Continual monitoring of hospital ECO system and
its antimicrobial susceptibility is an imperative in
prevention of endemic hospital infection. The aim of this paper was to present the significant changes in dynamic balance and antibiotic resistance in the hospital ECO system of the surgical Intensive Care Unit in the period of 15 years (1991-2007). The results obtained have shown decreased isolation of gram negative bacilli from 90% (1991) to 63% (2007)and significant increased isolation of Staphylococcus
aureus. Structure of microorganisms found in hospital
setting during 1991-1994 was: Pseudomonas aeruginosa (41%), Acinetobacter spp. 2006-07:Staphylococcus aureus (32%), Acinetobacter spp.(27%), Pseudomonas aeruginosa (14%), and Klebsiella aerogenes (11%) Proteus mirabilis (9%), E. coli (5%). The analysis revealed that Pseudomonas aeruginosa
was pushed out from the first to the third place, being
replaced by Staphylococcus aureus, mainly MRSA(87% out of the total SA). There were endemic strains of enterobacteria (multiresistant Proteus mirabilis, E.coli and Klebsiellaaerogenes), which had no significant
importance in causing infection in ICU 15 years ago.
Acinetobacter spp. has proved to be a very important
hospital pathogen over the last 3 years within its
population there has been an increase of strains of
extremely multiresistant mutants that are susceptible
only to imipenem (10% of resistance) and greatly
enlarged resistance percentage to amikacyn (80%).
Conclusion
1. The MRSA has become a common nosocomial
pathogen in investigated ICU instead of
Pseudomonas aeruginosa.
2. Continual monitoring of ICU should be
implemented in order to perceive changes in the
ICU dynamic balance on time
