| Abstract | Cilj: Odrediti promjenu u rezistenciji sojeva Acinetobacter baumannii na antimikrobna sredstva u razdoblju od 2008. do 2012. godine, te odrediti primjereno terapijsko sredstvo za liječenje infekcija uzrokovanih sojevima A. baumannii.
Ispitanici i metode: Istraživanje je presječno. Iz pismohrane Kliničkog zavoda za mikrobiologiju i parazitologiju Kliničkog bolničkog centra Split za dvogodišnje razdoblje od 01.siječnja 2008. do 31.prosinca 2008. do 01.siječnja 2012 do 31.prosinca 2012. godine izdvojeni su podatci o sojevima A. baumannii izoliranim iz različitih uzoraka (krvi, urina, aspirata traheje, intravenskog katetera) koji su uzeti od bolesnika iz Jedinice intenzivnog liječenja KBC Split te rezultati ispitivanja osjetljivosti tih sojeva na antibiotike. Osjetljivost sojeva na antibiotike je određivana metodom disk-difuzije i/ili E-testa.
Glavne mjere ishoda su osjetljivost sojeva A. baumannii na ispitivane antibiotike, usporedba osjetljivosti sojeva 2008. i 2012. godine na ispitivane antibiotike, utvrđivanje porasta rezistencije (u postotcima) te određivanje primjerenog terapijskog sredstva za liječenje infekcija uzrokovanih A.baumannii.
Rezultati: Usporedbom rezultata testiranja osjetljivosti sojeva A. baumannii na antibiotike 2008. i 2012. godine uočen je statistički značajan porast rezistencije na amikacin (p<0,001), ciprofloksacin (p<0,004), gentamicin (p<0,028), imipenem+cilastatin (p<0,001), meropenem (p<0,001) te piperacilin+tazobaktam (p<0,004). Nije bilo statistički značajne razklike u osjetljivosti na ampicilin+sulbaktam (p<0,008). U ispitivanom razdoblju nije zabilježena rezistencija na kolistin.
Zaključci: Rezistencija sojeva A. baumannii je u promatranom razdoblju porasla, najviše na karbapenemske antibiotike. Ampicilin +sulbaktam je prvi lijek izbora za liječenje infekcija uzrokovanih sa A. baumannii s obzirom na niski stupanj rezistencije bakterije na ove antibiotik. U obzir dolazi i kolistin u slučaju da je soj rezistentan na ampicilin+sulbaktam. |
| Abstract (english) | Objective: To determine the change in resistance pattern in Acinetobacter baumannii strains to antimicrobial agents in the period since 2008. to 2012. and to determine the appropriate therapeutic agent for the treatment of infections caused by such strains.
Patients and Methods: The study was cross-sectional. From the archives of the Department of Clinical Microbiology, University Hospital Centre Split in two-year period (from January 01, 2008 to December 31, 2008 till January 01, 2012 to December 31, 2012) data about A. baumannii strains were extracted. Strains were isolated from various clinical samples (bronchial aspirate, wound swabs, catheter tip, abdominal samples, peak drain, blood, urine, tracheal aspirate, intravenous catheter). Samples were obtained from patients from Intensive Care Unit at University Hospital Centre Split. Results of sensitivity testing of these strains to antibiotics were also obtained. The sensitivity of strains to antibiotics was determined using disk diffusion method and / or E-test.
The main outcome measures were sensitivity pattern of A. baumannii strains to antimicrobals tested, comparison of resistance rates of the strains tested in 2008. and 2012. and the choice of the appropriate therapeutic agent for the treatment of infections caused by A.baumannii
Results: Comparison of antibiotic susceptibility rates of A. baumannii strains in years 2008. and 2012. showed statistically significant increase in resistance rates to amikacin (p <0.001), ciprofloxacin (p <0.004), gentamicin (p <0.028), imipenem + cilastatin (p <0.001), meropenem (p <0.001), and piperacillin + tazobactam (p <0.004). There was no statistically significant difference in susceptibility rates to ampicillin + sulbactam (p<0,008). There was no resistance to colistin observed.
Conclusions: Resistance rates of A. baumannii strains in the study period have grown, especially to carbapenem antibiotics. Ampicillin + sulbactam is the drug of choice for treatment of infections caused by A. baumannii because it showed low level of resistance. Colistin is appropriate choice in case of infection caused by ampicillin + sulbactam resistant strain. |
