patient's body of the CF, the definition and monitoring of the antibiotic sensitivity of microorganisms isolated from the patient over time, and the study of hypermutability was shown. One of the main tasks of monitoring is molecular genetic analysis of pathogens by PCR for the purpose of intraspecies identification, typing of pathogens and detection of epidemic markers and clones (including international ones), identification of genetic determinants of antibiotic resistance.

Conclusion. The introduction of ES for chronic lung infection will improve the quality of etiological diagnosis, will contribute early identification of the sources of infections and prevent the spread of CLI pathogens among patients with CF in hospitals and in non-hospital conditions, as well as optimize the tactics of CLI antimicrobial therapy. The main directions of preventing the spread of CLI pathogens should be the separation of patients with various infections during outpatient examination and isolation during hospitalization.

About the Authors

L. R. Avetisyan
National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya
Russian Federation

Lusine R. Avetisyan - Cand. Sci. (Med.), Leading Researcher at Laboratory of Molecular Epidemiology of Nosocomial Infections.

18, Gamalei st., Moscow, 123098, +7-903-1231611



I. A. Shaginyan
National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya
Russian Federation

Igor A. Shaginyan - Dr. Sci. (Med.), head of Laboratory of Molecular Epidemiology of Nosocomial Infections.

Ga-maleya st. 18, Moscow, 123098,+7(499)193-61-17



M. Yu. Chernukha
National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya
Russian Federation

Marina Yu. Chernukha - Dr. Sci. (Med.), leading researcher at Laboratory of Molecular Epidemiology of Nosocomial Infections.

Gamaleya st. 18, Moscow, 123098. +7 (499)193-55-94



E. M. Burmistrov
National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya
Russian Federation

Egor M. Burmistrov - junior researcher of Laboratory of Molecular Epidemiology.

Gamaleya st. 18, Moscow, 123098,+7(499)193-55-94



O. S. Medvedeva
National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya
Russian Federation

Olga S. Medvedeva - junior researcher at Laboratory of Molecular Epidemiology.

Gamaleya st. 18, Moscow, 123098,+7(499)193-55-94



E. V. Rusakova
National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya
Russian Federation

Ekaterina V. Rusakova - Dr. Sci. (Med.), professor, leading researcher of Scientific and Department of National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya.

Gamaleya st. 18, Moscow, 123098,+7(903)2519610



E. A. Siyanova
National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya
Russian Federation

Ekaterina A. Siyanova - junior researcher at Laboratory of Molecular Epidemiology of Nosocomial Infections.

Gamaleya st. 18, Moscow, 123098,+7(499)1935594



Е. I. Kondrateva
Research Centre of Medical Genetics
Russian Federation

Elena I. Kondrateva - Dr. Sci. (Med.), professor, head of Scientific Department of Cystic Fibrosis of MGSC.

115478 Moscow, 1 Moskvorechie, +7(499)1370197



A. G. Chuchlin
Pirogov Russian National Research Medical University
Russian Federation

Alexandr G. Chuchalin - Dr. Sci. (Med.), Academic of RAS, head of department of Hospital Therapy of Pirogov RNRMU.

Ostrovitianov str. 1, Moscow 117997, +7 (495) 43436-90



A. L. Ginzburg
National Research Center for Epidemiology and Microbiology named after the honorary academician NF Gamaleya
Russian Federation

Alexandr L.Ginzburg - Dr. Sci. (Biol.), Academic of RAS, head NRCEM named after the honorary academician N.F. Gamaleya.

Gamaleya st. 18, Moscow, 123098, +7 (499) 1933001



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Review

For citations:


Avetisyan L.R., Shaginyan I.A., Chernukha M.Yu., Burmistrov E.M., Medvedeva O.S., Rusakova E.V., Siyanova E.A., Kondrateva Е.I., Chuchlin A.G., Ginzburg A.L. Directions of Epidemiological Surveillance of Chronic Lung Infections Caused by Burkholderia cepacia Complex, Achromobacter spp., Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus in Patients with Cystic Fibrosis. Epidemiology and Vaccinal Prevention. 2020;19(1):14-23. (In Russ.) https://doi.org/10.31631/2073-3046-2020-19-1-14-23

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ISSN 2073-3046 (Print)
ISSN 2619-0494 (Online)