Susanna Felsenstein1, Sarantsetseg Bira2, Narangerel Altanmircheg2, Enkhtur Shonkhuuz3, Ariuntuya Ochirpurev4, David Warburton5,6. 1. Cork University Hospital University College Cork, Wilton, Cork, Republic of Ireland. 2. Central Laboratory Department, National Center for Maternal and Child Health, Ulaanbaatar, Mongolia. 3. Critical Care Medicine, National Center for Maternal and Child Health, Ulaanbaatar, Mongolia. 4. Health emergencies and food safety, Office of the WHO Representative in Mongolia, Ulaanbaatar, Mongolia. 5. Keck School of Medicine, University of Southern California, USA. 6. Ostrow School of Dentistry, University of Southern California, USA.
Abstract
INTRODUCTION: Information on microbiological and susceptibility profiles of Monoglian bacterial isolates is scarce. Resistance profiles, patient demographics and microbiological work-up of gram positive isolates were analyzed in order to develop infection control activities and policies at the National Center for Maternity and Children's Health (NCMCH) in Ulaanbataar, Mongolia. METHODS: All gram positive isolates of specimens submitted to the microbiology laboratory at NCMCH between January 2014 and August 2017 were included. Data collected included demographic data, specimen type, in-/outpatient status, hospital ward of sample origin, and antimicrobial susceptibility testing profile. Susceptibility testing was performed by trained microbiologists at the NCMCH microbiology laboratory. T-test, Mann-Whitney, Chi-square and Fisher exact tests were used as appropriate. RESULTS: Of 11,889 isolates, 4012 (33.7%) were gram positive, with most identified as S. aureus (62.6%, n=2512). Rates of methicillin resistance (MRSA) remained stable at a quarter, but was significantly higher among inpatients (inpatients: 630/2002, 31.5%; outpatients 67/290, 23.1%; p≤0.05) and sterile site isolates (sterile: 83/171, 48.5%; non-sterile: 416/1678, 24.8%; p≤0.01). The vast majority of S. pneumoniae isolates (12/14; 85%) was found to be penicillin resistant by oxacillin disk diffusion. While identification of Group B streptococci was rare (n=137) due to of lack of diagnostic measures available, the number of enterococcal isolates identified increased significantly due to implementation of improved microbiological work-up (2015: n=7; 2016: n=26; 2017: n=83). CONCLUSION: Compared with published studies from neighboring nations, the rates of antimicrobial resistance among gram positive isolates at NCMCH, particularly with respect to S. aureus and S. pneumoniae, were much higher. Further improvement of microbiological diagnostics and collaboration of stakeholders is required to address the pressing infection control and stewardship issues and to ensure reliable identification of relevant pathogens in Mongolia.
INTRODUCTION: Information on microbiological and susceptibility profiles of Monoglian bacterial isolates is scarce. Resistance profiles, patient demographics and microbiological work-up of gram positive isolates were analyzed in order to develop infection control activities and policies at the National Center for Maternity and Children's Health (NCMCH) in Ulaanbataar, Mongolia. METHODS: All gram positive isolates of specimens submitted to the microbiology laboratory at NCMCH between January 2014 and August 2017 were included. Data collected included demographic data, specimen type, in-/outpatient status, hospital ward of sample origin, and antimicrobial susceptibility testing profile. Susceptibility testing was performed by trained microbiologists at the NCMCH microbiology laboratory. T-test, Mann-Whitney, Chi-square and Fisher exact tests were used as appropriate. RESULTS: Of 11,889 isolates, 4012 (33.7%) were gram positive, with most identified as S. aureus (62.6%, n=2512). Rates of methicillin resistance (MRSA) remained stable at a quarter, but was significantly higher among inpatients (inpatients: 630/2002, 31.5%; outpatients 67/290, 23.1%; p≤0.05) and sterile site isolates (sterile: 83/171, 48.5%; non-sterile: 416/1678, 24.8%; p≤0.01). The vast majority of S. pneumoniae isolates (12/14; 85%) was found to be penicillin resistant by oxacillin disk diffusion. While identification of Group B streptococci was rare (n=137) due to of lack of diagnostic measures available, the number of enterococcal isolates identified increased significantly due to implementation of improved microbiological work-up (2015: n=7; 2016: n=26; 2017: n=83). CONCLUSION: Compared with published studies from neighboring nations, the rates of antimicrobial resistance among gram positive isolates at NCMCH, particularly with respect to S. aureus and S. pneumoniae, were much higher. Further improvement of microbiological diagnostics and collaboration of stakeholders is required to address the pressing infection control and stewardship issues and to ensure reliable identification of relevant pathogens in Mongolia.
Entities:
Keywords:
Child Health; Communicable Diseases; Epidemiology; Maternal and Child Health; Mongolia; Women Health
Authors: Ann Versporten; Peter Zarb; Isabelle Caniaux; Marie-Françoise Gros; Nico Drapier; Mark Miller; Vincent Jarlier; Dilip Nathwani; Herman Goossens Journal: Lancet Glob Health Date: 2018-04-23 Impact factor: 26.763
Authors: Diana Panesso; Paul J Planet; Lorena Diaz; Jean-Emmanuel Hugonnet; Truc T Tran; Apurva Narechania; Jose M Munita; Sandra Rincon; Lina P Carvajal; Jinnethe Reyes; Alejandra Londoño; Hannah Smith; Robert Sebra; Gintaras Deikus; George M Weinstock; Barbara E Murray; Flavia Rossi; Michel Arthur; Cesar A Arias Journal: Emerg Infect Dis Date: 2015-10 Impact factor: 6.883