RESUMO
From the second semester of 2002 to the end of the first semester of 2005, a total of 2544 bacterial strains were isolated from the blood stream of patients with clinical sepsis and bacteremia hospitalized in six University Hospitals in the Slovak Republic. Almost 30% of strains were coagulase-negative staphylococci (CONS), about 14% were Staphylococcus aureus and, of the Gram-negative bacteria, up to 9% were Klebsiella pneumoniae. All CONS, S. aureus and Enterococcus spp. strains were found to be still susceptible to vancomycin, but the resistance of CONS and/or S. aureus to macrolides and fluoroquinolones dramatically increased during the period of this study. Among Gram-negative bacteria, increasing levels of resistance to higher generation cephalosporins, to fluoroquinolones resistance in Pseudomonas aeruginosa and Acinetobacter spp. to meropenem was recorded, which is alarming. The results were periodically submitted to cooperating hospitals with proposals for rationalizing the prophylactic and general use of indicated antibiotics as well as for improving hospital hygiene measures and anti-epidemic practices.
Assuntos
Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Resistência Microbiana a Medicamentos , Bactérias Gram-Negativas/efeitos dos fármacos , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Humanos , Testes de Sensibilidade Microbiana , Sepse/tratamento farmacológico , Sepse/microbiologia , Staphylococcus/efeitos dos fármacos , Staphylococcus/isolamento & purificaçãoRESUMO
The aim of the study was to monitor the prevalence of pathogens and development of resistance in bacteria isolated from bacteremic patients. Five University Clinics and/or Regional Hospitals in the Slovak Republic participated in the study and a total of 421 isolates were collected in the second half of the year 2002. The most prevalent organisms were coagulase-negative staphylococci (CONS) (19%), Staphylococcus aureus (18.3%), among Gram-negative bacteria Escherichia coli (13.3%), Klebsiella pneumoniae (11.4%) and Pseudomonas aeruginosa (7.8%) followed by enterococci, Acinetobacter baumannii and Enterobacter sp. All CONS and S. aureus were susceptible to vancomycin; resistance to oxacillin was observed for 55% of the CONS and only for 4% of S. aureus isolates. A higher prevalence of resistance to erythromycin, clindamycin, gentamicin and ofloxacin was found in CONS in comparison to S. aureus. Enterococcus sp. isolates were fully susceptible to vancomycin and teicoplanin. Gentamicin, amoxicillin/clavulanate, third generation cephalosporins and ciprofloxacin showed good activity against E. coli. Although 17% of K. pneumoniae isolates were resistant to ciprofloxacin, it was the most effective drug against K. pneumoniae; the prevalence of resistance to other antibiotics was rather higher. Gentamicin and ciprofloxacin were the most active against Enterobacter sp. isolates and ceftazidime and meropenem against P. aeruginosa.
Assuntos
Antibacterianos/farmacologia , Bacteriemia/microbiologia , Farmacorresistência Bacteriana Múltipla , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Bacteriemia/tratamento farmacológico , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Estudos de Amostragem , Sensibilidade e Especificidade , EslováquiaRESUMO
Sera from 18 prostitutes from Bratislava were examined for the presence of antibodies to several sexually transmitted pathogens, namely Herpes simplex virus 2 (HSV-2), Human immunodeficiency viruses 1 and 2 (HIV-1 and HIV-2), Hepatitis B and C viruses (HBV and HCV), Chlamydia trachomatis, and Treponema pallidum. Results of this screening indicated that 11 prostitutes (61%) carried 1 or more sexually transmitted infections. The most prevalent antibodies were directed against HSV-2 (9 cases, i.e. 50%), which represents the most common sexually transmitted infection agent.
Assuntos
Trabalho Sexual , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Chlamydia trachomatis/imunologia , Feminino , Soroprevalência de HIV , HIV-1/imunologia , HIV-2/imunologia , Antígenos de Superfície da Hepatite B/sangue , Hepatite C/imunologia , Herpesvirus Humano 2/imunologia , Humanos , Incidência , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Virais Sexualmente Transmissíveis/virologia , Eslováquia/epidemiologia , Treponema pallidum/imunologiaRESUMO
The occurrence of positive synergy between antibiotic discs of amoxicillin/clavulanate and cefoperazone was registered in two Klebsiella pneumoniae strains, isolated from hospitals in Czech and Slovak Republic, indicating the presence of genes coding for an extended-spectrum beta-lactamase active also against cefoperazone, a broad-spectrum cephalosporin. Sulbactam inhibited the hydrolysis of cefoperazone by cell-free lysates of these strains which substantiates its use in combination with cefoperazone. Resistance to cephalothin, cefotaxime, ceftazidime, cefoperazone, cefepime and aztreonam was transferred from K. pneumoniae isolates to Escherichia coli K-12 3110 and to Proteus mirabilis P-38 recipient strains.
Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Antibacterianos/farmacologia , Cefoperazona/farmacologia , Resistência a Múltiplos Medicamentos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/efeitos dos fármacos , Cefalosporinas/farmacologia , Infecção Hospitalar/tratamento farmacológico , República Tcheca , Interações Medicamentosas , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Humanos , Hidrólise , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/patogenicidade , Proteus mirabilis/efeitos dos fármacos , Proteus mirabilis/genética , EslováquiaRESUMO
Sixty-seven multiresistant nosocomial Acinetobacter baumannii isolates from patients hospitalized mostly in intensive care units of seven clinics in Slovak and Czech Republic were tested to determine their ability to transfer antibiotic resistance. All isolates were resistant to kanamycin, ticarcillin, cephalothin, cefotaxime, ceftazidime, aztreonam and susceptible to carbapenems, sulbactam and ampicillin/sulbactam. Sixty-five out of 67 strains transferred resistance determinants to Escherichia coli K-12 and Proteus mirabilis P-38 recipients. Analysis of selected transconjugants by an indirect selection method showed a more variable pattern of transferred resistance determinants. The clonal spread of strains transferring resistance seems to be an additional risk for occurrence of strains resistant to ceftazidime and aztreonam.
Assuntos
Acinetobacter/efeitos dos fármacos , Infecção Hospitalar/tratamento farmacológico , Resistência a Múltiplos Medicamentos , Escherichia coli/efeitos dos fármacos , Transferência Genética Horizontal , Acinetobacter/genética , Acinetobacter/patogenicidade , Infecções por Acinetobacter/tratamento farmacológico , República Tcheca , Escherichia coli/genética , Escherichia coli/patogenicidade , Humanos , Unidades de Terapia Intensiva , Dinâmica Populacional , Fatores de Risco , EslováquiaRESUMO
In thirty patients after EPS and gall extraction for cultivation ceftriaxon in preventive dose 1 g was administered. This group of patients was compared with a group of 30 patients after EPS without preventive administration of antibiotic from clinical and biochemical point of view. Most frequently occurring bacteria in the gall of patients after EPS were Pseudomonas aeruginosa and E. coli. All of the detected bacteria were sufficiently sensitive to ceftriaxon. Preventive effect of ceftriaxon was manifested in statistically significant fall of hyperbilirubinemia and hyperamylasemia 24 hours after EPS (p > 0.05). (Tab. 5, Ref. 8.)