Metrika članka

  • citati u SCindeksu: 0
  • citati u Google Scholaru:[=>]
  • posete u prethodnih 30 dana:5
  • preuzimanja u prethodnih 30 dana:4
članak: 1 od 1  
Medicinski časopis
2012, vol. 46, br. 3, str. 126-131
jezik rada: srpski
stručni članak
doi:10.5937/mckg46-1899


Osetljivost urinarnih patogena na antimikrobnu terapiju kod pacijenata u primarnoj zdravstvenoj zaštiti
Institut za javno zdravlje, Kragujevac

e-adresa: enci2001@gmail.com

Sažetak

Cilj. Cilj studije je ispitivanje etiologije urinarnih infekcija, kao i osetljivost urinarnih patogena na antimikrobnu terapiju kod pacijenata u primarnoj zdravstvenoj zaštiti. Metode. Istraživanje je sprovedeno retrospektivno na osnovu prikupljenih i analiziranih rezultata trogodišnjih (2009-2011) mikrobioloških analiza uzročnika urinarnih infekcija i antibiograma u mikrobiološkoj laboratoriji Instituta za javno zdravlje Kragujevac. Mikroorganizmi su identifikovani nakon zasejavanja i rasta na hromogenom agaru i ispitana je osetljivost na antibiotike disk-difuzionom metodom na Mueller-Hinton agaru (Biomerieux). Rezultati su analizirani χ2-testom, pri p ≤ 0,05. Rezultati. Od ukupno 44.559 ispitivanih uzoraka, pozitivno na infekciju bilo je 14.738 (33,1%). Najčešći izolati su bili Escherichia coli, Proteus spp, Klebsiella spp, Enterococcus spp i Pseudomonas spp. Najčešće izolovani mikroorganizam kod žena je bila Escherichia coli (72%), a kod muškaraca Klebsiella spp. (28,3%). Takođe, zapažen je pad osetljivosti Proteus spp. na aminoglikozide i hinolone, zatim pad osetljivosti Klebsiella spp. na cefalosporine II i III generacije i hinolone, pad osetljivosti enterokoka na doksiciklin i pad osetljivosti Pseudomonas spp. na cefalosporine III generacije. Porast ESBL (engl. extended spectrum beta-lactamase) sojeva zabeležen je kod E. coli (sa 0,08% na 0,62%) i Proteus spp. (sa 0,49% na 4,14%). Zaključak. Navedeni podaci ukazuju na problem razvoja rezistencije mikroorganizama na antimikrobne lekove, ne samo u bolničkim uslovima, već i u opštoj populaciji. Iz tog razloga neophodno je praćenje cirkulišućih sojeva u različitim životnim uslovima, pojave rezistencije, istraživanje mehanizama rezistencije, i u skladu s tim, formiranje odgovarajućih terapeutskih protokola.

Ključne reči

Reference

Amin, M., Mehdinejad, M., Pourdangchi, Z. (2009) Study of bacteria isolated from urinary tract infections and determination of their susceptibility to antibiotics. Jundishapur J microbiol, 2: 118-23
Araújo, S.M.H.A., Mourão, T.C., Oliveira, J.L., Melo, I.F.S., Araújo, C.A.A., Araújo, N.A.A., Melo, M.C.A., Araújo, S.R., Daher, E.F. (2011) Antimicrobial resistance of uropathogens in women with acute uncomplicated cystitis from primary care settings. International urology and nephrology, 43(2): 461-6
Arpin, C., Quentin, C., Grobost, F., Cambau, E., Robert, J., Dubois, V., Coulange, L., André, C. (2009) Nationwide survey of extended-spectrum {beta}-lactamase-producing Enterobacteriaceae in the French community setting. Journal of antimicrobial chemotherapy, 63(6): 1205-14
Beyene, G., Tsegaye, W. (2011) Bacterial uropathogens in urinary tract infection and antibiotic susceptibility pattern in jimma university specialized hospital, southwest ethiopia. Ethiopian journal of health sciences, 21(2): 141-6
Coque, T.M., Baquero, F., Canton, R. (2008) Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. Euro sureveill, 13: 1-11
Daoud, Z., Afif, C. (2011) Escherichia coli isolated from urinary tract infections of lebanese patients between 2000 and 2009: Epidemiology and profiles of resistance. Chemother res pract, ID 218431, 6.doi: 10.1155/2011/218431
de Backer, D., Christiaens, T., Heytens, S., de Sutter, A., Stobberingh, E.E., Verschraegen, G. (2008) Evolution of bacterial susceptibility pattern of Escherichia coli in uncomplicated urinary tract infections in a country with high antibiotic consumption: A comparison of two surveys with a 10 year interval. Journal of Antimicrobial Chemotherapy, 62(2): 364-368
Durgaryan, A.A. (2010) Ispitivanje direktne antibakterijske aktivnosti prolinom-bogatih peptida, galarmina i analoga, na meticilin-rezistentni Stafilokokus aureus i klinički značajne Gram-pozitivne i Gram-negativne bakterije, in vitro. PONS - medicinski časopis, vol. 7, br. 4, str. 131-137
Fang, H., Lundberg, C., Olsson-Liljequist, B., Hedin, G., Lindbäck, E., Rosenberg, A., Struwe, J. (2004) Molecular epidemiological analysis of Escherichia coli isolates producing extended-spectrum beta-lactamases for identification of nosocomial outbreaks in Stockholm, Sweden. Journal of clinical microbiology, 42(12): 5917-20
Han, Y., Yu, S., Tao, Y. (2012) Urinary tract infections in the neonatal intensive care unit: Clinical analysis of 229 cases. Zhongguo dang dai er ke za zhi, 14(3): 177-80
Hooton, T.M. (2000) Pathogenesis of urinary tract infections: An update. Journal of Antimicrobial Chemotherapy, 46(90001): 1-7
Jovanović, D., Ilić, N., Đokić, D., Tošović, S., Relić, T., Baskić, D. (2011) IgM serokonverzija na Campylobacter jejuni u prve dve godine života kod dece sa gastrointenstinalnim simptomima. Medicinski časopis, vol. 45, br. 1, str. 24-28
Khanemeh, Z.R., Afshar, A.T. (2009) Antimicrobial susceptibility pattern of urinary tract pathogens. Saudy J kidney dis transpl, 20: 251-3
Kumar, M.S., Lakshmi, V., Rajagopalan, R. (2006) Occurrence of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Indian journal of medical microbiology, 24(3): 208-11
Livermore, D.M., Canton, R., Gniadkowski, M., Nordmann, P., Rossolini, G.M., Arlet, G., Ayala, J., Coque, T.M., Kern-Zdanowicz, I., Luzzaro, F., Poirel, L., Woodford, N. (2007) CTX-M: Changing the face of ESBLs in Europe. Journal of antimicrobial chemotherapy, 59(2): 165-74
Llor, C., Aspiroz, C., Cano, A., Barranco, M. (2012) The use of amoxicillin and clavulanic acid and quinolones as first choice antibiotics in uncomplicated urinary tract infections in Spain should be reviewed. Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria / Aten Primaria, 44(7): 443-4
Lytsy, B., Sandegren, L., Tano, E., Torell, E., Andersson, D.I., Melhus, A. (2008) The first major extended-spectrum beta-lactamase outbreak in Scandinavia was caused by clonal spread of a multiresistant Klebsiella pneumoniae producing CTX-M-15. APMIS, 116(4): 302-8
National Committee for Clinical Laboratory Standards (2011) Performance standards for antimicrobial susceptibility testing. Wayne, Eighteenth informational supplement
Okesola, A.O., Aroundegbe, T.I. (2011) Antibiotic resistance pattern of uropathogenic Escherichia coli in South West Nigeria. African journal of medicine and medical sciences, 40(3): 235-8
Pitout, J.D.D., Nordmann, P., Laupland, K.B., Poirel, L. (2005) Emergence of Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs) in the community. Journal of antimicrobial chemotherapy, 56(1): 52-9
Rodríguez-Baño, J., López-Cerero, L., Navarro, M.D., Díaz, de A.P., Pascual, A. (2008) Faecal carriage of extended-spectrum beta-lactamase-producing Escherichia coli: Prevalence, risk factors and molecular epidemiology. Journal of antimicrobial chemotherapy, 62(5): 1142-9
Ronald, A. (2002) The etiology of urinary tract infection: Traditional and emerging pathogens. American Journal of Medicine, 113(1): 14-19
Stamm, W.E., Norrby, S.R. (2001) Urinary tract infections: Disease panorama and challenges. Journal of infectious diseases, 183 Suppl 1: S1-4
Stapleton, A.E. (2003) Urinary tract infections on healthy women. Curr treat opt infect dis, 5: 43-51
Strom, B.L., Collins, M., West, S.L., Kreisberg, J., Weller, S. (1987) Sexual activity, contraceptive use, and other risk factors for symptomatic and asymptomatic bacteriuria. A case-control study. Annals of internal medicine, 107(6): 816-23
Valverde, A., Coque, T.M., Sánchez-Moreno, P.M., Rollán, A., Baquero, F., Cantón, R. (2004) Dramatic increase in prevalence of fecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae during nonoutbreak situations in Spain. Journal of clinical microbiology, 42(10): 4769-75
Walkty, A., Lagacé-Wiens, P.R.S., Karlowsky, J.A., Hoban, D.J., Manickam, K., Adam, H., Pieroni, P., Alfa, M. (2012) Change in antimicrobial susceptibility of Escherichia coli urinary tract isolates at a single institution over a period of 10 years. Canadian journal of microbiology, 58(3): 345-9