Phenotypic and genomic analysis of bacteria from war wounds in Dnipro, Ukraine.

Objectives: To better understand the source and potential transmission routes of antibiotic-resistant bacteria infecting injured service members in Ukraine. Methods: Phenotypic and genomic characterizations were performed on 11 Gram-negative pathogens cultured from war wounds at an intermediate evacuation hospital in Dnipro. Results: The analysis revealed both susceptible and extensively drug-resistant strains present in cultures, including high-risk global clones carrying carbapenemases. Conclusions: Globally distributed carbapenemase-producing lineages are being acquired early in the medical evacuation process.

MICROBIOLOGICAL FEATURES OF STAPHYLOCOCCUS ASSOCIATED WITH COMPLICATIONS OF DENTAL IMPLANTATION.

OBJECTIVE: The aim: To describe microbiological features of the Staphylococcus spp. involved in complications of dental implantation. PATIENTS AND METHODS: Materials and methods: The main method was bacteriological. Indentification of the obtained isolates was done using commercially available test kits. Adhesive properties were evaluated using Brillis technique. Biofilm-forming ability was studied according to Christensen et al. Antimicrobial susceptibility testing was done following EUCAST recomendations. RESULTS: Results: There were 26 smears taken from the peri-implant area and gingival pockets of 12 patients. We obtained 38 isolates. Most of the patients were positive for Streptococcus spp. - 94% and Staphylococcus spp. - 90%. Among the representatives of Staphylococcus spp., the initial share of clinical isolates was S. aureus (34.21%) with inherent coagulase-positive properties. Coagulase-negative pathogens accounted for 65.79% of Staphylococcus spp., among them S. epidermidis, S. hominis, S. warneri were the main. All obtained isolates had typical properties, but appearance of small colonial variants of S. aureus was also recorded. Antimicrobial susceptibility testing was performed in 100% of cases. Among 13 isolates of S. aureus there were 2 cultures resistant to cefoxitin, i. e. methicillin-resistant by phenotype. Clinical isolates of S. aureus, colonizing peri-implant tissues in infectious-inflammatory complications of dental implantation, also had high adhesive and biofilm-forming properties. Clinical isolates of S. epidermidis an average ability to form biofilms. CONCLUSION: Conclusions: There is a prooved direct correlation between biofilm-forming ability and adhesive properties in highly biofilm-forming clinical isolates involved in the occurrence of purulent-inflammatory complications in peri-implant site.

COVID-19 at War: The Joint Forces Operation in Ukraine.

The ongoing pandemic disaster of coronavirus erupted with the first confirmed cases in Wuhan, China, in December 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) novel coronavirus, the disease referred to as coronavirus disease 2019, or COVID-19. The World Health Organization (WHO) confirmed the outbreak and determined it a global pandemic. The current pandemic has infected nearly 300 million people and killed over 3 million. The current COVID-19 pandemic is smashing every public health barrier, guardrail, and safety measure in underdeveloped and the most developed countries alike, with peaks and troughs across time. Greatly impacted are those regions experiencing conflict and war. Morbidity and mortality increase logarithmically for those communities at risk and that lack the ability to promote basic preventative measures. States around the globe struggle to unify responses, make gains on preparedness levels, identify and symptomatically treat positive cases, and labs across the globe frantically rollout various vaccines and effective surveillance and therapeutic mechanisms. The incidence and prevalence of COVID-19 may continue to increase globally as no unified disaster response is manifested and disinformation spreads. During this failure in response, virus variants are erupting at a dizzying pace. Ungoverned spaces where nonstate actors predominate and active war zones may become the next epicenter for COVID-19 fatality rates. As the incidence rates continue to rise, hospitals in North America and Europe exceed surge capacity, and immunity post infection struggles to be adequately described. The global threat in previously high-quality, robust infrastructure health-care systems in the most developed economies are failing the challenge posed by COVID-19; how will less-developed economies and those health-care infrastructures that are destroyed by war and conflict fare until adequate vaccine penetrance in these communities or adequate treatment are established? Ukraine and other states in the Black Sea Region are under threat and are exposed to armed Russian aggression against territorial sovereignty daily. Ukraine, where Russia has been waging war since 2014, faces this specific dual threat: disaster response to violence and a deadly infectious disease. To best serve biosurveillance, aid in pandemic disaster response, and bolster health security in Europe, across the North Atlantic Treaty Alliance (NATO) and Black Sea regions, increased NATO integration, across Ukraine's disaster response structures within the Ministries of Health, Defense, and Interior must be reinforced and expanded to mitigate the COVID-19 disaster.

Acute inhalation toxicity of aerosolized electrochemically generated solution of sodium hypochlorite.

OBJECTIVE: The objective was to determine the inhalation toxicity of the electrochemically generated sodium hypochlorite solution after its single administration to laboratory animals in the form of a highly dispersed aerosol. MATERIALS AND METHODS: The study has been conducted according to the OECD Test Guideline №403 'Acute Inhalation Toxicity.' Laboratory animals were exposed to inhalation of an aerosol containing 1.7 ± 0.13 mg/m3 of active chlorine. The hematological and biochemical parameters of the blood of experimental animals have been determined, as well as specific parameters: the activity of cathepsins B and L, catalase, and α1-antitrypsin. Histological study of the lungs of animals has been carried out. RESULTS: During inhalation and 14 days after it, no death of the animals was observed; the behavior, appearance, and weight gain did not differ from the control group. There were no significant deviations in hematological parameters, except the decrease in the level of platelets. The biochemical study showed slight changes in the activity of alkaline phosphatase and aspartate aminotransferase on the 1st day after inhalation; these parameters returned to normal within 14 days of observation. Specific biochemical parameters did not show the development of oxidative stress. No specific histological pathologies of lung tissue have been found. CONCLUSIONS: Thus, the studied electrochemically generated sodium hypochlorite solution under single inhalation exposure in aerosol form practically does not cause a toxic effect. The data obtained allow classifying such solution to the 4th (or even 5th - after additional studies) class of toxicity in accordance with Globally Harmonized System of Classification and Labeling of Chemicals.

MICROBIOLOGICAL FEATURES OF STAPHYLOCOCCUS AUREUS ISOLATED FROM RESPIRATORY TRACT OF CHILDREN WITH CYSTIC FIBROSIS.

OBJECTIVE: The aim: To determine the prevalence rate of Staphylococcus aureus infection among children with Cystic Fibrosis in the Dnieper region, to provide microbiological characteristics of the isolates and to elevate their susceptibility to antimicrobials. PATIENTS AND METHODS: Materials and methods: Sputum, tracheobronchial lavage waters and/ or deep smear from the posterior pharyngeal wall were taken from children with genetically confirmed Cystic Fibrosis. Bacteriological method was the main. The first screening for small colony variants of Staphylococcus aureus was carried out after 48 hours of incubation. The antimicrobials susceptibility testing was determined by disk-diffusion method according to the EUCAST 2019. Microsoft Office Excel 2010 was used for statistical data processing. RESULTS: Results: Twenty one children were enrolled in the survey. The culture of Staphylococcus spp. was obtained from all patients with 40.8% positive for Staphylococcus aureus. Small colony variants appeared with the prevalence rate 21.6% after 48 hours of incubation. The frequency of associations between Staphylococcus aureus with auxotroph phenotype with the presence of Pseudomonas aeruginosa was significantly higher than with wild-type group. The 3d-generation aminoglycosides, the 3d-generation fluoroquinolones, linezolid, rifampicin and tetracyclines showed the best antimicrobial activity, however, resistance to cefoxitin and gentamicin was significantly higher in auxotroph-modified group. CONCLUSION: Conclusions: Infection Staphylococcus aureus is common among children. The appearance of auxotrophs registered after treatment with aminoglycosides and/ or co-trimoxazole and co-infection Pseudomonas aeruginosa. Isolates of Staphylococcus aureus showed good chemotherapeutic sensitivity, but tendency in increasing resistance registered for auxotroph-modified phenotype.