ABSTRACT
INTRODUCTION: European Centre for Diseases Control (ECDC), involved in the surveillance of nosocomial infections (NI) and resistance to antimicrobials (AMR) in Europe, estimates 4 million IN/year, among whom 37,000 deceased, out of which half are determined by multiresistant germs (MDR). A phenomenon encountered more and more often is that of pan-resistance of germs, without the option for an optimal antibiotherapy. The allarming increase of AMR is a phenomenon which our country also faces in the present. MATERIAL, METHOD, RESULTS: Resistance rate registered in Intensive Care Units in Timisoara during 2005-2007 (when we participated in the Helics European network) situates us among the last places among the European countries that participated--with 50-60% MRSA strains, 24% E. coli BLSE strains, 62,7% K. pneumoniae BLSE strains, 34% P. aeruginosa BLSE. Furthermore, data registered in ambulatory in the South-West part of Romania during 2006-2007 (processed by the greatest private laboratory in the region) are not more optimistic--26% MRSA strains, 4,25% E. coli BLSE, 12,49% K. pneumoniae BLSE, 8,69% P. aeruginosa BLSE. CONCLUSIONS: As the management of MDR produced infections requires huge costs, a better antibiotic policy in the Romanian hospitals and ambulatory is compulsive, being more efficient to spend for control than for the treatment of these infections.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Cross Infection/epidemiology , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial , Escherichia coli/drug effects , Klebsiella pneumoniae/drug effects , Pseudomonas aeruginosa/drug effects , Anti-Bacterial Agents/pharmacology , Cross Infection/drug therapy , Humans , Incidence , Intensive Care Units , Microbial Sensitivity Tests , Population Surveillance , Romania/epidemiologyABSTRACT
OBJECTIVES: Between November 2001-January 2002 we collected 406 samples from patients hospitalized in Intensive Care adults and new-borns Unit (ICU). The aim was to observe the colonization and infection status with bacteria that may have nosocomial potential and to establish circulating phenotypes in ICUs. METHODS: The identification was performed by API (bioMerieux) method, and we have performed the antimicrobial susceptibility tests by both: API method and by Kirby-Bauer disc-diffusion test. RESULTS: We isolated 295 strains with nosocomial potential: 34 MRSA strains, 23 MRCNS strains, 29 ESBL producing gram negative rods, etc. CONCLUSIONS: We observed the presence of multiple drug resistant bacteria which play an important roll in both: massive colonization of patients and in the etiology of nosocomial infections. This leads us to the conclusion that antibiotic resistance pattern should be interpreted by the bacteriologist and a consistent policy concerning the use of antimicrobial drugs in hospital settings should be instituted.
Subject(s)
Anti-Bacterial Agents , Cross Infection/microbiology , Drug Resistance, Microbial , Adult , Anti-Bacterial Agents/pharmacology , Cross Infection/drug therapy , Escherichia coli/drug effects , Humans , Infant, Newborn , Intensive Care Units , Klebsiella pneumoniae/drug effects , Microbial Sensitivity Tests , Phenotype , Retrospective Studies , Staphylococcus aureus/drug effectsABSTRACT
The case of a 37-year-old woman, dressmaker, with congenital lower limb amelia is presented. The specific and complementary investigations revealed the absence of the left half of sacrum, coccyx, together with the left iliac bone, ischium and pubis. Urography demonstrated the absence of left kidney. Ultrasonography revealed the presence of the spleen. The data in the literature are reviewed and some comments are made.
