Int. Rev. Allergol. Clin. Immunol. Family Med., 2016, XXII/1: 016-022 Maximize

Int. Rev. Allergol. Clin. Immunol. Family Med., 2016, XXII/1: 016-022

Title: Contemporary threat caused by alert-pathogens 

Authors: Płusa T, Komaszyńska A, Kluczyńska K, Pokłoński J, Wyszkowski W. 

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Alert-pathogens and antibiotic use within 20 months of observation

Płusa T, Komaszyńska A, Kluczyńska K, Pokłoński J, Wyszkowski W.

EMC Medical Institute SA – Department of Internal Medicine and Lung Disease, Hospital st. Anna in Piaseczno, Poland

Int Rev Allergol Clin Immunol Family Med, 2016; Vol. 22, No. 1, 016

Among bacterial pathogens characterized by a special resistance to the treatment, so distinguished alert-pathogens that pose a growing threat to health and life.
The aim of the study
was to analyze the number of those found alert-pathogens in hospital infections and assessment of the number and type of antibiotics used in the two wards within 20 months.
Material and methods
. The analysis included 7520 patients hospitalized in the internal diseases and surgical departments of hospital EMC Piaseczno in a period of 20 months (from February 2014 to September 2015). In a retrospective analysis the medical documentation was the base. In 696 patients (321 women and 375 men) aged 73.21+/-13.54 years swabs from the nose and groin to test for carriers of alert-pathogens. Another group consisted of 224 patients (89 women, 135 men) aged 76.34 +/- 17.21 years hospitalized in the two departments, whose swabs from wounds and bedsores were examined. The use of antibiotics was analyzed by determining the average daily dose of defined (DDD) groups of antibiotics in the two comparable periods in the department of surgery and internal medicine.
. The number of raised alert pathogens accounted for 41.95% of the results of swabs and 17.86% of bedsores and wounds. The main pathogens emergency confirm the presence of Staphylococcus aureus (28.76%) and Klebsiella pneumoniae (23.63%) of the swabs tested, while the test group and bedsore wounds dominated Klebsiella pneumoniae infection (30%) and Staphylococcus aureus (20%). In the comparable periods decreased consumption of cephalosporins, for the same value of DDD in relation to fluoroquinolones in the department of internal diseases and significantly reduced in the surgery department. It is worth emphasizing significant increase in the use of carbapenems in patients hospitalized in the department of internal diseases associated with the emergence of patients infected with a strain of Klebsiella pneumoniae NDM, which showed a wide resistance to most antibiotics.
. Based on analysis of the results of microbiological tests, it was found that the main pathogens isolated from nasal swabs and groin performed at admission patients were Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii and Proteus mirabilis, including strains of multidrug resistance. With swabs collected from wounds and bedsores were isolated by the incidence of Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter baumannii, Escherichia coli and Proteus mirabilis. The main groups used in patient care are cephalosporins (beta-lactams), fluoroquinolones and macrolides.

Key words: alarm pathogens, antibiotics, nosocomial infections