Antibiotic susceptibility of isolates from paediatric intensive care units in Zagreb.
OBJECTIVE
Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program is a longitudinal global surveillance study to monitor in vitro data on microbial susceptibility in centers that prescribe meropenem. Results of the six years period (2002-2007) for the antimicrobial efficacy of meropenem compared to other broad-spectrum agents against Gram-negative and Gram-positive isolates collected at pediatric intensive care units of the University Hospital Center Zagreb in Croatia were reported.


METHODS
A total of 110 Gram-negative and 43 Gram-positive pathogens from pediatric specimens were tested. The minimum-inhibitory concentrations (MICs) were determined by broth microdilution method according to CLSI.


RESULTS
There was no resistance to either imipenem or meropenem observed for Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis. High resistance rates of K. pneumoniae to ceftazidime and gentamicin (50%) are a raising concern. Pseudomonas aeruginosa was the most resistant Gram-negative species with two (12%) of the strains resistant to meropenem, three (18%) to imipenem, 10 (47%) to gentamicin and six (35%) to piperacillin/tazobactam and ciprofloxacin. According to our results meropenem remains an appropriate antibiotic for the treatment of severe infections caused by Gram-negative bacteria in pediatric population.


CONCLUSIONS
The results indicate that meropenem has excellent potency and spectrum of activity despite being prescribed for a long time for the treatment of seriously ill patients, and still appears to be a reliable option for the initial empirical therapy of serious nosocomial infections in children. However, later studies have shown the emergence of carbapenem-resistant Gram-negative bacteria after 2008.
1Department of Microbiology, School of Medicine, University of Zagreb, 2University Hospital Center Zagreb, 3Department of Microbiology, Istria County Public Health Institute, Pula, 4Department of Microbiology, Public Health Institute Osijek, 5Department of Parasitology, National Public Health Institute, Zagreb, 6Health Care Center "Centar", Zagreb; Croatia.
Branka
B
Bedenić
Esmina
E
Prahin
Mirna
M
Vranić-Ladavac
Vlasta
V
Atalić
Mario
M
Sviben
Sonja
S
Frančula-Zaninović
Vanda
V
Plečko
Smilja
S
Kalenić
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D017523:Croatia; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008826:Microbial Sensitivity Tests
D000900:Anti-Bacterial Agents