Antibioticorezistenţa microbiană în infecţiile septico-purulente nosocomiale de profil ortopedie și traumatologie: studiu epidemiologic, descriptiv, transversal

Abstract

Intoducere. Utilizarea pe scară largă a preparatelor antimicrobiene în profilaxia și tratamentul infecţiilor septicopurulente nosocomiale (ISPN) a condus la apariţia tulpinilor polirezistente la antibiotice. Infecţiile produse de microor-ganisme rezistente reprezintă o problemă majoră pentru sănătatea publică, determinând un nivel înalt de morbiditate şi mortalitate, eşecuri terapeutice. Material și metode. Cercetarea dată reprezintă un studiu epidemiologic descriptiv, transversal, care se bazează pe metoda de analiză retrospectivă a 2013 tulpini, izolate de la pacienţii cu ISPN în Spitalului Clinic de Traumatologie şi Ortopedie, examinate pe parcursul anilor 2009-2010 și 2013-2014. Studierea antibioticorezistenţei/sensibilităţii microorganismelor a fost realizată în laboratorul bacteriologic al Spitalului Clinic de Traumatologie şi Ortopedie prin metoda disc difuzimetrică. Rezultate. Sensibilitatea/rezistenţa agenţilor cauzali în infecţiile septico-purulente de profil ortopedie și traumatologie este variată, iar valorile acestor parametri diferă în funcţie de grupul antibioticului, variind de la 29,0 până la 97,0% de probe sensibile şi viceversa, de la 26,0 până la 98% de probe rezistente. O pondere mai înaltă a antibioticorezistenţei a fost înregistrată la microorganismele gramnegative (57,72%), precum și la tulpinile izolate în asocieri de microorganisme (67,0%), mai cu seamă, faţă de grupurile preparatelor antimicrobiene larg utilizate în practica medicală – cefalosporine (66,15%), peniciline (63,95%) și sulfamide (70,77%). Concluzii. Agenţii cauzali în patologia septico-purulentă de profil ortopedie și traumatologie, poartă un caracter polietiologic şi manifestă rezistenţă înaltă faţă de antibiotice, iar evitarea eșecurilor terapeutice pot fi prevenite, doar luând în calcul rezultatele antibioticogramei. Rezultatele studiului confirmă necesitatea elaborării şi implementării programului de achiziţionare și utilizare raţională a preparatelor antibacteriene, supraveghere şi control a antibioticorezistenţei microbiene, adecvat staţionarului medical.

Intoduction. The widespread use of antimicrobial drugs in the prophylaxis and treatment of septic-purulent nosocomial infections (SPNI) led to the appearance of poly resistant strains to antibiotics. Infections caused by resistant micro-maorganisms are a major public health problem, determining a high level of morbidity and mortality treatment failures. Material and methods. This research is an epidemiological, descriptive, transversal study, based on retrospective analysis method of the 2013 strains, isolated from patients with SPNI in Clinical Hospital of Orthopedy and Traumatology, examined in 2009-2010 and 2013-2014. Antibiotics resistance/ sensitivity of the microorganisms study has been achieved in the bacteriological laboratory of the Clinical Hospital of Orthopedy and Traumatology, using disk diffusion method. Results. Sensitivity/resistance of the causative agents in septic purulent orthopedic and traumatic infections is varied, and the values of these parameters vary depending on the antibiotic group, ranging from 29.0 up to 97.0% – sensitive samples, and vice versa, from 26.0 to 98% – resistant samles. A higher share of antibiotics resistance was recorded in gramnegative microorganisms (57.72%), as well as – in isolated strains microorganisms associations (67.0%), especially the groups of antimicrobial preparations. widely used in medical practice – cephalosporin (66.15%), penicillin (63.95%) and sulfamide (70.77%). Conclusions. Causative agents in orthopedic and traumatic septic-purulent pathology has a polyetiologic character and exhibit high resistance to antibiotics and avoidance of treatment failures can be prevented, only taking into account the results of antibiotic resistance. The study results confirm the necessity to develop and implement the program of acquisition and rational use of antibacterial drugs, supervision and control of microbial antibiotics resistance, appropriate to the medical station.

Intoduction. The widespread use of antimicrobial drugs in the prophylaxis and treatment of septic-purulent nosocomial infections (SPNI) led to the appearance of poly resistant strains to antibiotics. Infections caused by resistant micro-maorganisms are a major public health problem, determining a high level of morbidity and mortality treatment failures. Material and methods. This research is an epidemiological, descriptive, transversal study, based on retrospective analysis method of the 2013 strains, isolated from patients with SPNI in Clinical Hospital of Orthopedy and Traumatology, examined in 2009-2010 and 2013-2014. Antibiotics resistance/ sensitivity of the microorganisms study has been achieved in the bacteriological laboratory of the Clinical Hospital of Orthopedy and Traumatology, using disk diffusion method. Results. Sensitivity/resistance of the causative agents in septic purulent orthopedic and traumatic infections is varied, and the values of these parameters vary depending on the antibiotic group, ranging from 29.0 up to 97.0% – sensitive samples, and vice versa, from 26.0 to 98% – resistant samles. A higher share of antibiotics resistance was recorded in gramnegative microorganisms (57.72%), as well as – in isolated strains microorganisms associations (67.0%), especially the groups of antimicrobial preparations. widely used in medical practice – cephalosporin (66.15%), penicillin (63.95%) and sulfamide (70.77%). Conclusions. Causative agents in orthopedic and traumatic septic-purulent pathology has a polyetiologic character and exhibit high resistance to antibiotics and avoidance of treatment failures can be prevented, only taking into account the results of antibiotic resistance. The study results confirm the necessity to develop and implement the program of acquisition and rational use of antibacterial drugs, supervision and control of microbial antibiotics resistance, appropriate to the medical station.