[Nonfermentative gram-negative bacteria: isolation rates and antibiotic sensitivity].
The isolation rates of nonfermentative gram-negative bacteria (NFGNB) are analyzed in the inpatients treated at the B. V. Petrovsky Russian Surgery Research Center in 2005-2009 and antibiotic resistance trends in nosocomial strains of NFGNB are traced in the above period. The study of the etiological structure of nosocomial infections has shown that the past 2 years (2008 and 2009) were marked by a clear tendency for the preponderance of gram-positive coccal pathogens (46.8 and 53.9%) with a considerable (1.5-2-fold) reduction in the proportion of representatives of enterobacteria (31.5 and 24.5%) and NFGB (13.4 and 11.3%), but with an increase in the proportion of fungi up to 7.1 and 8.6%, respectively. Among the NFGNBs, P. aeruginosa remains ohe of the most common pathogens for nosocomial infections although its portion in the number of all etiologically significant microorganisms was substantially reduced (from 13% in 2005 to 4.6% in 2009). It continues to remain one of the most common causative agents for infections of the urinary tract (e.g., after renal transplantation) and upper and lower respiratory tract (e.g. nosocomial pneumonia) and for those developing after surgical interventions (postoperative wound suppuration discharged along the drainages, from a T-sized tube, etc.). Among the NFGNBs, Acinetobacter spp. was the second frequently isolated pathogen, the isolation rate for which also decreased from 7.9% in 2005 to 2.6% in 2009. Polymyxin B and carbapenems (imipenem, meropenem, and doripenem) showed the highest activity against the vast majority of the test strains; however, there was an absolutely clear declining trend in the proportion of carbapenem-sensitive strains among virtually all the NFGNBs under study. According to the proportion of imipenem-, meropenem-, and doripenem-sensitive nosocomial P. aeroginosa strains (66.7, 46.6, and 44.7%, respectively), doripenem had the least activity. Acinetobacter spp. strains sensitive to these drugs showed the same trend (85.1, 51.2, and 39.2%, respectively). Meropenem and doripenem were equally active against B. cepacia strains, each demonstrated 50% sensitivity. As compared with meropenem, doripenem had a preferential activity against only O. anthropi (75 and 57.1% sensitivity, respectively). All the three carbapenems were inactive against S. maltophilia.
Bogomolova
N S
NS
Bol'shakov
L V
LV
Kuznetsova
S M
SM
Oreshkina
T D
TD
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents