Zaporožskij Medicinskij Žurnal (Feb 2017)
Family Еnterobacteriaceae spp. antibiotic resistance as the main pathogen of the urinary tract infections among adult women
Abstract
A growing antibiotic resistance among the pathogens of infectious and inflammatory diseases is an extremely serious problem in medicine and nephrology, in particular. Knowledge of urinary tract infections pathogens regional bacterial resistance is the «basis» of a differentiated approach to empirical antibacterial treatment as a pathogenetic treatment of this pathology. The aim of the article is to determine the range and dynamics of the family Enterobacteriaceae antibiotic resistance as dominate among different groups of the urinary tract infections pathogens in adult women of the Chernivtsi region. Materials and Methods. A retrospective analysis of the bacteriological examination of 396 urine samples of the Chernivtsi region adult women (2009–2013) was conducted with the purpose of the diagnosis “Urinary Tract Infections” (UTI) verification. Results. 99 strains of the family Enterobacteriaceae (except Proteus) were extracted in etiologically significant quantities. The range of the extracted strains sensitivity to antibiotic medicine (antibiotics) was investigated. Temporal dynamic changes of the antibiotic resistance of Enterobacteriaceae as the pathogens of the urinary tract infections were analyzed. Conclusions. Dynamics (2009–2013) of the family Enterobacteriaceae strains resistance (except Proteus) as the main pathogen of the urinary tract infections in women living in Chernivtsi region was largely dependent on the group of antibacterials and mostly characterized by «undulating» varied pattern. Results of the study show that uropathogen E.coli extracted from the women living in this region retains sensitivity to penicillin series antibiotics (c2= 3.89; р < 0.05), fluoroquinolones (c2= 9.15; р < 0.01) and chloramphenicol (c2= 5.37; р < 0.05). A clear tendency to reduce antibiotic resistance strains of E.coli to cephalosporins of the 1st generation and presence of «undulating curve» resistance to cephalosporins of the 3rd generation is traced. Regional microbiological monitoring makes it possible to analyze the spectrum of UTI pathogens and their sensitivity to antibacterial drugs, to take measures timely to prevent the development of uropathogen bacterial multiresistance and introduce modifications into local clinical protocols of UTI treatment in hospitals of the Chernivtsi region.
Keywords
