Current state and tendencies of antibiotic resistance in Hungary

This survey is based on data for 245 903 isolates reported by Public Health Network laboratories in 1983. Facultatively pathogenic Gram-negative bacteria comprised two-third of the isolates, and--except Escherichia coli--were resistant in a high percent to the most frequently used antibiotics. Oxacillin and vancomycin were the most effective against Staphylococcus aureus being in 94.7% resistant to penicillin. In contrast to other streptococci, all Streptococcus pyogenes strains were sensitive to penicillin. The majority of the Gram-positive strains were resistant to tetracycline. A comparison to results reported earlier (1974 to 1983) showed an increasing resistance rate mainly to ampicillin, carbenicillin, co-trimoxazole and gentamicin, which were introduced in therapy during this period. Resistance rate of almost all species has increased to gentamicin, e.g. that of Proteus mirabilis has risen tenfold. Emergence of Haemophilus influenzae resistant to ampicillin, and increasing resistance rates of P. mirabilis and Streptococcus pneumoniae to almost all drugs are remarkable findings. The increasing or variable usage of drugs that have been used for a long time did not influence resistance markedly. In some instances the resistance rates even diminished, e.g. the tetracycline resistance of agents associated with enteric diseases. A restricted use of chloramphenicol reflected in a decreased resistance of some species. Multiresistant Gram-negative strains--which are resistant to all drugs frequently used in Hungary--were isolated in 12.7% from a representative clinical material. The frequent occurrence of multiresistant P. mirabilis and Acinetobacter isolates is a new phenomenon. Surprisingly, the percentage of multiresistant E. coli strains was very low. Amikacin and netilmicin were found to be the most effective against multiresistant isolates.