RESUMEN
Sensitivity to antibiotics of the most common pathogens isolated from the upper airways in north-west part of Poland shown significant regional variation. The rise in resistance to penicillin for Streptococcus pneumoniae (to 22%) and to macrolides for Streptococcus pyogenes, Streptococcus pneumoniae and Staphylococcus aureus was observed. No differences in sensitivity have been found between pathogens isolated from hospital and ambulatory patients.
Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/microbiología , Penicilinas/uso terapéutico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/microbiología , Infecciones Bacterianas/epidemiología , Áreas de Influencia de Salud , Humanos , Macrólidos , Pruebas de Sensibilidad Microbiana , Polonia/epidemiología , Infecciones del Sistema Respiratorio/epidemiologíaRESUMEN
One hundred forty-nine Staphylococcus aureus strains were collected between 1994 and 1996 from ambulatory and hospitalized patients in Western Pomerania (north-western part of Poland). The bacteria were isolated from wounds, bronchial tree, bronchoalveolar lavage (BAL), sputum, throat swabs, nose swabs, eye swabs, blood, peritoneal fluid and urine. Resistance to methicillin was checked by disc diffusion test and confirmed using screening according to NCCLS standards. Growth strains was established with crystal violet staining. Furthermore, sensitivity to 17 other antibiotics was tested. Macrorestriction patterns of DNA was studied using the restriction enzyme Sma I and pulsed field gel electrophoresis system (BioRad). Almost all MRSA were identified as multidrug-resistant and all were sensitive to mupirocin, vancomycin and teicoplanin. Basing on Sma I PFGE patterns, 17 different genotypes were identified. The majority of MRSA belonged to Sma I type A (60 isolates) in which 9 closely related subtypes (A1 divided by A9) were identified. The most common was subtype A1 (37 strains), followed by A2 (12 strains), A3 (3), A4 (3), and A5 divided by A9 (each representing a single strain). The strains were ubiquitous and showed large variation as to phenotype. Eleven other MRSA with an identical Sma I PFGE patterns were classified as type B. These strains were predominantly present in material collected at the Department of Urology, Second State Clinical Hospital in Szczecin, First State Clinical Hospital and from outpatients. A typical feature of these strains was an identical resistogram. The remaining types and subtypes (C1, C2, D, E, F, G, and H) were represented by single MRSA strains (Tab. 1). The results indicate that MRSA strains of Staphylococcus aureus present in the region of Western Pomerania belong in general to two genotypes distinguished by Sma I PFGE as type A and B.
Asunto(s)
Resistencia a la Meticilina/genética , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/genética , Resistencia a Múltiples Medicamentos/genética , Genotipo , Humanos , Fenotipo , Polonia , Especificidad de la Especie , Staphylococcus aureus/clasificación , Staphylococcus aureus/aislamiento & purificaciónRESUMEN
Over a fivefold increase, from 11% to 58%, in the prevalence of methicillin-resistance was observed in 1994-95 amongst clinical isolates of Staphylococcus aureus in the State Clinical Hospital No 2 in Szczecin, one of the largest hospitals in the West Pomeranian region of Poland. The aim of this study was to see if any one particular strain was responsible for this apparent outbreak. Fifty-six randomly selected isolates were typed by SmaI macrorestriction analysis using PFGE and by analysis of antimicrobial susceptibility patterns. Results indicate the presence of two epidemic multi-drug resistant MRSA strains. Over 85% of typed MRSA belonged to the first strain, which was probably present in the hospital long before 1994. MRSA of this strain were isolated from patients in 8 hospital wards. The second strain was introduced into two wards of the hospital in the last year of the study.
Asunto(s)
Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Resistencia a Múltiples Medicamentos , Resistencia a la Meticilina , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/clasificación , Humanos , Polonia/epidemiología , Prevalencia , Especificidad de la Especie , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificaciónRESUMEN
The authors have analyzed 5305 urine samples from patients with significant bacteriuria, examined in 1988-1992 at the Department of Microbiology and Immunology of the Pomeranian Academy of Medicine, performing analyses for the State Clinical Hospital No. 2 in Szczecin, and in the Bacteriology Laboratory of the Municipal Health Care Group in Szczecin. The results obtained demonstrate a dominance of Escherichia coli among patients of general medicine ambulatories and internal medicine departments (70%), while patients of the urologic department and urologic out-patient clinic were positive for this bacteria in only 30-40%. It should be mentioned that a significant increase in the number of infections by Pseudomonas, Acinetobacter, and Serratia strains has been observed, mainly among patients after urologic operations.
Asunto(s)
Bacteriuria/microbiología , Sistema Urinario/microbiología , Instituciones de Atención Ambulatoria , Escherichia coli/aislamiento & purificación , Enfermedades Urogenitales Femeninas/cirugía , Humanos , Enfermedades Urogenitales Masculinas , Polonia , Periodo Posoperatorio , UrologíaRESUMEN
The authors have examined 379 women for infection by Chlamydia trachomatis, performing vaginal smears and routine bacterial cultures. C. trachomatis was discovered in 33.2% of the women, most frequently accompanied by erosion of the collum, cervicitis and CIN-Ca. Women with C. trachomatis had the following levels of vaginal purity: 1-44.4%, 2-23.0%, 3 and 4-29.4%, 3.2% -leukocytes only. Leukocytes were present in significantly more women with level 1 of vaginal purity than in the control group. Additional infections (Gardnerella vaginalis, Streptococcus agalactiae, Candida albicans, Escherichia coli and Trichomonas vaginalis) were found in only a small percentage of women with C. trachomatis, just as in controls. The presence of leukocytes or level 1 of vaginal hygiene with leukocytes may favour C. trachomatis, just as in controls. The presence of leukocytes or level 1 of vaginal hygiene with leukocytes may favour C. trachomatis infection, therefore these cases should be subjected to a more thorough examination.
Asunto(s)
Infecciones por Chlamydia/microbiología , Chlamydia trachomatis/aislamiento & purificación , Vaginitis/microbiología , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Cervicitis Uterina/complicaciones , Cervicitis Uterina/microbiología , Frotis Vaginal , Vaginitis/complicacionesRESUMEN
The authors have compared susceptibility of bacteria isolated from various clinical material in 1989-1991 to ofloxacin. Staphylococcus aureus, Escherichia coli, Proteus, Klebsiella, and Enterobacter were frequently susceptible to the antibiotic, the percentage of resistant strains being less than 10-20%. A higher percentage of resistance was noted for Pseudomonas aeruginosa--approx. 40%. A gradual increase in resistance to ofloxacin among Streptococcus faecalis, Serratia and Acinetobacter strains was observed.
Asunto(s)
Bacterias/efectos de los fármacos , Ofloxacino/farmacología , Farmacorresistencia Microbiana , Humanos , Especificidad de la EspecieRESUMEN
The authors have compared the susceptibility of bacterial strains isolated from clinical material in 1990 and 1991 to the most frequently used cephalosporins: cefuroxime, ceftazidime and cefotaxime. The highest susceptibility in 1990 was to cefotaxime, which was seldom used at that time, unlike cefuroxime and ceftazidime. In 1991 an increase in the number of strains resistant to cefotaxime was found, in parallel with a further rise in resistance to cefuroxime and ceftazidime. Frequent use of an antibiotic in a certain region favours the development of resistance. This observation calls for rational therapy with antibiotics, supported by regular studies of susceptibility of the strains in the region.