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Shchudro O, Konopkina L, Pertseva T, Botvinikova L, Bielosludtseva K. The role of NT-proBNP in patients discharged after COVID-19 pneumonia. Eur J Cardiovasc Nurs 2022. [PMCID: PMC9384412 DOI: 10.1093/eurjcn/zvac060.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Aims The long-term health effects after SARS-CoV-2 infection remain poorly understood. The aim of our study was to define the cardiac disorders in the early postCOVID period. Methods and resuts Was observed 85 patients (40 (47,1%) men, 45 (52,9%) women, average age – 44,2 (39,3; 47,1)) on 48,3 (45,0; 56,2) days after the onset of the first symptoms of COVID-19. The main group were divided into 3 subgroups: 1 – 39 patients after moderate COVID-19 pneumonia, 2 – 36 patients after severe COVID-19 pneumonia, 3 – 10 patients after critical COVID-19 pneumonia. The subgroups were comparable in gender and age. All patients before COVID-19 were virtually healthy and had no history of cardiovascular disease, including arrhythmias. All patients underwent general clinical methods of examination, determination of SpO2, echocardiography and measured NT-proBNP concentration in serum. In 100% patients was the level of SpO2 more than 95% (average 97,5 (96,3; 98,8)%) and preserved left ventricular ejection fraction (LVEF) (average 62,3 (60,2; 74,3)%). In patients after moderate COVID-19 pneumonia, the level of NT-proBNP was significantly lower (79,4 (59,9; 75,3) pg/ml) than in patients after severe (145,0 (66,9; 170,9) pg/ml) and critical (149,7 (79,3; 138,5) pg/ml) COVID-19 pneumonia (p < 0,01). But concentration NT-proBNP in patients after severe and critical COVID-19 pneumonia didn’t differ significantly (p > 0,05). Conclusions Patients after severe and critical COVID-19 pneumonia are at risk for developing cardiac disorders in the early postCOVID period. Determining the level of NT-proBNP, and not just performing echocardiography, after discharged in such patients will help to customize the most appropriate therapeutic strategies.
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Affiliation(s)
- O Shchudro
- Dnipro State Medical University , Dnipro , Ukraine
| | - L Konopkina
- Dnipro State Medical University , Dnipro , Ukraine
| | - T Pertseva
- Dnipro State Medical University , Dnipro , Ukraine
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Torumkuney D, Bratus E, Yuvko O, Pertseva T, Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2016-17 in Ukraine: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. J Antimicrob Chemother 2021; 75:i100-i111. [PMID: 32337596 DOI: 10.1093/jac/dkaa087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2016-17 from Ukraine. METHODS MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS A total of 177 viable clinical isolates, including 78 S. pneumoniae and 99 H. influenzae, were collected. Overall, ∼98% of S. pneumoniae isolates were susceptible to penicillin by CLSI IV or EUCAST high-dose breakpoints and 73.1% were susceptible by CLSI oral or EUCAST low-dose IV breakpoints. Susceptibility rates of 76.9%-100% were observed for most antibiotics by all breakpoints except trimethoprim/sulfamethoxazole (41%-69.2%) and cefaclor, which showed the greatest difference between breakpoints: 0% by EUCAST, 28.2% by PK/PD and 73.1% by CLSI. All S. pneumoniae isolates were susceptible to amoxicillin/clavulanic acid by CLSI and PK/PD breakpoints. H. influenzae isolates were almost all β-lactamase negative (90.9%). One isolate was β-lactamase negative and ampicillin resistant (BLNAR) by CLSI and four isolates were BLNAR by EUCAST criteria. Susceptibility of isolates was high (≥90.9%) by CLSI breakpoints for all antibiotics tested except trimethoprim/sulfamethoxazole (61.6%). Susceptibility using EUCAST breakpoints was similar for ampicillin (90.9%) and amoxicillin/clavulanic acid (95%) but was low for cefuroxime (oral), where only 10.1% of isolates were susceptible. All S. pneumoniae and H. influenzae isolates were susceptible to the fluoroquinolones by all breakpoints. Susceptibility to ceftriaxone was also 100% for H. influenzae and ≥91% for S. pneumoniae isolates by all breakpoints. The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. CONCLUSIONS Antibiotic susceptibility in these respiratory tract pathogens was generally high in Ukraine. These data are important for empirical therapy choices in the treatment of CA-RTIs.
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Affiliation(s)
- D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
| | - E Bratus
- Dnipropetrovsk State Medical Academy Diagnostic Center, Soborna Square, 4, 49027 Dnipro, Ukraine
| | - O Yuvko
- Dnipropetrovsk State Medical Academy Diagnostic Center, Soborna Square, 4, 49027 Dnipro, Ukraine
| | - T Pertseva
- Dnipropetrovsk State Medical Academy, Vernadskogo Street, 9, 49044 Dnipro, Ukraine
| | - I Morrissey
- IHMA, Europe Sàrl, Route de l'Ile-au-Bois, 1A, 1870 Monthey/VS, Switzerland
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Torumkuney D, Pertseva T, Bratus E, Dziublik A, Yachnyk V, Liskova A, Sopko O, Malynovska K, Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2014-16 in Ukraine and the Slovak Republic. J Antimicrob Chemother 2019; 73:v28-v35. [PMID: 29659885 DOI: 10.1093/jac/dky069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objectives To determine antibiotic susceptibility in isolates of Streptococcus pneumoniae and Haemophilus influenzae collected in 2014-16 from Ukraine and the Slovak Republic. Methods MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Results S. pneumoniae isolates collected in Ukraine (n = 100) showed susceptibility rates ≥97% for amoxicillin, amoxicillin/clavulanic acid, penicillin [intravenous (iv) non-meningitis] and fluoroquinolones, between 83% and 86% for oral penicillin, macrolides and cefaclor, and 75% for trimethoprim/sulfamethoxazole. Susceptibility was substantially lower in the Slovak Republic (n = 95). All isolates were susceptible to the fluoroquinolones, but susceptibility to penicillin, amoxicillin, amoxicillin/clavulanic acid, cefuroxime and trimethoprim/sulfamethoxazole varied between 61% and 64%, with only 44% of isolates susceptible to the macrolides. Susceptibility of H. influenzae was more homogeneous, with susceptibility to amoxicillin/clavulanic acid, ceftriaxone, cefuroxime, azithromycin and the fluoroquinolones seen in >90% of isolates by CLSI criteria in both countries. Much greater variability was seen across breakpoints, especially for azithromycin, cefaclor and cefuroxime. The β-lactamase rate was 5.1% (5/98) in the Slovak Republic and 7.3% (7/96) in Ukraine, but the Slovak Republic also had a relatively high rate of β-lactamase-negative-ampicillin-resistant (BLNAR) isolates (7.1%; 7/98). Conclusions The variability found across these two neighbouring countries illustrates the need to monitor and publish national and local resistance patterns. This information is not only critical for effective empirical therapy but can also be used to help shape and support antimicrobial stewardship efforts in order to limit antibiotic resistance.
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Affiliation(s)
- D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex, TW8 9GS, UK
| | - T Pertseva
- Dnipropetrovsk State Medical Academy, Soborna Square 4, 49027, Dnipro, Ukraine
| | - E Bratus
- Dnipropetrovsk State Medical Academy, Diagnostic Center, Soborna Square 4, 49027, Dnipropetrovsk, Kyiv, Ukraine
| | - A Dziublik
- State Organization National Institute of Phthisiology and Pulmonology named after F. G. Yanovsky, National Academy of Medical Sciences of Ukraine, Amosova Str. 10, 03680, Kiev, Ukraine
| | - V Yachnyk
- State Organization National Institute of Phthisiology and Pulmonology named after F. G. Yanovsky, National Academy of Medical Sciences of Ukraine, Amosova Str. 10, 03680, Kiev, Ukraine
| | - A Liskova
- Nitra Teaching Hospital, Department of Clinical Microbiology, Spitalska 6, 950 01 Nitra, Slovak Republic
| | - O Sopko
- GlaxoSmithKline, Pavla Tychyny avenue, 1-V, Kyiv, 02152, Ukraine
| | - K Malynovska
- GlaxoSmithKline, Pavla Tychyny avenue, 1-V, Kyiv, 02152, Ukraine
| | - I Morrissey
- IHMA Europe Sàrl, Route de l'Ile-au-Bois 1A, 1870 Monthey/VS, Switzerland
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Pertseva T, Borysova I. THE FORECAST OF LETHAL OUTCOME IN CHRONIC LEUKEMIA PATIENTS WITH PNEUMONIA. Georgian Med News 2019:91-97. [PMID: 31101784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of the study - to create a mathematical model for forecasting of poor pneumonia outcome in patients with chronic leukemia in order to optimize treatment. Study included 323 patients with pneumonia and chronic leukemia. All indicators obtained in the study were entered into electronic database of formalized medical histories like a table "object-feature". These results were subjected to stepwise multidimensional statistical processing using non-parametric dispersive analysis by Kruskal-Wallis, correlation analysis with Spearman's rank correlation coefficient, and ROC - analysis. The statistically significant level was p <0,05 (5%). We determined that the forecast of pneumonia poor outcome in patients with chronic leukemia is associated with: leukocytes, lymphocytes, neutrophils, platelets, erythrocytes, hemoglobin and immunity: B (CD19+) (G/L), T (CD4+) (%), immunoregulatory index (CD4+/СD8+) and IgG (g/l). A mathematical model for predicting the pneumonia poor outcome in patients with chronic leukemia was created in our study: PPO=exp (-0.073-0.994*(leukocytes)+4.842*(P.aeroginosa))/[1+exp (-0.073-0.994*(leukocytes)+4.842*(R. aeroginosa)]. Using in clinical practice the proposed mathematical model of prediction pneumonia poor outcome in patients with chronic leukemia will allow determining the treatment place and timely optimizing the treatment program.
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Affiliation(s)
- T Pertseva
- State Establishment "Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine", Ukraine
| | - I Borysova
- State Establishment "Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine", Ukraine
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Torumkuney D, Pertseva T, Bratus E, Dziublik A, Yachnyk V, Liskova A, Sopko O, Malynovska K, Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2014–16 in Ukraine and the Slovak Republic. J Antimicrob Chemother 2018; 73:2276. [DOI: 10.1093/jac/dky220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Feshchenko Y, Dzyublik A, Pertseva T, Bratus E, Dzyublik Y, Gladka G, Morrissey I, Torumkuney D. Results from the Survey of Antibiotic Resistance (SOAR) 2011-13 in Ukraine. J Antimicrob Chemother 2016; 71 Suppl 1:i63-9. [PMID: 27048583 DOI: 10.1093/jac/dkw068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the antibiotic susceptibility of respiratory isolates of Streptococcus pneumoniae and Haemophilus influenzae collected in 2011-13 from Ukraine. METHODS MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS A total of 134 isolates of S. pneumoniae and 67 of H. influenzae were collected from eight sites in Ukraine. Overall, 87.3% of S. pneumoniae were penicillin susceptible by CLSI oral breakpoints and 99.3% by CLSI iv breakpoints. Susceptibility to amoxicillin/clavulanic acid (amoxicillin), ceftriaxone and levofloxacin was 100% by CLSI and PK/PD breakpoints. Cephalosporin and macrolide susceptibility was ≥95.5% and 88.1%, respectively using CLSI breakpoints. Trimethoprim/sulfamethoxazole was essentially inactive against pneumococci. Of the 67 H. influenzae tested, 4.5% were β-lactamase positive and all H. influenzae were fully susceptible to amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, cefixime and levofloxacin (all breakpoints). Cefuroxime susceptibility was 100% by CLSI but 73.1% by EUCAST and PK/PD breakpoints. A discrepancy was found in macrolide susceptibility between CLSI (∼100% susceptible), EUCAST (22%-43% susceptible) and PK/PD (0%-22% susceptible) breakpoints. Trimethoprim/sulfamethoxazole was poorly active (59.7% susceptible). CONCLUSIONS Generally, antibiotic resistance was low in respiratory pathogens from Ukraine. However, only amoxicillin/clavulanic acid (amoxicillin), ceftriaxone and levofloxacin were fully active against both species. Trimethoprim/sulfamethoxazole was the least active, particularly against S. pneumoniae. Some susceptibility differences were apparent between CLSI, EUCAST and PK/PD breakpoints, especially with macrolides against H. influenzae. These data suggest that further efforts are required to harmonize these international breakpoints. Future studies are warranted to monitor continued low resistance levels in Ukraine compared with other parts of Eastern Europe.
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Affiliation(s)
- Y Feshchenko
- State Organization National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky, National Academy of Medical Sciences of Ukraine, 10 Amosova Str., 03680, Kiev, Ukraine
| | - A Dzyublik
- State Organization National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky, National Academy of Medical Sciences of Ukraine, 10 Amosova Str., 03680, Kiev, Ukraine
| | - T Pertseva
- Dnepropetrovsk State Medical Academy, 4 Dzovtneva Square 49027, Dnepropetrovsk, Ukraine
| | - E Bratus
- Dnepropetrovsk State Medical Academy, Diagnostic Center, 4 Dzovtneva Square 49027, Dnepropetrovsk, Ukraine
| | - Y Dzyublik
- State Organization National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky, National Academy of Medical Sciences of Ukraine, 10 Amosova Str., 03680, Kiev, Ukraine
| | - G Gladka
- GlaxoSmithKline Ukraine, Pavla Tychyny Avenue, 1-V, 02152, Kiev, Ukraine
| | - I Morrissey
- IHMA Europe Sàrl, 9A route de la Corniche, Epalinges 1066, Switzerland
| | - D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
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Bontsevich R, Pertseva T, Myronenko O, Nurmatova Y, Chukhareva N. P361 The relation of medics to vaccination against an influenza virus. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70602-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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