Djuric Olivera, Jovanovic Snezana, Stosovic Branka, Tosic Tanja, Jovanovic Milica, Markovic-Denic Ljiljana
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
J Infect Dev Ctries. 2016 Dec 30;10(12):1325-1331. doi: 10.3855/jidc.7695.
We aimed to report the distribution and resistance patterns of eight invasive clinically relevant bacteria surveyed in the Clinical Center of Serbia (CCS) in Belgrade.
A total of 477 clinical blood stream isolates of Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter spp. were collected in the period from January to December 2013. Antimicrobial susceptibility testing was performed using standard methods and interpreted using the Clinical and Laboratory Standards Institute (CLSI) breakpoint criteria.
Acinetobacter spp. was the most prevalent bacteria encountered (37%), followed by K. pneumoniae (25.7%). Multidrug resistance was observed in 92.5% of all isolates. Out of 177 strains of Acinetobacter spp., 97.7% were resistant to fluoroquinolones and carbapenems. Resistance to aminoglycosides, fluoroquinolones, and third-generation cephalosporins was 97.1%, 95.4%, and 95.8% among K. pneumoniae and 21.4%, 21.7%, and 31% among E. coli isolates, respectively. In total, 65.1% of K. pneumoniae and 12.1% of E. coli isolates were determined to be extended-spectrum beta-lactamase (ESBL) positive. High-level aminoglycoside resistance of E. faecalis was 71.4%, and glycopeptide resistance of E. faecium was 95%. Out of 66 strains of S. aureus, 63.4% were methicillin resistant.
The majority of bloodstream isolates of clinically relevant bacteria in CCS were multidrug resistant. The biggest concerns are carbapenem-resistant Acinetobacter spp., K. pneumoniae, and P. aeruginosa; third-generation cephalosporin-resistant E. coli; vancomycin-resistant E. faecium; and methicillin-resistant S. aureus. Stricter measures of infection control and antibiotic use are needed.
我们旨在报告在贝尔格莱德塞尔维亚临床中心（CCS）调查的八种具有临床相关性的侵袭性细菌的分布及耐药模式。
2013年1月至12月期间共收集了477株金黄色葡萄球菌、肺炎链球菌、粪肠球菌、屎肠球菌、肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌和不动杆菌属的临床血流分离株。采用标准方法进行药敏试验，并根据临床和实验室标准协会（CLSI）的断点标准进行解读。
不动杆菌属是最常见的细菌（37%），其次是肺炎克雷伯菌（25.7%）。在所有分离株中，92.5%观察到多重耐药。在177株不动杆菌属菌株中，97.7%对氟喹诺酮类和碳青霉烯类耐药。肺炎克雷伯菌对氨基糖苷类、氟喹诺酮类和第三代头孢菌素的耐药率分别为97.1%、95.4%和95.8%，大肠埃希菌分离株的耐药率分别为21.4%、21.7%和31%。总共，65.1%的肺炎克雷伯菌和12.1%的大肠埃希菌分离株被确定为超广谱β-内酰胺酶（ESBL）阳性。粪肠球菌的高水平氨基糖苷类耐药率为71.4%，屎肠球菌的糖肽类耐药率为95%。在66株金黄色葡萄球菌中，63.4%对甲氧西林耐药。
CCS中具有临床相关性细菌的大多数血流分离株具有多重耐药性。最令人担忧的是耐碳青霉烯类的不动杆菌属、肺炎克雷伯菌和铜绿假单胞菌；耐第三代头孢菌素的大肠埃希菌；耐万古霉素的屎肠球菌；以及耐甲氧西林的金黄色葡萄球菌。需要采取更严格的感染控制和抗生素使用措施。
