[Multiresistant bacterial strains in infections of children treated at the National Research Institute of Mother and Child in 1999]. / Udzial wieloopornych szczepów bakteryjnych w zakazeniach u dzieci leczonych w Instytucie Matki i Dziecka w 1999 roku.

The aim of the study was the evaluation of multiresistant strains in infections of children treated at the National Research Institute of Mother and Child (NRIMC). During 1999, 23145 inoculations and 3873 antibiotic susceptibility tests were done. 2711 multiresistant strains were detected of which 59.2% were Gram-negative rods and 40.8% - Gram-positive cocci. The Gram-negative rods were tested for production of beta-lactamases (ESBL), resistance to aminoglicosides, imipenem and piperacillin/tazobactam. Gram-positive cocci were tested for methicilin and aminoglicosides resistance. Cross-resistance between macrolides, lincosamides and streptogramines was also investigated. Significant participation of multiresistant bacterial strains, mainly Gram-negative, in infections among patients treated in intensive care units of the Institute should be stressed.

[Clinical and laboratory diagnosis of Listeria monocytogenes on the basis of own investigations]. / Diagnostyka kliniczna i laboratoryjna zakazen Listeria monocytogenes. Badania wlasne.

The authors have described the issues surrounding Listeria monocytogenes infection with reference to cases diagnosed and managed during the 5-year period (1995-2000) in the Clinical Department of Neonatal Pathology and Intensive Care of the National Institute of Mother and Child in Warsaw. Four cases of congenital listeriosis have been diagnosed. Some mothers presented with "flu-like" symptoms. All mothers delivered prematurely (29 hbd - 32 hbd). Among the 4 infants the most common clinical features were: perinatal asphyxia, respiratory distress, pathological icterus, haematologic abnormalities. Septicemia occurred in 50% of cases; pneumonia in 100%. Three of them presented skin manifestations; one of the neonates had mucosal abnormalities of the laryngopharynx. Cerebral sonography showed intracranial hemorrhage. One of the infants died within 7 days of birth. The other two neonates developed posthemorrhagic hydrocephalus. Only one infant has normal development. Although listeriosis appears to be not a frequent cause of perinatal infection, clinicians must be aware of Listeria, particularly in gravid patients who present with fever and "flu-like" illness and go into premature labour. Initial therapy implemented in our Department, with ampicillin and aminoglycosides seem to be the most appropriate.

[Bacterial flora in urinary tract infections of children and susceptibility to drugs]. / Flora bakteryjna w zakazeniach dróg moczowych u dzieci i jej lekowrazliwosc.

The material consisted of 902 strains isolated from children with urinary tract infection with significant bacteriuria. Among isolated strains, Enterobacteriaceae consisted 67.4%, Gram-positive cocci 18.8% and non-fermenting Gram-negative bacilli (both against Gram-negative bacilli and Gram-positive cocci), appeared aminoglycosides and III generation cephalosporins (from 63 to 83% of susceptible strains). K. pneumoniae and P. aeruginosa were most resistant to antimicrobials tested. The authors point out that empiric antibiotic therapy of bacterial urinary tract infections in children which is not preceded by identification of the pathogen and determination of its drug susceptibility, can be ineffective in over 50% of cases.

[Bacterial and clinical evaluation of axetil cefuroxime in suspension]. / Bakteriologiczna i kliniczna ocena aksetylu cefuroksymu w zawiesinie.

For determination of cefuroxime activity, MIC was determined for 320 strains and by a diffusion-disc method susceptibility to this antibiotic of 3321 microorganisms isolated from children treated in Institute of Mother and Child was tested. Therapeutic value of axetil cefuroxime in suspension (Zinnat-Glaxo) was determined basing on specific and bacteriologically monitored treatment of 30 children (22 with respiratory tract infections and 8 with urinary tract infections). Etiological agents of these infections were: M. catarrhalis, H. parainfluenzae, S. aureus, P. rettgeri, E. coli and K. pneumoniae. MIC 50 of cefuroxime in mg/l was following: K. pneumoniae and S. pyogenes--0.12; M. catarrhalis--1; S. aureus and P. mirabilis--2; E. coli--4; K. pneumoniae--8, C. freundii--16; P. vulgaris--32, S. marcescens--128 and E. cloacae--256. Correlation was found between MIC values and percentages of susceptible strains. In 25 children full therapeutic effect was obtained. In 3 children partial recovery was noted, but they required application of an additional antibiotic. These studies demonstrated that majority of microorganisms responsible for infection of respiratory and urinary tract is susceptible to cefuroxime and that axetil cefuroxime in suspension presents as a very useful antibiotic, especially in pediatric ambulatory treatment.

[Susceptibility of bacteria to selected cephalosporins of the II and III generation]. / Wrazliwosc drobnoustrojów na wybrane cefalosporyny II i III generacji.

Susceptibility of 1893 strains of bacteria responsible for infections in children treated in the Institute of Mother and Child in 1991 was investigated. Sensitivity to cefuroxime, cefamandole, cefotaxime, ceftriaxone and ceftazidime were tested by application of discs produced by Bio-Mérieux. MIC for cefuroxime against selected clinical strains was determined by a solid medium dilution method. Cefamandole in comparison with cefuroxime was more effective for S. aureus (94.7%), coagulase-negative staphylococci (93.1%), P. rettger (87.5%), M. morganii (76.9%) and P. vulgaris (63.6%). Cefuroxime was more active against P. mirabilis and C. freundii. Percentages of Enterobacteriaceae and Gram-positive cocci sensitive to III generation cephalosporins were high and amounted to 60-100%. Cefotaxime was active against higher percentages of S. marcescens (94.1%), C. freundii (76.0%), K. pneumoniae (54.8%), S. aureus (79.0%) and coagulase-negative staphylococci (82.2%) when compared with ceftazidime and ceftriaxone. P. aeruginosa, other non-fermenting Gram-negative bacteria and A. calcoaceticus were most susceptible to ceftazidime. Comparison of MIC50 and MIC ranges for cefotaxime and cefuroxime indicates significantly higher activity of cefotaxime toward all tested strains of Enterobacteriaceae.