SAŽETAK

Praćenje distribucije sojeva određenih bakterijskih vrsta i njihove osetljivosti na antibiotike veoma su značajan parametar u svakodnevnoj kliničkoj praksi, jer se na osnovu ovih pokazatelja, u određenoj sredini, može rukovoditi pri izboru antibiotika i pratiti uspeh antibiotske terapije. U našoj sredini, od ukupno 484 izolata najviše je bilo sojeva S. aureus 73 (15%) od kojih je 50 (10% u odnosu na ukupan broj izolata) MRSA, zatim Staphylococcus species 62(13%) od kojih je 18 (10% u odnosu na ukupan broj izolata) MRSS, Acinetobacter species 57 (12%), Pseudomonas aeruginosa 53 (11%), Pseudomonas species 42 (9%), Enterococcus species 30 (6%), Enterobacter species 29 (6%), Klebsiella species 25 (5%), Stenotrophomonas maltophilia 19 (4%), dok su ostale bakterije zastupljene u veoma niskom procentu. Najveći procenat rezistencije zapažen je kod sojeva Stenotrophomonas maltophilia, koji su 100% rezistentni na imipenem i meropenem i visoko rezistentni na cefalosporine III generacije, Acinetobacter species, koji su 100% rezistentni na cefalosporine III generacije i ciprofloksacin, dok su sojevi Pseudomonas aeruginosa visoko rezistentni na ciprofloksacin (79%) i gentamicin (84%), a nizak je procenat rezistencije na imipenem i meropenem (5%). Značajno je, da u našem istraživanju nije bilo vankomicin rezistentnih sojeva Enterococcus species i vankomicin intermedijernih, odnosno vankomicin rezistentnih sojeva S. aureus koji u svetu predstavljaju veliki problem u svakodnevnoj kliničkoj praksi.

Ključne reči: rezistencija, antibiotik, Gram pozitivne bakterije, Gram negativne bakterije

SUMMARY

Monitoring the distribution of the strains of certain bacterial species and their sensitivity to antibiotics may be very helpful in the routine clinical practice. These parameters may determine the choice of antibiotics in a certain environment and help assess the efficacy of the applied treatment. The majority of 484 strains isolated in our environment were S. aureus strains - 73 (15%), 50 of them (making 10% of the total number of isolates) were MRSA. With 62 (13%) Staphylococcus isolates, this was the second frequent bacterial species registered, of which 18% (10% of the total number of isolates) were MRSS. Acinetobacter species were detected in 57 (12%) isolates, Pseudomonas aeruginosa in 53 (11%), Pseudomonas species in 42 (9%), Enterococcus species in 30 (6%), Enterobacter species in 29 (6%), Klebsiella species in 25 (5%), Stenotrophomonas maltophilia in 19 (4%) isolates, while other bacterial species were rather fewer. The highest resistance was registered in Stenotrophomonas maltophilia species, 100% of which were resistant to imipenem and meropenem, and also resistant to the 3rd generation cephalosporines in a very high percentage. Acinetobacter species were found to be 100% resistant to the 3rd generation cephalosporines and ciprofloxacin, while Pseudomonas aeruginosa strains exhibited a high resistance to ciprofloxacin (79) and gentamicin (84%), and a low resistance to imipenem and meropenem (5% respectively). It is significant that in our investigation no Enterococcus species resistant to vancomycin were registered, neither were the vancomycin resistant or intermediary S. aureus strains, unlike elsewhere in the world where they represent a significant problem in every-day practice.

Key words: resistance, antibiotic, Gram- positive bacteria, Gram-negative bacteria

Mr sc med. dr Tatjana Kurucin
Centar za medicinsku mikrobiologiju, Institut za plućne bolesti, Sremska Kamenica