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Professor Sergey V. Yakovlev, MD, PhD 1 st Moscow State Med. Univ., Moscow, Russia

54 th ICAAC, Washington, DC, 09/06/2014 Slide Session 056: Novel Infection Control Observations. Multicentre Study of the Prevalence and Clinical Value of Hospital-Acquired Infections in Emergency Hospitals of Russia (ERGINI Study) [K-574]. Professor Sergey V. Yakovlev, MD, PhD

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Professor Sergey V. Yakovlev, MD, PhD 1 st Moscow State Med. Univ., Moscow, Russia

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  1. 54th ICAAC, Washington, DC, 09/06/2014 Slide Session 056: Novel Infection Control Observations Multicentre Study of the Prevalence and Clinical Value of Hospital-Acquired Infections in Emergency Hospitals of Russia (ERGINI Study) [K-574] Professor Sergey V. Yakovlev, MD, PhD 1st Moscow State Med. Univ., Moscow, Russia Co-authors: Prof. V.B.Beloborodov, Dr. M.P.Suvorova, Prof. V.A.Rudnov, Dr. A.A.Rog, and ERGINI Study Group

  2. Disclosures • Consultancy, lecturing • Astellas, AstraZeneca, MSD, Novartis, Pfizer • Advisory Boards • Pfizer, R-farm • Research Grants • Pfizer

  3. Hospital-acquired infections: a major public health threat in XXI century • Increased morbidity due to objectives reasons1 • Increased mortality2 • Increased in-hospital stay and costs3 • Limited treatment options due to high prevalence of MDR nosocomial pathogens 1 Carlet J, e.a. CID 2009;49:747-9 2 Klevens RM, e.a. Public Health Report 2007;122:160-6 3 Stone PW, e.a. Am J Infect Contr 2005;33:542-7

  4. Background • The methodical state system of surveillance of HAI is not available in Russia • The registration and reporting of HAI in the majority of cases is not mandatory • About 30,000 cases of HAI recorded in annual reports of state epidemiological service are seemed to be badly underestimated • The prevalence data on HAIs outside the ICU is not available heretofore

  5. The Aim of the ERGINI Study • To study the prevalence, epidemiological and microbiological characteristics, clinical value and outcomes of HAI in 5 different units of emergency multifields hospitals in Russia

  6. ERGINI Study design • Prospective • Multicentre • 1-day prevalence study with 28-days follow-up • 32 emergency hospitals from18 cities of RF • 1 day of investigation in each study unit: • ICU, Therapeutic, General Surgery, Urology, Neurology • Schedule time: January – May 2013

  7. Methods Including criteria • All patients treated in medical unit on the day of study were included HAIs detection • Careful inspection of case reports • Examination of clinical and laboratory data for the presence of HAI according to CDC criteria

  8. Patients • Totally 3809 pts were included in the study during 5 days of investigation ICU Therapy Surgery Urology Neurology 449 1281 1431 342 306 • Number of patients with • No infection 2432 • Community-acquired infection 1087 • Hospital-acquired infection 290

  9. ERGINI Study: main results Prevalence of HAIs: 7.61% (95%CI 6.81%, 8.50%) ICUNeurologyTherapySurgeryUrology 27.6% 13.7% 4.7% 3.8% 3.8% Clinical relevanceHAI+No HAI Mortality, % 16.5 3.0 Length of hospital stay, days 24.6±11.4 16.2±15.3 The estimated annual number of HAIs in Russia ≈ 2,300,000 cases

  10. Severity of infection Infection Grade Hospital-acquired Community-acquired Sepsis 55.6% 80.4% Severe sepsis 36.1% 16.7% Septic shock 8.3% 2.9%

  11. HAIs: epidemiology & microbiology Infection sitePredominant pathogens Lower RTI 39.6% Klebsiella spp. 19,6% UTI 16.7% Escherichia coli 12,2% SSTI 14.3% Staphylococcus aureus 11,2% IAI 9.9% Acinetobacter spp. 10,9% Clinical sepsis 9.9%Candida spp. 8,3%

  12. ERGINI Study: the prevalence of resistant nosocomial Gram+ pathogens % 69 49 17 2

  13. ERGINI Study: the prevalence of resistant nosocomial Gram- pathogens % 95 79 74 61 41

  14. Conclusion • The prevalence of hospital-acquired infections in Russian emergency multifields hospitals is high • These infections make a strong impact on the length of hospital stay and hospital mortality • The difficulties of HAI’s antimicrobial treatment are associated with significant prevalence of cephalosporin- and carbapenem-resistant Gram-negative pathogens

  15. Limitation of the study • We can’t exactly extrapolate these findings to the all types of hospitals like tertialy hospital and special-purpose institutions (oncologic, hematologic, transplantologist)

  16. Acknowledgment Participants of the investigation – ERGINI Study Group • Moscow: Suvorova M, Beloborodov V, Kameneva T, Rog A, Berdnikova N, Tokareva I, Nikiforova S, Molostova T, Erofeeva S, Meleshina Y, Anderzhanova A, Novozhilova E, Shalyapina O, Gavrilov M, Dmitrieva I. • S-Petersburg: Shlyapnikov S, Naser N. • Krasnodar: Basin E. • Volgograd: Barkanova O. • Samara: Petrovskaya Y. • Ulyanovsk: Kovelenov S. • Tolyatti: Nikolaeva T. • Surgut: Trapeznikova B. • Barnaul: Ovtchinnikova O. • Yaroslavl: Paliutin S. • Voronezh: Kotelnikova T. • Ekaterinburg: Bagin V, Rudnov V. • Ufa: Abubakirova A, Zolotuchin K. • Chelyabinsk: Pribytkova O. • Yakutsk: Portnyagina U. • Ulan-Ude: Danchinova A. • Vologda: Grishina N. • Vladivostok: Eliseeva E. Statistics: Rebrova O.

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