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.

BackgroundA significant prevalence of osteoarthritis (OA), the most disability joint disease in the world, which is important in the search for the new treatment. Analysis of modern therapy of OA was the reason for research efficacy of NSAIDs and SYSADOA on biochemical, inflammatory and immunological signs in the treatment of OA.ObjectivesDifferentiated approach to the treatment of OA depending of presence of hyperuricemia.Methods176 patients (144 women, 32 men) was exanimated, aged (59,71±0,86) years with confirmed radiographic OA according to Kellgren and Lawrence scale. Division into groups was performed depending on treatment. For 14 days group 1 (n=30) received nimesulide 100 mg twice daily, and group 2 (n=30) - meloxicam 15 mg 1 per day. For 6 months 3rd group (n=54) received diacerein 50 mg twice a day and the 4th group (n=32) - chondroitine sulfate (CS) 500 mg twice daily. 5th group (n=30) received glucosamine sulfate (GS) 400 mg 3 times per week for 1.5 months. It was estimated dynamics of VAS, WOMAC, Lequesne, uric acid (UA), CRP, IL-1β, IGF-1, NO, ESR, biochemical indicators. Statistical analysis - SPSS Statistics.ResultsNimesulide compared to meloxicam found more effective for WOMAC index, the reduction of pain, stiffness and functional failure 53.93% vs 37.3%, 29.7% vs 13.5%, 41.6% vs 26.6% respectively. Only nimesulide decreased NO by 40.2%, and showed a decrease trend of UA from 375,33±24,6 to 321,57±19,6 mkmol/l while meloxicam had no effect on their levels. In 60% of patients with OA was found hyperuricemia with nephrolithiasis. Was showed the relation between the severity of OA and the presence of hyperuricemia by VAS, Lequesne, WOMAC, lesions more number joints, higher stage of X-ray progress. Diacerein, CS and GS showed clinical effect on pain reduction by VAS, Lequesne, WOMAC (p<0.05), respectively. Was showed lower levels of CRP, IL-1, NO during treatment by diacerein (CRP from 5,6 (IQR: 3,6–8,0) to 3,0 (IQR: 1,95–4,3) mg/l, IL-1 from 19,47 (IQR: 15,22–23,81) to 12,0 (IQR: 9,0–16,2) pg/ml, NO of 4,09 (IQR: 3,0–4,19) to 2,2 (IQR: 1,0–3,44) mmol/l), CS (CRP from 6,0 (IQR: 3,25–9,0) to 3,10 (IQR: 1,81–6,0) mg/l, IL-1 20,0 (IQR: 11,5–26,52) pg/ml to 16,7 (IQR: 9,80–18,62) pg/ml, NO of 3,0 (IQR: 2,05–4,00) to 2,0 (IQR: 2,0–3,0) mmol/l) and GS (CRP from 6,0 (IQR: 4,0–8,45) to 4,0 (IQR: 4,0–6,0) mg/l, IL-1 from 4,69 (IQR: 2,5–7,59) to 2,52 (IQR: 1,75–3,94) pg/ml, NO 3,28 (IQR: 2,02–4,79) to 2,37 (IQR: 1,59–3,03) mmol/l) (p<0,05). Diacerein reduced UA from 415,5 (IQR: 347,0–452,5) to 374,0 (IQR: 318,75–423,5) mkmol/l (p=0.001) and glucose from 5,1 (IQR: 4,8–5,8) mmol/l to 4,88 (IQR: 4,00–5,40) mmol/l (p=0.0001). CS in patients with hyperuricemia (p=0.001) increased the level of UA, which reduced the efficacy of CS, but without hyperuricemia didn't influence the level of UA and efficacy of CS.ConclusionsWas showed that nimesulide is more effective than meloxicam during first 14 days, and reduces NO, an important proinflammatory factor. The presence of hyperuricemia in 60% patients with OA, resulted in...

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The aim: To evaluate the potential of transmission of methicillin-resistance Staphylococcus aureus (MRSA) in Ukrainian acute care hospitals. Materials and methods: We performed a multicenter cross-sectional study. Definitions of HAI were used from the CDC/ NHSN. The susceptibility to antibiotics was determined by disk diffusion method according to the EUCAST. The cefoxitin-resistant isolates S.aureus were analyzed for the presence of the mecA gene and femA endogenous control gene using PCR. The virulence factor encoding genes (lukS-PV and lukF-PV) were detected by PCR. Results: Of 2,421 patients with HAIs caused S.aureus included in the study, 28.7% patients had MRSA. Prevalence of nasal carriage rate of MRSA among healthcare workers (HCWs) was 33.3%. MRSA contamination of hands and uniforms/gowns of HCW were 32.2% and 29.7%, respectively. MRSA contamination in the inanimate environment surfaces in near- and extended patients areas were 26.9%. The predominant MRSA contamination in hospital environment surfaces were: room inner door knob (32.8%), bed rails (28.9%), room light switch (28.9%), chair (27.9%), bedside table handle (20.6%), bedside table (20.5%), and tray table (13.7%). The PVL gene was present in 38.7% of MRSA strains, isolated from patients with HAIs and in 55.7% of MRSA, isolated from environment surfaces in patient area. In addition, the PVL genes were detected in over 56.3% of MRSA isolated from HCWs carrier. Conclusions: The majority of MRSA is acquired during hospitalization. Environmental surfaces may serve as potential reservoirs for nosocomial MRSA and facilitate transmissions via contact.

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