engleski

Antibiotic susceptibilities of bacterial isolates from paediatric intensive care units included in MYSTIC programe

Background and aim The aim of the study was to analyze antibiotic susceptibilities of Gram- negative and Gram-positive bacterial isolates from pediatric intensive care units included in Mystic programe. Methods The isolates were collected from various clinical specimens at pedriatic intensive care units of the Clinical Hospital Center Zagreb in Croatia. The minimum- inhibitory concentrations (MIC) were determined by broth microdilution method according to CLSI. Extended-spectrum β-lactamases were detected by double-disk synergy test. Results There was no resistance to either imipenem or meropenem observed for E. coli, K. pneumoniae and P. mirabilis. 37% of E. coli isolates showed resistance to gentamicin and 12% to ciprofloxacin. High rates of resistance of K. pneumoniae to ceftazidime and gentamicin (40%) are raising concern (Table 1). Prevalence of ESBLs was 37% in E. coli and 50% in K. pneumoniae. According to MIC90 carbapenems were the most potent antibiotics against Enterobacter cloacae whereas ceftazidime was the least potent antibiotic tested (Table 2). All A. baumannii strains were resistant to gentamicin (Table 3). 11% of P. aeruginosa strains were resistant to carbapenems and 22% to gentamicin, piperacillin/tazobactam and ciprofloxacin (Table 4). Among Gram-positive pathogens staphylococci showed susceptibility to most tested antibiotics (Table 5) contrary to enterococci which showed 85% resistance to gentamicin (Table 6). All enterococci were resistant to cephalosporins due to their intrinsic resistance. Conclusions • These data provide evidence that despite the continued use of meropenem, carbapenem resistance is not increasing among those species tested except for P.aeruginosa, in pediatric ICU, and suggest that clinicians can still administer carbapenems as reliable and effective choice in managing serious nosocomial infections in children. • Low resistance rates to ciprofloxacin are probably due to the fact the fluoroquinolones are not prescribed in children. • Meropenem showed better activity against Gram-negative bacteria while imipenem was more efficient against Gram-positive cocci. • Instrinsic resistance of enterococci to cephalosporins is atributed to the lack of autolytic enzyme in the bacterial cell wall.

Antibiotics ; bacterial resistance ; infections ; intensive care

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