Paluchowska Paulina, Skałkowska Małgorzata, Spelak Anna, Budak Alicja
Zakład Mikrobiologii Farmaceutycznej, Uniwersytet Jagielloński Collegium Medicum w Krakowie.
Med Dosw Mikrobiol. 2012;64(1):45-53.
Multidrug-resistant gram-negative non-fermenting bacilli are an important cause of nosocomial infection. Aim of this study was to analyze the prevalence and antimicrobial susceptibility of rods of the species Acinetobacter baumannii and Pseudomonas aeruginosa, belonging to multidrug-resistant alert pathogens.
105 (70%) strains of A. baumannii and 46 (30%) strains of P. aeruginosa were isolated from 125 patients hospitalized in the Specialistic Hospital in Krakow, in the years 2008-2010. Taken into account first isolate from the patient. The condition for inclusion in the study was the resistance or reduced susceptibility to selected groups of antibiotics, such as beta-lactams, aminoglycosides and fluoroquinolones. Bacterial identification and antimicrobial susceptibility testing were performed by automated system Vitek 2 Compact (bioMerieux, Poland). All strains were tested with phenotypic method Etest MBL (AB Biodisk, Sweden) for the presence of resistance mechanism associated with the production of metallo-beta-lactamases.
Bacilli of the species A. baumannii were isolated most frequently from patients from the Department of Anesthesiology and Intensive Care (52%) and Burn Therapy Unit (25%), with clinical materials collected from the respiratory tract (51%), the wound swabs (18%), urine (11%) and blood (11%). Production of metallo-beta-lactamases was found in 24 (22.9%) strains of A. baumannii. Drugs effective against multidrug-resistant isolates of A. baumannii were colistin and amikacin. Department of anesthesiology and intensive care (59%) and unit of internal medicine (11%) were the main source of multidrug-resistant strains of P. aeruginosa. Pathogens were mainly isolated from clinical specimens collected from the respiratory tract (61%), urine (15%) and wound swabs (13%). Seven (15.2%) strains of P. aeruginosa produced the metallo-beta-lactamases. With regard to colistin and piperacillin with tazobactam was noted the highest percentage of susceptible isolates.
MDR bacteria belonging to alert pathogens are an important cause of many severe and difficult to treat infections which greatly increases the morbidity and mortality among hospitalized patients worldwide. Epidemiological studies and detection of local resistance patterns can provide useful information which can be used in the development of strategies to combat the rising tide of microbial antibiotic resistance.
多重耐药革兰氏阴性非发酵菌是医院感染的重要原因。本研究旨在分析鲍曼不动杆菌和铜绿假单胞菌这两种属于多重耐药预警病原体的杆菌的流行情况及抗菌药敏性。
2008 - 2010年期间，从克拉科夫专科医院住院的125例患者中分离出105株（70%）鲍曼不动杆菌和46株（30%）铜绿假单胞菌。考虑患者的首次分离株。纳入研究的条件是对某些抗生素组，如β-内酰胺类、氨基糖苷类和氟喹诺酮类耐药或敏感性降低。细菌鉴定和抗菌药敏试验采用Vitek 2 Compact自动化系统（波兰生物梅里埃公司）进行。所有菌株均采用Etest MBL表型方法（瑞典AB Biodisk公司）检测与金属β-内酰胺酶产生相关的耐药机制。
鲍曼不动杆菌最常从麻醉与重症监护科（52%）和烧伤治疗科（25%）的患者中分离得到，临床标本主要取自呼吸道（51%）、伤口拭子（18%）、尿液（11%）和血液（11%）。在24株（22.9%）鲍曼不动杆菌中发现了金属β-内酰胺酶的产生。对多重耐药鲍曼不动杆菌有效的药物是黏菌素和阿米卡星。麻醉与重症监护科（59%）和内科（11%）是多重耐药铜绿假单胞菌的主要来源。病原体主要从呼吸道（61%）、尿液（15%）和伤口拭子（13%）采集的临床标本中分离得到。7株（15.2%）铜绿假单胞菌产生了金属β-内酰胺酶。就黏菌素和哌拉西林-他唑巴坦而言，敏感分离株的比例最高。
属于预警病原体的多重耐药菌是许多严重且难以治疗的感染的重要原因，这大大增加了全球住院患者的发病率和死亡率。流行病学研究和局部耐药模式的检测可提供有用信息，可用于制定应对微生物抗生素耐药性上升趋势的策略。
