Seroprevalence and risk factors of Leptospira sp. among different groups in the Jordanian population: first study.

BACKGROUND: Leptospirosis is re-emerging as a major public health problem worldwide. However, there are limited data on the disease from the Middle East, including from Jordan, despite recent outbreaks occurring in Jordan's neighbouring countries. METHODS: Sera samples from 809 participants in 11 governorates were tested for Leptospira sp. seropositivity to determine the seroprevalence and risk factors of Leptospira sp. in Jordan. RESULTS: Overall, 3.3% (95% confidence interval [CI] 2.2 to 4.8) of individuals tested were seropositive for Leptospira antibodies. Individuals who drink surface water (spring or rain water) had 5.69 (95% CI 2.57 to 12.60) higher odds of seropositivity compared with individuals who used municipal or filtered water, after controlling for age and practicing horticulture. CONCLUSIONS: This is the first seroprevalence study of Leptospira sp. in Jordan and included important data on environmental and animal exposures.

BLOODSTREAM INFECTIONS ASSOCIATED WITH INTENSIVE CARE UNIT AT A MULTIPROFILE HOSPITAL, TBILISI, GEORGIA.

Bloodstream infections (BSIs) are associated with a high mortality rate, additional hospital days and excess hospital costs. Intensive Care Unit (ICU) patients are at high risk of nosocomial BSIs because of their weakened condition caused by underlying disease, frequent invasive diagnostic and therapeutic procedures. Catheterization is the most common cause of hospital-acquired BSIs. The major causes of catheter-related BSI (CRBSI) are microorganisms from the patient's and medical personnel's skin and contamination of the catheter hub. From July 1, 2015 through June 30, 2016, were collected blood cultures from patients fulfilling the criteria for systemic inflammatory response syndrome in a tertiary care hospital ICU in Tbilisi. Blood culturing procedures and techniques and antimicrobial susceptibility testing, following methods set out by EUCAST. From microbiologically studied 84 blood samples 21 (25%) were positive for growth, 19 (90.5%) samples were monomicrobial, whereas 2 (9.5%) samples were polymicrobial. On the basis of microbiological, clinical and epidemiological data 21 patients were diagnosed as ICU associated BSI. Among them 16 (76.2%) patients were diagnosed primary BSI and CLABSI, four (23.8%) patients - secondary BSI; three of them were caused with ventilator-associated pneumonia, one - with catheter-associated urinary tract infection. The most common microorganism isolated from ICU associated BSI cases were Coagulase-negative staphylococci (30,4%), A. baumannii (21.7%) and K. pneumoniae (17.4%). Preventing BSIs should be a priority for hospitals and for this they must be introduced to modern methods infection prevention and control.

EPIDEMIOLOGY OF CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE IN INTENSIVE CARE UNITS OF MULTIPROFILE HOSPITALS IN TBILISI, GEORGIA.

Klebsiella pneumoniae is one of the most frequent cause of health care associated infections. Dissemination of carbapenem-resistant (CR) K. pneumoniae infections significantly trend toward patient morbidity, length of stay and mortality. The aim of this research was to study prevalence and risk-factors of CR K. pneumoniae in Georgia. To identify risk factors for hospital-acquired carbapenem-resistant (CR) K. pneumoniae, from January 1, 2017 through February 28, 2018, an observational case-control study was performed in the ICUs of two tertiary-care hospitals in Tbilisi (High Medical Technology Centre and Ghudushauri National Medical Centre). All isolated K. pneumoniae cultures were tested on antibiotic susceptibility tests (AST). AST was performed by disk diffusion methods and E-test for MIC detection. For the first time CR K. pneumoniae isolates were screened for the presence of KPC, VIM, IMP, NDM and OXA carbapenemase in a PCR. Totally, 46 cultures of K. pneumoniae were isolated. Among them 20 (43.5%) were resistant to carbapenems. Most frequently CR K. pneumoniae cultures were isolated in patients with ventilator associated pneumonia (75%). Main risk factors of carbapenem-resistant from invasive procedures were: mechanical ventilation (OR 30.4, 95% CI 3.504-263.752, p=0.0003), nasogastric tube (OR 17.0, 95% CI 3.202-90.257, p=0.0002), central venous catheter (OR 10.06, 95% CI 1.152-87.849, p=0.028) and previous use of antibiotics (OR 10.059, 95% CI 1.152-87.849, p=0.028), especially carbapenem and 3rd generation cephalosporin. Predominant is OXA-producing K. pneumoniae, NDM-producing K. pneumoniae is relatively rare. To control dissemination of CR K. pneumoniae infection prevention and control should be toughened in medical facilities, and screening for early detection of patients with CR K. pneumoniae should be done.