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The aim: To evaluate the quality of cleaning and disinfection of surfaces scheduled for daily cleaning and degree of bacterial contamination of hospital rooms and the patients’ inanimate environment in Kyiv acute care hospitals, Ukraine. Materials and methods: We performed a multicenter prospectively study of the quality of cleaning and disinfection of surfaces scheduled for daily cleaning in 9 acute care hospitals by use of an ultraviolet fluorescence targeting method and microbial methods. Results: A total 9,104 environmental samples from were collected and tested. The cleaning and disinfection of surfaces were not being performed properly in most cases. Complete removal of the mark was 49.1%, partial removal was 37,5%, and mark was still visible, i.e. this area had not been processed was 13,4% when the ultraviolet fluorescence targeting method procedures were used, respectively. The predominant bacterial agents in hospital environment surfaces were: Escherichia coli, Enterobacter spp., Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus spp., Citrobacter spp., Acinetobacter spp., and Enterococcus spp. The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 31.5% and of methicillin-resistance in Staphylococcus aureus (MRSA) 14.9%. Vancomycin resistance was observed in 5.2% of isolated enterococci (VRE). Resistance to third-generation cephalosporins was observed in 12.7% E.coli isolates and was in 11.2% K. pneumoniae isolates. Carbapenem resistance was identified in 24.7% of P.aeruginosa isolates and 59.3% of Acinetibacter spp. isolates. Conclusions: In a hospital rooms, patient environmental surfaces can be a vehicle for the transmission of multidrug-resistant (MDR) bacterial agents that cause healthcare-associated infections.

The aim: To obtain the first estimates the incidence of surgical site infection in patients undergoing neurosurgical procedures and antimicrobial resistance of responsible pathogens, and determine their impact on inpatient mortality in Ukraine. Materials and methods: We performed a multicenter prospective study was patient-based data of SSIs were according to CDC/NHSN methodology. This study included patients undergoing a neurosurgical procedure in 11 tertiary care hospitals from different regions of Ukraine from January 1st, 2018 to December 31st, 2020. Results: A total of 1697 neurosurgical procedures associated with a 90-day SSI were identified (19.4% of 8741 procedures). Of these, 69.5% SSI were identified after craniotomy and 30.5% after ventricular shunt. The Meningitis or ventriculitis (20.9%) were found to be the most common underlying condition among these patients followed by Intracranial infection (18.7%), and Osteomyelitis (14.6%) congenital malformation. Over a 90-day surveillance period, 387 died (4.4%). Fifty seven percent of deaths in SSI patients were attributable to infection. Meningitis or ventriculitis and Intracranial infection were associated with a higher mortality. Craniotomy was associated with a higher mortality more frequently than did Ventricular shunt. Escherichia coli were most commonly reported, accounting for 26.3% of all organisms, followed by Staphylococcus aureus, Enterobacter spp., Pseudomonas aeruginosa, Enterococcus spp., and Klebsiella pneumoniae. Meticillin resistance was found in 33.7% of S. aureus isolates, and vancomycin resistance was found in 12.7% of enterococci. Conclusions: The incidence of SSI and mortality after neurosurgical procedures in Ukraine is high. This is due to increase emergence of antimicrobial-resistant pathogens and risk factors in neurosurgery patients.

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Objective – to evaluate long-term results of treatment of patients with arteriovenous malformations AVM of the spinal cord. Materials and methods. A retrospective analysis of clinical and angiographic data of the results of treatment of patients with spinal AVM for the period from 2005 to 2019 was conducted. In SO «Scientific-Practical Center of Endovascular Neuroradiology NAMS of Ukraine» 47 patients were operated on endovascular method. The age of patients ranged from 11 to 62 years (middle age is 45.3 years). There were 29 men (61.7 %), 18 women (38.3 %). Liquid cyanoacrylate embolizant was used for endovascular intervention. The operations were performed with transfemoral access. Accoding the classification proposed by Anson and Spetzler in 1992 patients with type I were 31 (65.9 %), with ІІ type – 8 (17.0 %), with ІIІ type – 5 (10.6 %), with IV type – 3 (6.4 %). Magnetic resonance tomography and spinal angiography were used for diagnostics AVM.Results. Total exclusion of AVM from the bloodstream was achieved in 22 (46.8 %) cases. Out of the 31 (65.9 %) patients with type I AVM, 17 (54.8 %) had an early transient deepening of the neurological deficit. In this group, complete dissection of arteriovenous fistula was achieved in 16 (51.6 %) patients. In 8 (17.0 %) patients with type II AVM, complete exclusion of AVM was achieved in 5 (62.5 %) cases. In this case, 6 (75.0 %) patients were observed early postoperative deepening of neurological symptoms. In 5 (10.6 %) patients with type III AVM, total exclusion was achieved in 1 (20.0 %) case. Transient deepening of neurological deficit was noted in 3 (60.0 %) patients. In 3 (75.0 %) patients with type IV AVM, total embolization was achieved in 1 (33.0 %) observation. Neurological impairment occurred in 1 (33.0 %) patient. In all groups there were no fatalities.Conclusions. Angiography is the gold standard of diagnosis and dynamic monitoring of patients with spinal cord AVM. The use of endovascular treatment of AVM can stop the further progression of neurological deficits, which, however, is not always associated with the total exclusion of AVM. The best neurological improvement and total exclusion were achieved in patients with type I AVM. Radicality, efficacy and deepening of neurological deficiency depend on angioarchitectonics of AVM. The main condition for carrying out embolization is to achieve a safe level of catheterization of the afferent.