Frekvence bakteriálních patogenů a jejich rezistence k anti-mikrobním preparátům na Dětské klinice FN v Olomouci

Frequency of Bacterial Pathogens and their Resistance to Antimicrobial Drugs at the PaediatricClinic, Faculty Hospital Olomouc

The investigation presents data on the prevalence of bacterial pathogenic microorganisms in patients of thePaediatric Clinic of the Faculty Hospital in Olomouc and on the development of resistance to antimicrobial drugsduring the three-year period from 1995 - 1997, incl. provisions within the framework of the antibiotic policy. Themost frequently isolated bacteria were Escherichia coli (19.1 - 20.9%), Staphylococcus epidermidis (12.1 - 16.7 %),Streptococcus viridans (10.3 - 11.4 %), Klebsiella pneumoniae (4.3 - 8.9 %), Staphylococcus aureus (5.4 - 8.5 %),Haemophilus influenzae (5.0 - 7.9 %), Pseudomonas aeruginosa (4.4 - 5.8 %) and Enterococcus sp. (3.3 - 5.7 %).At the Paediatric Clinic a significant rise (p = 0.05) was recorded in the resistance of Pseudomonas aeruginosato ceftazidime (from 1.9% in 1995 to 34.5% in 1997). This very negative trend could be associated among otherswith an increase of the selective pressure of this preparation by 122% (when using parameter RDDDATB). Therewas also a significant rise (p = 0.05) of the resistance of strains of Pseudomonas aeruginosa to ofloxacine (from1.9% to 18.2%) and to ciprofloxacine (from 1.1% to 13.8%), whereby the increase of the selective pressure offluoroquinolones can be characterized by the increase of RDDDATB from 0.08 in 1996 to 0.21 in 1997, which is anincrease of 162.5%. An adverse trend is also the increased frequency of gentamicin resistant strains of Pseudomo-nas aeruginosa (from 8.8% to 24.1%).The increased resistance of Klebsiella pneumoniae to cefotaxime (from 2.0% to 57.1%) and ceftazidime (from1.5% to 52.2%) in 1996 was due to ESBL positive bacterial strains at the neonatal department.

Key words:
pathogenic bacteria, resistance, antibiotherapy, antibiotic policy