CATHETER-ASSOCIATED URINARY TRACT INFECTIONS AFTER CAESAREAN SECTION IN UKRAINE: RESULTS A MULTICENTER STUDY (2020-2022).

OBJECTIVE: The aim: To obtain the first national estimates of the current prevalence rate of catheter-associated urinary tract infections (CAUTIs) after caesarean section (CSEC) and antimicrobial resistance of causing pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: Prospective multicentre surveillance was conducted from January 2020 to December 2022 in 15 women hospitals of Ukraine. Definitions of CAUTIs were adapted from the CDC/NHSN. Antibiotic susceptibility was done by the disc diffusion test as recommended by European Committee on Antimicrobial Susceptibility Testing guidelines. RESULTS: Results: A total of 15,892 catheterized women undergoing primary CSEC and 13.6% CAUTI were identified. The most common uropathogen was Escherichia coli, Proteus mirabilis, and Enterococcus species followed by Providencia stuartii and Pseudomonas aeruginosa. Many uropathogens isolated from CAUTI cases were found to be multidrug resistant. CONCLUSION: Conclusions: This study showed that CAUTIs in catheterized women undergoing primary CSEC in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics. Optimizing the management and empirical antimicrobial therapy may reduce the burden of CAUTIs in catheterized women undergoing primary CSEC, but prevention is the key element.

BACTERIAL INFECTION CAUSES OF PREGNANCY LOSS AND PREMATURE BIRTH IN THE WOMEN IN UKRAINE.

OBJECTIVE: The aim: To find out whether or not the presence of pregnancy loss and preterm birth was associated with the history of healthcare-associated infection (HAI) of women reproductive tract. PATIENTS AND METHODS: Materials and methods: We performed a retrospective cohort study was based on surveillance data. This study included 1,027 fertile women aged 21-50 years admitted to 8 hospitals from 2017-2019 with complaints to pregnancy loss or preterm birth. Definitions HAI of women reproductive tract were used from the CDC/ NHSN. RESULTS: Results: Of 1,027 fertile women with complaints to pregnancy loss or preterm birth, 702 (68.4%) HAIs of reproductive tract were detected. The predominant HAIs were: postpartum endometritis (19.1), bacterial vaginitis (15.8%), chorioamnionitis (11.3%), vaginal cuff infection (9.1%), and parametritis (5.6%). According to the statistical data, a significant association between HAI of women reproductive tract and the history of pregnancy loss (p < 0.05) was determined. The presence of HAI had no effect on the first trimester miscarriage (p > 0.05), but HAI women reproductive tract had strongly affected the second trimester pregnancy losses (p < 0.05). Main causative agents of HAI were Escherichia coli (31.5%), Enterobacter spp. (18.4%), Klebsiella pneumoniae (12.5%), Enterococcus faecalis (11.6%),Staphylococcus aureus (10.2%), Pseudomonas aeruginosa (8.4%). CONCLUSION: Conclusions: This study identified a significant association between healthcare-associated infection of women reproductive tract and a history of miscarriage. However, there was no association between HAI and a history of preterm birth.