Journal of IMAB (Dec 2017)

ANTIMICROBIAL SUSCEPTIBILITY OF CLINICALLY SIGNIFICANT ISOLATES OF ENTEROBACTER SPP., OBTAINED FROM PATIENTS, HOSPITALISED IN VARNA UNIVERSITY HOSPITAL DURING THE PERIOD 2014 – 2016

  • Dobromira Dimitrova,
  • Temenuga Stoeva,
  • Rumyana Markovska,
  • Petya Stankova,
  • Milena Bozhkova,
  • Gergana Nedelcheva,
  • Ivan Mitov

DOI
https://doi.org/10.5272/jimab.2017234.1828
Journal volume & issue
Vol. 23, no. 4
pp. 1828 – 1833

Abstract

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Purpose: Rapidly increasing antimicrobial resistance in medically important bacterial species from family Enterobacteriaceae is one of the most significant microbiological, clinical and epidemiological issues of modern medicine. The aim of this study is to investigate the antibiotic susceptibility of clinically significant isolates of Enterobacter spp., obtained from patients, hospitalized in University Hospital “Saint Marina” – Varna during the period 2014 – 2016. Material and methods: a total of 433 clinical isolates of Enterobacter spp.from blood cultures, urine and wound secretions were studied. The species identification was made by conventional, semi-automated (Crystal, BD) and automated systems (Phoenix, BD). The susceptibility to piperacillin/tazobactam (TZP), ceftazidime (CAZ), meropenem (MEM), gentamicin (Gm), amikacin (Ak), ciprofloxacin (CIP), levofloxacin (LVX), trimethoprime/sulfamethoxazole (SXT) and tetracycline (Tet) was tested by disc-diffusion method and / or automated system Phoenix 100, BD. The results were interpreted according to EUCAST 2016 guidelines. Results: The resistance in the studied collection of isolates, shown in increasing order is as follows: Аk, 4.2% <LVF, 25.4% <TZP, 37.4% <Tet, 38.7% <SXT, 40% <CIP, 44.1% <Gm, 49.7% <CAZ, 57%. Meropenem demonstrated fully preserved activity. In the group of CAZ resistant isolates, the levels of antimicrobial resistance are: Аk, 5.7% <LVF, 42.9% <Tеt, 52.4% <SXT, 60.3% <TZP, 64.4% <CIP, 84.6% <Gm, 86.2%. The rate of CAZ resistant Enterobacter spp. was 66.9% among the urine isolates, 61.9% - among those from blood culture and 46.3% - in the group of isolates from wound secretions. In the three mentioned groups of isolates, the lowest level of resistance was detected to Ak (1.6%; 4%; 6.9%). The isolates from wound and blood cultures demonstrated the highest level of resistance to Gm (60.3%, 42.9%) and the urine isolates – to Тet (60%) and CIP (56.9%). Conclusions: CAZ resistant Enterobacter spp. demonstrated significantly higher levels of resistance in comparison to the whole studied group especially to quinolones and aminoglycosides. The highest level of CAZ resistant Enterobacter spp. was detected in the group of urine isolates.

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