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1

Zarazenia grzybicze u pacjentow hospitalizowanych na Oddziale Intensywnej Terapii

100%

Kurnatowski P. , Wieczorek A. , Gaszynski T. , Tyczkowska-Sieron E.

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nr 1

23-27

EN

Over the last years, systemic fungal infections have dramatically increased in hospitalized patients. The Candida is the main pathogen caused nosocomial fungal infections. The aim of the study: The aim was to analyze frequency of occurrence of the yeast-like fungi in different biological materials isolated from the patients of an Intensive Care Unit of the University Hospital of Lodz in the period of 2000-2003. Material and methods: 123 strains of fungi were analyzed with the use of API 20 C AUX® test (bioMarieux). Results: Among all the investigated Candida strains C. albicans accounted for 52.0%. Samples from respiratory system and urine most often contained the strains of C. albicans (56.3 and 60.5%, respectively); blood samples contained C. parapsilosis (44.8%). In patients who were untreated by bacterial antibiotics C. albicans was the most frequent species, whereas in patients who were ordered bacterial antibiotics it was C. parapsilosis that dominated. Conclusions: (1) Candida is the most frequent cause of fungal infections in patients hospitalized in an intensive care unit. (2) C. parapsilosis is the main pathogen caused bloodstream infections. This species is also more frequent in patients who were ordered antibacterial antibiotics over five days. (3). Species other than C. albicans become more and more frequent and dangerous.

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Czestosc wystepowania i lekoopornosc paleczek z rodziny Enterobacteriaceae izolowanych od pacjentow hospitalizowanych na oddzialach intensywnej terapii

84%

Rudnicka J. , Wroblewska M. , Marchel H. , Luczak M.

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nr 2

185-191

PL

Pacjenci hospitalizowani na oddziałach intensywnej terapii (OIT) są szczególnie narażeni na zakażenia wywołane przez bakterie oporne na wiele antybiotyków. Celem pracy była ocena częstości występowania i lekowrażliwości szczepów pałeczek Gram-ujemnych z rodziny Enterobacteriaceae izolowanych z materiałów klinicznych od tej grupy chorych, ze szczególnym uwzględnieniem profilu oddziału. Stwierdzono różnice w obrazie lekowrażliwości zależnie od rodzaju materialu klinicznego i profilu oddziału OIT.

EN

The aim of the study was estimation of frequency and susceptibility to antimicrobial agents of Gram-negative rods isolated from clinical specimens obtained from patients requiring intensive care, with emphasis on profile of the unit. The analysis comprised strains of Gram-negative rods isolated from patients of two intensive care units (ICUs) of a tertiary care hospital (1200 beds). Identification of cultured isolates was done using automated VITEK and API systems (bioMerieux, France). Susceptibility to antimicrobial agents was tested by a disk-diffusion method according to the NCCLS recommendations. In total the analysis comprised 722 strains of Gram-negative rods. In blood cultures predominated strains of Enterobacter spp. (42,5%) and Klebsiella pneumoniae (37,5%). In cultures of clinical specimens other than blood 41,6% comprised strains of Klebsiella pneumoniae, 14,8% Escherichia coli and 14,4% Proteus mirabilis. Frequency of multi-drug resistant strains of bacteria of the family Enterobacteriaceae was much higher among blood isolates in comparison to strains cultured from other clinical specimens. There was a relatively high percentage of strains of Enterobacteriaceae susceptible to piperacillin and tazobactam (69,0%) and ceftazidime(54,6%). Conclusions: 1. All strains were susceptible to carbapenems. 2. There was a relatively high percentage of strains of Gram- negative rods susceptible to piperacillin/tazobactam and ceftazidime. 3. Bacteria isolated from blood cultures were characterised by a much higher percentage of resistant strains in comparison to other specimens. 4. Longer stay in ICU promoted selection of strains resistant to antimicrobials.

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Czestosc wystepowania i lekooopornosc niefermentujacych paleczek Gram-ujemnych izolowanych od pacjentow hospitalizowanych na oddzialach intensywnej terapii szpitala klinicznego

67%

Wroblewska M. , Marchel H. , Rudnicka J. , Luczak M.

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nr 2

217-224

PL

Niefermentujące pałeczki Gram-ujemne są patogenami oportunistycznymi odgrywającymi coraz większą rolę w zakażeniach pacjentów leczonych na oddziałach intensywnej terapii (OIT). Celem pracy była ocena występowania i Iekowrażliwości niefermentujących pałeczek Gram-ujemnych izolowanych od tej grupy chorych, z uwzględnieniem profilu OIT. Stwierdzono różnice w częstości izolacji tych bakterii od pacjentów z różnych oddziałów oraz występowanie oporności szczepów Acinetobacter sp. na karbapenemy.

EN

The aim of the study was to assess frequency and susceptibility to antimicrobial agents of non- fermenting Gram-negative rods isolated from clinical specimens obtained from patients requiring intensive care, with emphasis on profile of the unit. Identification of cultured isolates was done using automated VITEK and API systems (bioMerieux, France). Susceptibility to antimicrobial agents was tested by a disk-diffusion method according to the NCCLS recommendations. In total the analysis comprised 425 strains of non-fermenting Gram-negative rods, constituting 58,9% of all isolates of Gram-negative bacteria. In blood cultures predominated strains of A. baumannii (46,8%) and P aeruginosa (40,4%), while in cultures of other clinical specimens these bacteria comprised 42,9% and 43,9% of isolates. Major differences were observed in frequency of these species on both ICU units. Strains of non-fermenting rods isolated from blood cultures comprised a lower percentage of strains susceptible to antimicrobials (particularly cefepime and carbapenems) than isolates cultured from other specimens. Strains of A. baumannii resistant to imipenem and meropenem were detected with a frequency of 12,5% and 26,7%, respectively. Resistance of P. aeruginosa strains to carbapenems was 62,2% and 44,3%, respectively. There was a relatively high percentage of strains susceptible to cefepime (82,0%), ceftazidime (78,9%), amikacin (77,8%) and piperacillin/tazobactam (69,7%). Conclusions: 1. There was a predominance (58,9%) of strains of Gram-negative non-fermenting rods. 2. Isolates from blood cultures were characterised by a much higher percentage of resistant strains in comparison to other specimens. 3. Strains of A. baumannii resistant to carbapenems were recorded. 4. There were differences in frequency and antimicrobial susceptibility among the strains of P. aeruginosa і A. baumannii depending on the type of clinical specimen and ICU profile.