Browsing by Author "Andjelkovic, Dragana (56806727700)"

Introduction: Coagulase-negative staphylococci (CoNS) are increasingly resistant nosocomial pathogens. We aimed to analyze the prevalence of CoNS isolates in clinical settings, the evolution of antimicrobial resistance of CoNS, and antibiotic consumption in a hospital. Methodology: This retrospective cohort study was carried out at a tertiary healthcare facility over 17 months. Identification of isolated cultures and antibiotic susceptibility testing were performed using the Vitek2 system. Of 1,217 isolates, 209 were obtained from 193 patients who had symptoms of nosocomial infections. Data were analyzed by descriptive statistics. Antibiotic consumption in the hospital is expressed in defined daily doses/100 patient days. Results: Sixty-one percent of patients were admitted to the internal medicine ward, while others were admitted to the surgical ward. Forty-four percent of Gram-positive isolates were from wound swabs, and 26% were from blood. The predominant Gram-positive bacteria were CoNS. Antibiotic resistance of CoNS was highest against beta-lactam antibiotics, macrolides, and tetracyclines. Tigecycline, linezolid, and vancomycin produced the highest activities against CoNS in in vitro conditions, and consumption of linezolid and tigecycline increased in the same period. Conclusion: There are just a few remaining therapeutic options for the treatment of CoNS according to our results; vancomycin, linezolid, and tigecycline might be considered as first-choice antibiotics, but such a hypothesis should be supported with a pharmacoeconomic analysis. Unfortunately, novel antimicrobial agents are still unavailable and/or too expensive in developing countries. However, inappropriate use of those antibiotics may lead to the rapid development of resistant strains in the near future. © 2016 Protic et al.

Introduction: Coagulase-negative staphylococci (CoNS) are increasingly resistant nosocomial pathogens. We aimed to analyze the prevalence of CoNS isolates in clinical settings, the evolution of antimicrobial resistance of CoNS, and antibiotic consumption in a hospital. Methodology: This retrospective cohort study was carried out at a tertiary healthcare facility over 17 months. Identification of isolated cultures and antibiotic susceptibility testing were performed using the Vitek2 system. Of 1,217 isolates, 209 were obtained from 193 patients who had symptoms of nosocomial infections. Data were analyzed by descriptive statistics. Antibiotic consumption in the hospital is expressed in defined daily doses/100 patient days. Results: Sixty-one percent of patients were admitted to the internal medicine ward, while others were admitted to the surgical ward. Forty-four percent of Gram-positive isolates were from wound swabs, and 26% were from blood. The predominant Gram-positive bacteria were CoNS. Antibiotic resistance of CoNS was highest against beta-lactam antibiotics, macrolides, and tetracyclines. Tigecycline, linezolid, and vancomycin produced the highest activities against CoNS in in vitro conditions, and consumption of linezolid and tigecycline increased in the same period. Conclusion: There are just a few remaining therapeutic options for the treatment of CoNS according to our results; vancomycin, linezolid, and tigecycline might be considered as first-choice antibiotics, but such a hypothesis should be supported with a pharmacoeconomic analysis. Unfortunately, novel antimicrobial agents are still unavailable and/or too expensive in developing countries. However, inappropriate use of those antibiotics may lead to the rapid development of resistant strains in the near future. © 2016 Protic et al.

Background: The incidence of nosocomial infections caused by multi-drug- and extended-drug resistant strains of Acinetobacter is constantly increasing all over the world, with a high mortality rate. We analyzed the in-hospital data on the sensitivity of Acinetobacter baumannii isolates and correlated them with antibiotic treatment and clinical outcomes of nosocomial infections over a 17-mo period. Methods: Retrospective analysis was performed at the Clinical Center "Bezanijska kosa," Belgrade, Serbia. Microbiologic data (number and sensitivity of A. baumannii isolates) and clinical data (medical records of 41 randomly selected patients who developed nosocomial infection caused by A. baumannii) were matched. Results: Acinetobacter baumannii, detected in 279 isolates and obtained from 19 patients (12% of all samples), was resistant to almost all antibiotics tested, including carbapenems, with the exception of colistin and tigecycline. It was obtained most often from the respiratory tract samples. Empiric treatment of the nosocomial infections (pneumonia in 75% of cases) involved cephalosporins, metronidazole, and carbapenems (80%, 66%, and 61% of patients, respectively), whereas tigecyclin and colistin were used primarily in targeted therapy (20% and 12% of patients, respectively). The mortality rate of patients treated empirically was significantly higher (p < 0.01), reaching 100% in the elderly. Conclusions: Nosocomial A. baumannii infections represent a significant clinical problem because of their high incidence, lack of susceptibility to the most commonly used antibiotics, and the often inappropriate treatment, which favors the development of multi-drug-resistant strains. © Mary Ann Liebert, Inc. 2016.