Multicentre Study of the Prevalence and Clinical Value of Hospital-Acquired Infections in Emergency Hospitals of Russia: ERGINI Study Team.

BACKGROUND: Hospital-acquired infection (HAI) is a common problem in intensive care units (ICU) and other hospital units. The methodical system of surveillance of hospital-acquired infections (HAI) is not available in Russia and there is no reliable data about the prevalence or epidemiology of HAI. We aimed in this pioneer study to determine the prevalence, epidemiological and microbiological characteristics, risk factors, clinical value and outcomes of HAI in different units of emergency multifields hospitals of Russia. METHODS: This prospective multicentre 1-day prevalence study with 28-days follow-up was realized between January and May 2013. Thirty two emergency hospitals with more than 500-beds from 18 cities participated in this study. The study was conducted separately on 5 different days in ICU, therapeutic, surgical, urology and neurology units. All patients treated in the unit on the day of the study were examined for the presence of HAI according to CDC criterias. Risk factors of HAI, nosological and etiological structure, susceptibility of pathogens were also evaluated. RESULTS: Totally 3809 patients were included in the study during 5 days of investigation in ICU and therapeutic, surgical, urology and neurology units (respectively 449, 1281, 1431, 342 and 306 patients). The total number of registered HAI was 290 and the prevalence of HAI was 7.61% (95% CI 6.81%, 8.50%). The greatest rate of HAI was registered in ICU (26.28%) and neurological unit (13.73%); the rate was lower in therapeutic, surgical and urology units (4.76, 4.12 and 2.92%). The prevalence of HAI.was similar in adult and pediatric hospitals .(7.62 and 7.54%). The prevalence of community-acquired infections was 28.53%. The lower respiratory tract was the most common site of infection, accounting for 42.4%.of HAIs followed by the urinary tract (19.0%), skin and soft tissue (13.4%), abdomen (11.4%) and intravascular (4.8%). 311 pathogens were isolated: 58.8% of isolates were gram-negative, 32.8% gram-positive, and 8.4% Candida spp. The most common bacterial isolates were Klebsiella spp. (19.6%), E.coli (12.2%), S.aureus (11.3%), Acinetobacter spp. (10.9%), E.faecalis (7.4%) and P.aeruginosa (7.1%). The resistance rate of E.coli and Klebsiella spp. to 3rd generation of cephalosporins was 60.5 and 95.1%. Only 26.5% of Acinetobacter isolates and 59,1% of P.aeruginosa isolates were susceptible to imipenem. The MRSA rate was 48.6%; 17,4% of E.faecalis were resistant to ampicillin. The mortality rate was higher in patients with HAI (16.5%) than in patients without HAI (3.0%); the mean length of hospital stay was also higher in patients with HAI (24.6±11,4 vs. 16.2±15,3 days). CONCLUSION: The prevalence of HAI in Russian hospitals is high. According to the prevalence data the estimating annual number of HAI in Russia is approximately 2,300,000 cases. The multi-drug resistant microorganisms were dominated among causative agents of HAI.

Device-independent, real-time identification of bacterial pathogens with a metal oxide-based olfactory sensor.

A novel olfactory method for bacterial species identification using an electronic nose device called the MonoNose was developed. Differential speciation of micro-organisms present in primary cultures of clinical samples could be performed by real-time identification of volatile organic compounds (VOCs) produced during microbial replication. Kinetic measurements show that the dynamic changes in headspace gas composition are orders of magnitude larger than the static differences at the end of fermentation. Eleven different, clinically relevant bacterial species were included in this study. For each of the species, two to eight different strains were used to take intra-species biodiversity into account. A total of 52 different strains were measured in an incubator at 37 degrees C. The results show that the diagnostic specificities varied from 100% for Clostridium difficile to 67% for Enterobacter cloacae with an overall average of 87%. Pathogen identification with a MonoNose can be achieved within 6-8 h of inoculation of the culture broths. The diagnostic specificity can be improved by broth modification to improve the VOC production of the pathogens involved.

[Radiation-modifying effect of hypoxia, and tissue basophils of skin in rats: possibility of individual prognosis]. / Radiomodifitsiruiushchee deistvie gipoksii i tkanevye bazofily kozhi u krys: vozmozhnosti individualnogo prognozirovaniia.

In experiments on rats the data about relationship between individual properties of skin tissue basophil population and animal's radioresistance under total gamma-irradiation (11 Gy) at severe hypoxia has been obtained. The method for estimation of state of tissue basophil population by means of reactivity index has been proposed. An opportunity for using of this index to predict some radiobiological patterns has been shown.

[Evaluation of risk factors of developing underlying and precancerous diseases of the uterine cervix]. / Otsenka faktorov riska razvitiia fonovykh i predrakovykh zabolevanii sheiki matki.

The paper analyzes risk factors for underlying and precancerous processes of the cervix uteri in females. The application of a mathematical instrument and computers made it possible to define the most significant risk factors and to evaluate the degree of their impact. The findings may be used in the program test in performing mass prophylactic surveys to identify a group of females who are at a high risk and require a more detailed examination.

[Possibilities of the automatic data processing in differential diagnosis of arteriosclerotic cardiosclerosis and rheumatic heart disease complicated by auricular fibrillation]. / O vozmozhnosti avtomatizarsii protsessa differentsial'noi diagnostiki ateroskleroticheskogo kardioskleroza i revmaticheskikh porokov serdtsa, oslozhnennykh mertsatel'noi aritmiei.

The possibility of applying some mathematical methods for automating the process of differential diagnosis between atherosclerotic cardiosclerosis and rheumatic heart diseases complicated by auricular fibrillation, based on employing computing technique in processing the cardiointervalographic findings, is discussed. The processing of cardiointervalograms taken in 2 groups of patients with diseases in question (totaling 49 persons) aged over 45 evidenced that in the differential diagnosis mathematical expectation and dispersion of the R-R intervals duration are most informative signs. It is shown that for the purpose of automatic diagnosis of atherosclerotic cardiosclerosis and rheumatic heart diseases complicated by auricular fibrillation with the method under discussion the sufficient length of cardiointervalograms equals 130--150 R--R-intervals.