Antibiotic resistance of Klebsiella pneumoniae against the background of the COVID-19 pandemic: experience of the multidisciplinary hospital

Frequency of bacterial co-infections among patients with COVID-19 is not high, and over-prescribing of antibiotics may contribute the selection of resistant strains of enterobacteria and gram-negative non-fermenting bacteria. The aim of the study was to assess the local features of antibiotic resistance of K. pneumoniae and its genetic mechanisms against background of the COVID-19 infection pandemic. Material and methods. There was selected 37 carbapenem-resistant K. pneumoniae strains isolated in 2016, 2017 and 2020 from hospitalized patients, including 15 strains, isolated from patients with COVID-19 infection. Minimal inhibitory concentrations (MICs) of meropenem and colistin were determined by broth microdilution method. Determination of MICs of eravacycline, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/relebactam was performed using Sensititre diagnostic system on EUMDROXF plates. Susceptibility to 11 combinations of 2 antibiotics was detected by modified method of multiply combination bactericidal testing. For 4 K. pneumoniae strains high-throughput sequencing was performed, followed with the subsequent search for determinants of antibiotic resistance and virulence, assessment of plasmid profiles. Results. All strains were resistant to meropenem (MIC50 32 mg/l, MIC90 128 mg/l) and produced KPC and OXA-48 carbapenemases. Strains isolated in 2016-2017 were susceptible to colistin (MIC <=2 mg/l), in 2020 only 26.7% of the strains retained their susceptibility (MIC50 64 mg/l, MIC90 256 mg/l). Susceptibility to combinations of two antibiotics with colistin included reduced from 84.6-100% in 2016-2017 till 26.6-66.7% in 2020. The strains isolated in 2020 retained their susceptibility to ceftazidime/avibactam (MIC <=1 mg/l). 5 strains resistant to cefiderocol with a MIC 8 mg/l were identified. Strains 2564 and 3125 isolated in 2020 from sputum of patients with COVID-19 infection belonged to different sequence-types (ST12 and ST23) and contained the blaOXA-48 carbapenemase gene, additionally strain 2564 contained the blaKPC-27carbapenemase gene. Resistance to colistin was caused by inactivation of the mgrB genes due to insertion of IS1 and IS5-like transposons. Conclusion. The performed genetic studies demonstrate a diversity of mechanisms of antibiotic resistance in K. pneumoniae leading to the formation of resistance including to antibiotics that haven't been used in Belarus till now.Copyright © 2021 Geotar Media Publishing Group. All Rights Reserved.

Study of Humoral Immunity against Coronavirus Infection COVID-19 in Vaccinated Individuals with Vaccines Available in the Republic of Belarus (Sputnik V (Gam-COVID-Vac), RF and Sinopharm (BBIBP-CorV), PRC)

Relevance. Many countries around the world are developing effective vaccines against SARS-CoV-2. The measure of the effectiveness of the vaccination process has traditionally been antibody production. The frequency and intensity of adverse reactions is also an important factor in making a decision regarding a vaccine. This study presents the results of the evaluation of the formation of humoral immunity and the occurrence of reactions in response to the administration of Sputnik V (Gam-COVID-Vac), RF, and Sinopharm (BBIBP-CorV), PRC. Aim. Analyze immunogenicity and reactogenicity of COVID-19 vaccines used in the Republic of Belarus (Sputnik V and Sinopharm). Materials and methods. Evaluation of postvaccination immune response by enzyme immunoassay and differential enzyme immunoassay for class G immunoglobulins to S-and N-proteins SARS-CoV-2. Blood plasma of the study participants was used as biological material. Blood sampling was performed 3 times: immediately before the first vaccine dose, on day 42, and 6 months after the first vaccine dose. To evaluate the frequency and intensity of postvaccination reactions, study participants were questioned. Results. At 42 days after administration of both vaccines, antibody levels are rising, with a significantly higher quantitative IgG count for the Sputnik V vaccine. This trend is also observed 6 months after the first dose of both vaccines, both among those previously infected with SARS-CoV-2 and those without a history of COVID-19. The comparison of Sputnik V and Sinopharm vaccine groups in terms of IgG (BAU/ml) levels to S-and N-proteins revealed a statistically significant difference in IgG levels to S-protein: the Sputnik V vaccine group had significantly higher IgG levels to S-protein than the Sinopharm vaccine group (p = 0.0000196). The incidence of adverse reactions in this study was 45%. All reactions noted were mild to moderate in severity. The most common were soreness and redness at the injection site, elevated body temperature, and a combination of several reactions. The increased body temperature after vaccination was more common among those vaccinated with the Sputnik V vaccine. Conclusion. Compared to Sinopharm, Sputnik V vaccine produces higher antibody level. Adverse reactions were observed in both vaccinated groups. However, significant statistical differences were found with regard to fever in the Sputnik V vaccine group, which occurred more frequently. © 2023, Numikom. All rights reserved.

Efficacy of COVID-19 vaccination in organized group: results of a prospective study.

Objective: to assess the efficacy of COVID-19 vaccination against in organized, group. Material(s) and Method(s): A total of 122 adults, employees of a higher education institution participated, in the study. Study participants were observed, prospectively and. filled, out a questionnaire where they indicated their age, presence of chronic diseases, history of COVID-19 and. vaccination, status. Finding(s): the study participants were divided, into two groups: 59 vaccinated. (48.36%) and. 63 unvaccinated. (51.64%) individuals with no differences in age between the groups. There were significantly fewer confirmed, cases of COVID-19 in the vaccinated, group (p=0,0008457, df=1;chi2=11,138), significant differences (p=0.0084;df=4;chi2=13.678) were observed, in the number of cases among study participants based, on their vaccination, status. Conclusion(s): participants diagnosed, with pneumonia were 75% unvaccinated. (p=0,00729;df=1;chi2=7,2). AH hospitalized. study participants were unvaccinated. (p=0,004678;chi2=8,0). None of the vaccinated, participants needed, respiratory support (p=0,0455;df=1;chi2=4,0). Chronic disease in vaccinated, subjects made a significant (p=0,04563;df=2;chi2=6,1743) impact on COVID-19 severity.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Efficacy of COVID-19 vaccination in organized group: results of a prospective study.

Objective: to assess the efficacy of COVID-19 vaccination against in organized, group. Material(s) and Method(s): A total of 122 adults, employees of a higher education institution participated, in the study. Study participants were observed, prospectively and. filled, out a questionnaire where they indicated their age, presence of chronic diseases, history of COVID-19 and. vaccination, status. Finding(s): the study participants were divided, into two groups: 59 vaccinated. (48.36%) and. 63 unvaccinated. (51.64%) individuals with no differences in age between the groups. There were significantly fewer confirmed, cases of COVID-19 in the vaccinated, group (p=0,0008457, df=1;chi2=11,138), significant differences (p=0.0084;df=4;chi2=13.678) were observed, in the number of cases among study participants based, on their vaccination, status. Conclusion(s): participants diagnosed, with pneumonia were 75% unvaccinated. (p=0,00729;df=1;chi2=7,2). AH hospitalized. study participants were unvaccinated. (p=0,004678;chi2=8,0). None of the vaccinated, participants needed, respiratory support (p=0,0455;df=1;chi2=4,0). Chronic disease in vaccinated, subjects made a significant (p=0,04563;df=2;chi2=6,1743) impact on COVID-19 severity.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Efficacy of COVID-19 vaccination in organized group: results of a prospective study

Objective: to assess the efficacy of COVID-19 vaccination against in organized, group. Materials and methods: A total of 122 adults, employees of a higher education institution participated, in the study. Study participants were observed, prospectively and. filled, out a questionnaire where they indicated their age, presence of chronic diseases, history of COVID-19 and. vaccination, status. Findings: the study participants were divided, into two groups: 59 vaccinated. (48.36%) and. 63 unvaccinated. (51.64%) individuals with no differences in age between the groups. There were significantly fewer confirmed, cases of COVID-19 in the vaccinated, group (р=0,0008457, df=1;χ2=11,138), significant differences (p=0.0084;df=4;χ2=13.678) were observed, in the number of cases among study participants based, on their vaccination, status. Conclusion: participants diagnosed, with pneumonia were 75% unvaccinated. (p=0,00729;df=1;χ2=7,2). AH hospitalized. study participants were unvaccinated. (p=0,004678;χ2=8,0). None of the vaccinated, participants needed, respiratory support (p=0,0455;df=1;χ2=4,0). Chronic disease in vaccinated, subjects made a significant (p=0,04563;df=2;χ2=6,1743) impact on COVID-19 severity. © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Efficacy of COVID-19 vaccination in organized group: results of a prospective study.

Objective: to assess the efficacy of COVID-19 vaccination against in organized, group. Material(s) and Method(s): A total of 122 adults, employees of a higher education institution participated, in the study. Study participants were observed, prospectively and. filled, out a questionnaire where they indicated their age, presence of chronic diseases, history of COVID-19 and. vaccination, status. Finding(s): the study participants were divided, into two groups: 59 vaccinated. (48.36%) and. 63 unvaccinated. (51.64%) individuals with no differences in age between the groups. There were significantly fewer confirmed, cases of COVID-19 in the vaccinated, group (p=0,0008457, df=1;chi2=11,138), significant differences (p=0.0084;df=4;chi2=13.678) were observed, in the number of cases among study participants based, on their vaccination, status. Conclusion(s): participants diagnosed, with pneumonia were 75% unvaccinated. (p=0,00729;df=1;chi2=7,2). AH hospitalized. study participants were unvaccinated. (p=0,004678;chi2=8,0). None of the vaccinated, participants needed, respiratory support (p=0,0455;df=1;chi2=4,0). Chronic disease in vaccinated, subjects made a significant (p=0,04563;df=2;chi2=6,1743) impact on COVID-19 severity.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Antibiotic resistance of Klebsiella pneumoniae against the background of the COVID-19 pandemic: experience of the multidisciplinary hospital

Frequency of bacterial co-infections among patients with COVID-19 is not high, and over-prescribing of antibiotics may contribute the selection of resistant strains of enterobacteria and gram-negative non-fermenting bacteria. The aim of the study was to assess the local features of antibiotic resistance of K. pneumoniae and its genetic mechanisms against background of the COVID-19 infection pandemic. Material and methods. There was selected 37 carbapenem-resistant K. pneumoniae strains isolated in 2016, 2017 and 2020 from hospitalized patients, including 15 strains, isolated from patients with COVID-19 infection. Minimal inhibitory concentrations (MICs) of meropenem and colistin were determined by broth microdilution method. Determination of MICs of eravacycline, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/relebactam was performed using Sensititre diagnostic system on EUMDROXF plates. Susceptibility to 11 combinations of 2 antibiotics was detected by modified method of multiply combination bactericidal testing. For 4 K. pneumoniae strains high-throughput sequencing was performed, followed with the subsequent search for determinants of antibiotic resistance and virulence, assessment of plasmid profiles. Results. All strains were resistant to meropenem (MIC50 32 mg/l, MIC90 128 mg/l) and produced KPC and OXA-48 carbapenemases. Strains isolated in 2016–2017 were susceptible to colistin (MIC ≤2 mg/l), in 2020 only 26.7% of the strains retained their susceptibility (MIC50 64 mg/l, MIC90 256 mg/l). Susceptibility to combinations of two antibiotics with colistin included reduced from 84.6–100% in 2016–2017 till 26.6–66.7% in 2020. The strains isolated in 2020 retained their susceptibility to ceftazidime/avibactam (MIC ≤1 mg/l). 5 strains resistant to cefiderocol with a MIC 8 mg/l were identified. Strains 2564 and 3125 isolated in 2020 from sputum of patients with COVID-19 infection belonged to different sequence-types (ST12 and ST23) and contained the blaOXA-48 carbapenemase gene, additionally strain 2564 contained the blaKPC-27carbapenemase gene. Resistance to colistin was caused by inactivation of the mgrB genes due to insertion of IS1 and IS5-like transposons. Conclusion. The performed genetic studies demonstrate a diversity of mechanisms of antibiotic resistance in K. pneumoniae leading to the formation of resistance including to antibiotics that haven’t been used in Belarus till now. © 2021 Geotar Media Publishing Group. All Rights Reserved.