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Susceptibility patterns of Gram-negative bacteria from a Polish intensive care unit, 1997-2000
Jan Patzer1, Danuta Dzierzanowska, Philip Turner
1Department of Clinical Microbiology, Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-736, Warsaw, Poland. patzer@czd.waw.pl
Abstract:
The susceptibility of Gram-negative bacterial strains (n=400) isolated from clinical specimens of children hospitalized in a Polish intensive care unit (ICU) between 1997 and 2000 was tested. Meropenem, imipenem and ciprofloxacin were most active (>90% susceptibility) against the tested isolates, with no observed reduction in activity over 4 years. Extended-spectrum beta-lactamases and AmpC beta-lactamase producers among Enterobacteriaceae isolates from this ICU continued to be a serious therapeutic problem, although the carbapenems were highly active against these resistance phenotypes. Resistance to aminoglycosides (gentamicin, tobramycin) and ceftazidime was a characteristic of >40% of tested isolates.
Insights
Meropenem, imipenem, and ciprofloxacin showed high activity against Gram-negative bacteria in a Polish pediatric intensive care unit (ICU). Carbapenems remained effective against problematic extended-spectrum beta-lactamase producers.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pediatric Critical Care
Background:
- Gram-negative bacterial infections pose a significant threat in pediatric intensive care units (ICUs).
- Antimicrobial resistance, particularly from extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase producing Enterobacteriaceae, complicates treatment.
- Monitoring antibiotic susceptibility is crucial for effective patient management in ICUs.
Purpose of the Study:
- To assess the antimicrobial susceptibility patterns of Gram-negative bacteria isolated from children in a Polish ICU.
- To evaluate the activity of key antibiotics, including carbapenems and ciprofloxacin, over a four-year period.
- To identify persistent challenges posed by specific resistance mechanisms like ESBL and AmpC production.
Main Methods:
- Analysis of 400 Gram-negative bacterial isolates from clinical specimens of hospitalized children.
- Susceptibility testing performed between 1997 and 2000.
- Evaluation of resistance to meropenem, imipenem, ciprofloxacin, aminoglycosides (gentamicin, tobramycin), and ceftazidime.
Main Results:
- Meropenem, imipenem, and ciprofloxacin demonstrated high activity (>90% susceptibility) against tested Gram-negative isolates.
- Antibiotic activity remained stable over the four-year study period.
- Over 40% of isolates exhibited resistance to aminoglycosides and ceftazidime.
- Carbapenems showed high activity against ESBL and AmpC producing Enterobacteriaceae, despite these being a therapeutic challenge.
Conclusions:
- Meropenem, imipenem, and ciprofloxacin are effective therapeutic options for Gram-negative infections in this pediatric ICU setting.
- Carbapenems maintain significant activity against problematic ESBL and AmpC producing Enterobacteriaceae.
- High rates of resistance to aminoglycosides and ceftazidime necessitate careful antibiotic selection.