Analiza zakażeń bakteryjnych u pacjentów Oddziału Intensywnej Terapii Uniwersyteckiego Szpitala Klinicznego Nr 1 w Łodzi w latach 2002-2015
[Bacterial infections in Intensive Care Unit patients analyzed on the example of the Lodz Medical University Hospital No 1 in the period 2002–2015]

STRESZCZENIE

W pracy dokonano przeglądu drobnoustrojów będących przyczyną zakażeń szpitalnych w Oddziale Intensywnej Terapii USK nr 1 w Łodzi w latach 2002-2015. Zasygnalizowano także problem wzrastającej oporności na karbapenemy wśród szczepów Pseudomonas aeruginosa i Acinetobacter spp.

ABSTRACT

Introduction: In the present study, nosocomial infections, increased resistance to carbapenem among clinical isolates of Pseudomonas aeruginosa and Acinetobacter spp. are analyzed on the example of the intensive care unit (ICU) at the Lodz Medical University Hospital No 1 in a long period of time (2002-2015). Methods: In the period from 2002 to 2015, 19870 bacteriological cultures were made from 4289 patients hospitalized at the ICU. Material for the study were swab from the surgical wound, blood, urine and bronchoalveolar lavage (BAL). The identification of the species and drug resistance were performed using VAITEC (BioMerieux®) by 2004, next PHENIX (Becton Dickinson) by 2012 and VITEC 2 - compact (BioMerieux®) until now. The blood was incubated in the BACTEC 9050. Results: Gram negative bacilli, predominantly Klebsiella pneumoniae and Pseudomonas aeruginosa, as well as staphylococci Staphylococcus aureus are a major cause of lower respiratory tract infections in ICU. The profile of bloodstream infections has changed over the period considered. Staphylococci was the main cause of bloodstream infections in the period 2002-2005, but since 2005 Klebsiella pneumoniae has dominated. Gram negative bacilli, mainly Escherichia coli and Klebsiella pneumoniae, were the most common pathogens to cause urinary tract infections. In the years 2014-2015, a significant increase in infections caused by Enterobacteriaceae strains ESBL(+) (extended-spectrum betalactamases) was observed. Conclusions: Klebsiella pneumoniae is a major cause of nosocomial infections in intensive care unit patients at the Lodz Medical University Hospital No 1. Increasing prevalence of antimicrobial resistance to β-lactam antibiotics (including carbapenems) among Pseudomonas aeruginosa and Acinetobacter spp. has been observed. Therefore, it is necessary to limit the use of carbapenems for the hospital treatment.