Bacterial resistance in eastern Europe--selected problems.

The profile of infection and pattern of bacterial resistance in Eastern Europe is distinct from that observed in other parts of the world. Several Polish investigations have reported that environmental pollution may increase the risk of respiratory disease. Studies from Hungary and Romania have documented a dramatic increase in the proportion of Streptococcus pneumoniae strains resistant to antibiotics. In comparison, resistance to these agents amongst Polish pneumococci isolates is lower, although these pathogens and Streptococcus pyogenes have displayed increasing tetracycline resistance. 20% of Polish Haemophilus influenzae isolates and a high percentage of Moraxella catarrhalis strains exhibit ampicillin resistance. Methicillin-resistant Staphylococcus aureus (MRSA) has been found to constitute 22% of Polish S. aureus strains. Two major clones of MRSA have been identified in Poland which differ in their degree of antimicrobial resistance. The pattern of antimicrobial resistance amongst Polish respiratory pathogens is undoubtedly a reflection of management policies and the use of these drugs. It is hoped that the economic and political changes taking place within Eastern Europe will provide the information and resources to establish more efficient infection control and antibiotic policy and thus delay and limit the appearance of bacterial resistance.