Czestosc wystepowania i lekoopornosc paleczek z rodziny Enterobacteriaceae izolowanych od pacjentow hospitalizowanych na oddzialach intensywnej terapii

Pacjenci hospitalizowani na oddziałach intensywnej terapii (OIT) są szczególnie narażeni na zakażenia wywołane przez bakterie oporne na wiele antybiotyków. Celem pracy była ocena częstości występowania i lekowrażliwości szczepów pałeczek Gram-ujemnych z rodziny Enterobacteriaceae izolowanych z materiałów klinicznych od tej grupy chorych, ze szczególnym uwzględnieniem profilu oddziału. Stwierdzono różnice w obrazie lekowrażliwości zależnie od rodzaju materialu klinicznego i profilu oddziału OIT.

The aim of the study was estimation of frequency and susceptibility to antimicrobial agents of Gram-negative rods isolated from clinical specimens obtained from patients requiring intensive care, with emphasis on profile of the unit. The analysis comprised strains of Gram-negative rods isolated from patients of two intensive care units (ICUs) of a tertiary care hospital (1200 beds). Identification of cultured isolates was done using automated VITEK and API systems (bioMerieux, France). Susceptibility to antimicrobial agents was tested by a disk-diffusion method according to the NCCLS recommendations. In total the analysis comprised 722 strains of Gram-negative rods. In blood cultures predominated strains of Enterobacter spp. (42,5%) and Klebsiella pneumoniae (37,5%). In cultures of clinical specimens other than blood 41,6% comprised strains of Klebsiella pneumoniae, 14,8% Escherichia coli and 14,4% Proteus mirabilis. Frequency of multi-drug resistant strains of bacteria of the family Enterobacteriaceae was much higher among blood isolates in comparison to strains cultured from other clinical specimens. There was a relatively high percentage of strains of Enterobacteriaceae susceptible to piperacillin and tazobactam (69,0%) and ceftazidime(54,6%). Conclusions: 1. All strains were susceptible to carbapenems. 2. There was a relatively high percentage of strains of Gram- negative rods susceptible to piperacillin/tazobactam and ceftazidime. 3. Bacteria isolated from blood cultures were characterised by a much higher percentage of resistant strains in comparison to other specimens. 4. Longer stay in ICU promoted selection of strains resistant to antimicrobials.