ONE HEALTH: ANTIBIOTIC-RESISTANT BACTERIA CONTAMINATION IN FRESH VEGETABLES SOLD AT A RETAIL MARKETS IN KYIV, UKRAINE.

OBJECTIVE: The aim: To obtain the first estimates data on the occurrence of antibiotic-resistant bacteria in a wide range of fresh vegetables available in the Kyiv city markets. PATIENTS AND METHODS: Materials and methods: We performed a multicenter study. Fresh vegetables samples were collected of the six different commodity groups from eleven of retail stores locatedin Kyiv, Ukraine. Samples were tested for up to eight bacteria of concern. The susceptibility to antibiotics was determined by disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing. RESULTS: Results: The antibiotic-resistant bacteria contamination in the fresh vegetables was 24.3%. The contamination among organic produce was significantly higher than in conventionally products. Contamination was found to be higher in leafy vegetables. The predominant contaminated bacteria were: Escherichia coli, Enterobacter spp. And Enterococcus faecalis, followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, E. faecium, Staphylococcus aureus and Acinetobacter spp. The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 36.8% and of methicillin-resistance in S. aureus (MRSA) 10.7%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae. Vancomycin resistance was observed in 3.1% of isolated enterococci (VRE). Carbapenem resistance was identified in 35.3% of P.aeruginosa isolates and 66.8% of Acinetibacter spp. isolates. Resistance to third-generation cephalosporins was observed in 9.7% K. pneumoniae and E.coli in 14.2% isolates. CONCLUSION: Conclusions: Research has shown that the majority of fresh vegetables available in Kiev markets is contaminated with antibiotic-resistant bacteria and is a potential vehicle for the transmission of these pathogens to consumers.

Prevalence of postpartum endometritis and antimicrobial resistance of responsible pathogens in ukraine: results a multicenter study (2015-2017).

OBJECTIVE: The aim: To obtain the prevalence of postpartum endometritis women and antimicrobial resistance of responsible pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: We performed a retrospective multicenter cohort study. The study population consisted of all women who had a vaginal delivery or cesarean section in 14 Regional Women's Hospitals of Ukraine. RESULTS: Results: Total 2460 of 25,344 patients were found to have postpartum endometritis, for an overall infection rate of 9.7%. The postpartum endometritis rates were 7.6% after vaginal delivery and 16.4% after cesarean section. Incidence of postpartum endometritis after cesarean section is affected mainly by the mode of delivery (scheduled caesarean deliveries (done before labor starts) - 13.8% and unscheduled caesarean deliveries (done after labor starts) - 22.5%. The predominant pathogens were: Escherichia coli (32.7%), Enterococcus faecalis (13.0%), Streptococcus spp. (12.1%), Klebsiella spp. (10.4%) and Enterobacter spp. (10%). Among the antimicrobial agents tested, the ertapenem, piperacillin/tazobactam, and cefotaxim were the most consistently active in vitro against Enterobacteriaceae in both vaginal deliveries and after cesarean section infections. The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 22.8% and of methicillin-resistance in Staphylococcus aureus (MRSA) 15.4%. CONCLUSION: Conclusions: Postpartum endometritis and antimicrobial resistance of responsible pathogens presents a significant burden to the hospital system. Postpartum infections surveillance is required in all women's hospitals. This knowledge is essential to develop targeted strategies to reduce the incidence of postpartum infections.

Disparities in treatment rates of paediatric end-stage renal disease across Europe: insights from the ESPN/ERA-EDTA registry.

BACKGROUND: Considerable disparities exist in the provision of paediatric renal replacement therapy (RRT) across Europe. This study aims to determine whether these disparities arise from geographical differences in the occurrence of renal disease, or whether country-level access-to-care factors may be responsible. METHODS: Incidence was defined as the number of new patients aged 0-14 years starting RRT per year, between 2007 and 2011, per million children (pmc), and was extracted from the ESPN/ERA-EDTA registry database for 35 European countries. Country-level indicators on macroeconomics, perinatal care and physical access to treatment were collected through an online survey and from the World Bank database. The estimated effect is presented per 1SD increase for each indicator. RESULTS: The incidence of paediatric RRT in Europe was 5.4 cases pmc. Incidence decreased from Western to Eastern Europe (-1.91 pmc/1321 km, P < 0.0001), and increased from Southern to Northern Europe (0.93 pmc/838 km, P = 0.002). Regional differences in the occurrence of specific renal diseases were marginal. Higher RRT treatment rates were found in wealthier countries (2.47 pmc/€10 378 GDP per capita, P < 0.0001), among those that tend to spend more on healthcare (1.45 pmc/1.7% public health expenditure, P < 0.0001), and among countries where patients pay less out-of-pocket for healthcare (-1.29 pmc/11.7% out-of-pocket health expenditure, P < 0.0001). Country neonatal mortality was inversely related with incidence in the youngest patients (ages 0-4, -1.1 pmc/2.1 deaths per 1000 births, P = 0.10). Countries with a higher incidence had a lower average age at RRT start, which was fully explained by country GDP per capita. CONCLUSIONS: Inequalities exist in the provision of paediatric RRT throughout Europe, most of which are explained by differences in country macroeconomics, which limit the provision of treatment particularly in the youngest patients. This poses a challenge for healthcare policy makers in their aim to ensure universal and equal access to high-quality healthcare services across Europe.