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A Polish multicenter survey of antimicrobial susceptibility and prevalence of beta-lactamase production among bacterial pathogens isolated from hospitalized and ambulatory patients
Authors:Z Zwolska  A Jezierska-Anczuków  K Filczak  M Basta  A Dworzyński  D Rogala-Zawada  A Samet
Affiliation:Zak?adu Mikrobiologii Instytutu Gru?licy i Chorób P?uc w Warszawie.
Abstract:The aim of the study was to establish the frequency of occurrence of bacterial pathogens with beta-lactamase activity, and pattern of resistance among aerobic and anaerobic strains isolated from: respiratory tract, urinary tract, skin and soft tissues (hospitalized patients) and throat swabs (ambulatory patients). The study was conducted in 1994 year in 6 bacteriological laboratories in four Polish towns (Warszawa, Kraków, Katowice, Gdańsk) according to the protocol. Sensitivity of bacteria was tested by the disc method on the Müeller-Hinton agar or chocolate agar according to NCCLS, activity of beta-lactamase was tested with nitrocephin. A total 2038 clinical strains--1869 aerobic and 169 anaerobic was well-defined and tested for susceptibility to ten antibiotics--amoxicilin, augmentin, ofloxacin, gentamycin, cefradin, erythromycin, cefuroxim, kotrimoxazol, cefalexin and cefaclor. Among the isolated aerobes Staphylococcus aureus (25.1%), E. coli (23.2%) and Haemophilus influenzae (14.0%) were most frequent, and in the group of anaerobes the most frequent were Bacteroides spp (40.8%) We have found 45.8% of all tested aerobic strains with beta-lactamase production, the highest proportion in pathogens isolated from respiratory tract--51.4%, 46.6% from urinary tract, and 48.4% from skin and soft tissues. Among the isolated anaerobic--68.8% of Bacteroides and 28.6% others produced beta-lactamase. Forty percentage of all strains were sensitive to amoxicilin, 70-90% of aerobic bacteria were sensitive to augmentin. Augmentin had a high activity against anaerobic bacteria too. Only a small proportion of the tested aerobic bacteria (12.2%) were resistant to ofloxacin, gentamycin showed a sufficient activity against tested strains (24.4% were resistant). The most frequent pathogen--Staphylococcus aureus was resistant to amoxicilin in 83.1% hospitalized patients, and in 73.9% in ambulatory patients.
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