THE RESISTANCE OF OUTPATIENT’S URINARY TRACT ISOLATES FROM FAMILY ENTEROBACTERIACEAE ON ANTIBACTERIAL AGENTS - SITUATION IN PRIMORSKO-GORANSKA COUNTY

Abstract

SAŽETAK Infekcije mokraćnoga sustava ubrajaju se među najčešće bakterijske infekcije, i jedan su od najučestalijih razloga primjene antibakterijskih lijekova. Iako bi bilo optimalno zasnivati liječenje na nalazima laboratorijskoga testiranja osjetljivosti, to u praksi često puta nije moguće. Stoga se liječenje najčešće započinje empirijski, na osnovi poznavanja osjetljivosti, odnosno otpornosti najvažnijih uzročnika infekcija prema antibakterijskim lijekovima na određenu području. Godine 2004. u Republici Hrvatskoj dogovorene su smjernice antimikrobnoga liječenja i profilakse infekcija mokraćnoga sustava. U ovome su radu prikazani rezultati ispitivanja osjetljivosti najvažnijih uzročnika mokraćnih infekcija – bakterija iz porodice Enterobacteriaceae – provedenih u Nastavnome zavodu za javno zdravstvo Primorsko- -goranske županije. Cilj je rada bio analiza stanja otpornosti najučestalijih izolata iz te porodice u trogodišnjem razdoblju (2004. – 2006.), usporedba dobivenih rezultata s preporukama danim u sklopu Smjernica antimikrobnoga liječenja nakon njihova objavljivanja, te usporedba s podacima iz drugih dijelova Hrvatske. Analizom je obuhvaćeno ukupno 15.076 izolata. Prema dobivenim rezultatima, udio otpornih izolata bakterija najniži je prema ceftibutenu (3%), potom slijede koamoksiklav (5%), cefuroksim i gentamicin (6%), te ciprofloksacin i norfloksacin (7% i 8%). Dok su na osnovi naših rezultata cefazolin i nitrofurantoin bili nedjelotvorni prema 13% obuhvaćenih sojeva, stupanj otpornosti bio je najviši prema ko-trimoksazolu (26%) i amoksicilinu (44%).ABSTRACT Urinary tract infections are very frequent and often caused by bacterial agents. Therefore, they are one of the most common reasons for antbacterial agents prescribing. In everyday’s practise the introduction of empiric antibiotic therapy is almost inevitable. The empiric therapy should be based on data regarding susceptibility/resistance of the most common causal bacterial agents against antibacterial drugs on certain area. During 2004, Recommendations for antimicrobial therapy and prophylaxis of urinary tract infections in Croatia were published. Present paper presents the results of antimicrobial susceptibility testing of the most important bacterial agents of urinary tract infections belonging to the family Enterobacteriaceae performed in Teaching Public Health Institute of Primorsko-Goranska County. The main goal of this paper was to determine the resistance rates against selected antimicrobials during the three year period (2004 – 2006) and comparison of these results with previously mentioned Recommendations after their publishing and results from the rest of Croatia. The total number of 15.076 isolates were analysed. The ratio of resistant isolates was lowest against ceftibuten (3%), followed by co-amoxiclav (5%), cephuroxim, gentamycin (6%), ciprofloxacin and norfloxacin (7% and 8% respectively). Cephasoline and nitrofurantoin were not active against 13% of analysed strains while the highest ratios of resistant strains were recorded against co-trimoxasole (26%) and amoxicillin (44%)