Healthcare-associated infections in postoperative patients with intracranial aneurysm in Ukraine.

OBJECTIVE: Aim: to investigate the epidemiology, microbiology, and risk factors for healthcare-associated infections (HAIs) in postoperative patients with intracranial aneurysm in Ukraine. PATIENTS AND METHODS: Materials and Methods: Retrospective cohort study was conducted from January 2018 to December 2022 in four tertiary care hospitals of Ukraine. The diagnostic criteria were based on specific HAI site were adapted from the CDC/NHSN case definitions. RESULTS: Results: Of 1,084 postoperative patients with intracranial aneurysm, 128 (11.4%) HAIs were observed. The most common of HAI type was possible ventilatorassociated pneumonia (38.2%) followed by central line-associated bloodstream infections (33.8%), catheter -associated urinary tract infection (18.5%), and surgical site infection (9.6%). Inpatient mortality from HAI was 5.1%. Emergency admission, mechanical ventilation, taking antiplatelet aggregation drugs, albumin reduction, hyperglycaemia, hyponatremia, surgical procedure, operation time > 4 h, mechanical ventilation, urinary catheter, and central venous catheterization were risk factors associated with HAI in patients with intracranial aneurysm surgery. A total of 26% cases of HAIs by MDROs were notified over the study period. Klebsiella spp. - essentially K. pneumoniae - were the most frequent, followed by Enterobacter spp. and Escherichia coli. Carbapenemase production in Enterobacterales constituted the most frequent mechanism of resistance, while ESBL-production in Enterobacterales and meticillin-resistance in Staphylococcus aureus (MRSA) were detected in 65,7% 62,3% and 20% of cases, respectively. CONCLUSION: Conclusions: The present study showed that HAIs is a common complication in postoperative patients with intracranial aneurysm in Ukraine and multidrugresistant organisms the major pathogen causing infection.

Healthcare-associated infections after neurosurgical procedures in Ukraine: a multicentre study (2020-2022).

OBJECTIVE: Aim: To investigate the epidemiology, microbiology, and risk factors for healthcare-associated infections (HAIs) after a neurosurgical procedure in Ukraine. PATIENTS AND METHODS: Materials and Methods: Prospective multicentre surveillance was conducted from January 2020 to December 2022 in 10 regional hospitals of Ukraine. Definitions of HAIs were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. RESULTS: Results: Of 8,623 neurosurgical patients, 1,579 (18.3%) HAIs were observed. The most frequently of HAI types were pneumonia (38.4%), surgical site infection (34.2%), urinary tract infection (18.1%) and bloodstream infection (9.3%). Death during hospitalization was reported in 11.3% of HAI cases. There was an association between HAIs after neurosurgical procedures and patients with diabetes mellitus, end-stage renal disease undergoing dialysis, and leukaemia. The strongest independent associations were observed for intubation, urinary catheters, and vascular catheters. Klebsiella pneumoniae were most commonly reported, accounting for 25.1% of all organisms, followed by Escherichia coli (17.6%), Staphylococcus aureus (9.9%), Pseudomonas aeruginosa (8.9%), Acinetobacter baumannii (8.5%), coagulase-negative staphylococci (6.8%), and Streptococcus spp. (5.5%). In total, 76.3% isolates from neurosurgical patients were MDROs. Antimicrobial resistance in Ukraine varies greatly by bacterial species, antimicrobial group, and region. CONCLUSION: Conclusions: Healthcare-associated infections are a cause for mortality and morbidity among neurosurgical patients. This is due to increase emergence of antimicrobial-resistant pathogens. Routinely collected surveillance data are of great value as a basis for studying the consequences of HAIs.

HEALTHCARE-ASSOCIATED INFECTION IN NEUROSURGICAL PATIENTS IN UKRAINE: RESULTS OF A MULTICENTER STUDY (2017-2019).

OBJECTIVE: The aim: To obtain the estimates of the current prevalence of healthcare-associated infection among neurosurgical patients and determine the antimicrobial resistance of responsible pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data of HAIs among neurosurgical patients from 2017 to 2019 in 7 regional hospitals. Definitions of HAI were used from the CDC/ NHSN. RESULTS: Results: Of 9,711 neurosurgical patients, 1,031 (20.9%) HAIs were observed. The most frequently of HAI types were surgical site infection (53.2%), pneumonia (17.3%), urinary tract infection (15.1%) and bloodstream infection (14.4%). The overall prevalence of HAIs was 20.9% within three months and was 12.8% during one month surveillance period. Death during hospitalization was reported in 11.3% of HAI cases. Escherichia coli were most commonly reported, accounting for 24.3% of all organisms, followed by Staphylococcus aureus (15.9%), Enterococcus spp (14.6%), Pseudomonas aeruginosa (13.4%), and Klebsiella pneumoniae (9.8%). Meticillin resistance was 34.6% of S.aureus isolates. Vancomycin resistance was in 7.1% of isolated enterococci. Among the gram-negative bacteria, third-generation cephalosporins resistance was found in 48.5% of K.pneumoniae and in 34.3% of E. coli isolates. Carbapenem resistance was reported in 11.7% of all included Enterobacteriaceae, also highest in K.pneumoniae, and in 32.4% of P.aeruginosa isolates and in 67.2% of Acinetobacter spp. isolates. CONCLUSION: Conclusions: Healthcare-associated infections are a cause for mortality and morbidity among hospitalized neurosurgical patients. This is due to increase emergence of antimicrobial-resistant pathogens. Routinely collected surveillance data are of great value as a basis for studying the consequences of HAIs.