Szczepy z rodziny Enterobacteriaceae oporne na karbapenemy izolowane w latach 2006–2011 z materiałów pochodzących od pacjentów leczonych w uniwersyteckim szpitalu klinicznym w północno-wschodniej Polsce
[Carbapenem-resistant strains from the family Enterobacteriaceae isolated in the period 2006–2011 from clinical specimens of patients treated at the university hospital in northeastern Poland]

Streszczenie

Celem pracy była ocena częstości występowania szczepów opornych na karbapenemy wśród pałeczek Enterobacteriaceae izolowanych w latach 2006-2011 w Uniwersyteckim Szpitalu Klinicznym w Białymstoku (UHB). Łącznie wyizolowano 216 szczepów opornych na karbapenemy, co stanowiło 0,96% wszystkich wyizolowanych pałeczek Enterobacteriaceae (n=22 391) na przestrzeni sześciu lat. Najwięcej szczepów opornych na karbapenemy zidentyfikowano w roku 2011 (96 szczepów, 44,44%). Oporność na karbapenemy
najczęściej występowała wśród pałeczek Klebsiella pneumoniae (n=103) i Enterobacter cloacae (n=85). W ciągu sześciu lat odnotowano wzrost występowania
szczepów z rodziny Enterobacteriaceae opornych na karbapenemy w Uniwersyteckim Szpitalu Klinicznym w Białymstoku.

Abstract

In recent years an alarming increase of carbapenem-resistant Enterobacteriaceae has been noticed, which creates frequent therapeutic problems, especially for patients residing in intensive care units (ICU). The aim of this study was to evaluate the prevalence of carbapenem-resistant strains of Enterobacteriaceae isolated in the years 2006-2011 at the University Hospital in Bialystok (UHB). Methods: Based on microbiological analysis reports we conducted a retrospective study of strains resistant to carbapenems. We assigned strains to three carbapenem-resistance phenotypes, and analyzed susceptibility to antibiotics and prevalence of these strains in hospital wards and in clinical specimens collected from hospitalized patients. During a six-year period, 216 strains resistant to carbapenems were tested, which represents 0.96% of all Enterobacteriaceae (n=22.391) isolated during this period. Results: The greatest number of carbapenem-resistant strains was identified in 2011 (96 strains, 44.44%). Antibiotics that showed the highest activity against strains occurring most frequently (Klebsiella pneumoniae [n=103] and Enterobacter cloacae [n=85]) were tigecycline (102 [99.03%] of K. pneumoniae tested strains and 61 [100%] of E. cloacae strains were susceptible), colistin (33 [86.84%] of K. pneumoniae tested strains and 84 [100%] of E. cloacae were susceptible), and amikacin (86 [83.49%] of K. pneumoniae tested strains and 26 [30.58%] of E. cloacae strains were susceptible). Conclusions: Carbapenem resistance among Enterobacteriaceae isolates showed a trend to increase during the six-year period of study. Because infections caused by carbapenem-resistant strains are frequently life-threatening, the effective strategies to control the spreading of antibiotic resistance are necessary.