Publication details
Role of Aminoglykosides in the Treatment of Multidrug-Resistant Strains of Pseudomonas aeruginosa in Severely Burned Patients
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| Year of publication | 2013 |
| Type | Conference abstract |
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| Description | Objective: To compare the sensitivity resp.resistance of "wild-type" and multiresistant strains of Pseudomonas aeruginosa to the most commonly used aminoglycosides (gentamicin,amikacin, tobramycin). Introduction: The main cause of mortality in severely burned patients today are undoubtedly infectious complications. Development of resistance of microorganisms is too fast to develop new drugs. Therefore, regular monitoring of sensitivity resp.resistance of bacteria to introduced antibiotics is absolutely necessary. Design: retrospective, monocentric Material and Methods: We enrolled 281 adult patients hospitalized in our clinic in the period 1.1.2005 to 31.12.2009. For each burned patient the microbiological monitoring is strictly individual, reflecting the current needs of the patient and epidemiological situation at the department. We were sending swabs and prints from burned areas as well as material from the lower respiratory tract, urinary tract, blood cultures, etc. to the Department of Clinical Microbiology. To determine the sensitivity respectively resistance of Pseudomonas aeruginosa was used disc diffusion method, in some cases was this method supplemented by assessing the minimum inhibitory concentration (MIC) of the antibiotic by Etest. Strains of Pseudomonas aeruginosa were evaluated as multi-drug-resistant (MDR) if they were resistant to at least three of the five groups of anti-Pseudomonas antibiotics (penicillins, cephalosporins, aminoglycosides, carbapenems, fluoroquinolones). Results: In 281 adult patients hospitalized in the followed period for thermal trauma was isolated a total of 1943 strains of Pseudomonas aeruginosa (including re-captured strains). Number of multiresistant strains of Pseudomonas aeruginosa was 432 (22.2%). From the total of 1943 strains of Pseudomonas aeruginosa were resistant to gentamicin, tobramycin and amikacin, in 2005 (69%, 34%, 30% of the strains), and in 2009 (68%, 43% and 34% of the strains). Of the 432 strains of multidrug-resistant Pseudomonas aeruginosa were resistant to gentamicin, tobramycin and amikacin in 2005 (100%, 74%, 53% of strains) and in 2009 (100%, 87%, 71% of strains) Conclusion: Pseudomonas aeruginosa is dreaded hospital strain, causing a wide range of infections in critically ill patients. Aminoglycosides are established group of antibiotics in the treatment of infections caused by Pseudomonas aeruginosa. The most effective aminoglycoside in the fight against strains of Pseudomonas aeruginosa seems to be amikacin, which maintained relatively good sensitivity with a variety of multi-resistant strains not only in our work but also in clinical experience. |