Антибиотикорезистентность синегнойной инфекции при лёгочном поражении у детей с муковисцидозом

Abstract

Aim of our study was to evaluate changes of antibiotiс susceptibility patterns of Ps.aeruginosa infection in patients with cystic fibrosis Materials and methods. The study included 63 sputum-samples of collected from patients aged from 1 to 26 years (20girls/women and 16 boys/men) with confirmed diagnosis of cystic fibrosis. The antibiotic susceptibility patterns in patients with cystic fibrosis with confirmed Pseudomonas aeruginosa infection were evaluated. The identification of the infectious agent was performed by spread of the biological material (sputum) on the bacteriological culture media (chocolate agar, blood agar). The next step was to determine the diagnostic bacterial titer (>106 cells/ml of sputum). Muller-Hinton agar was the bacteriological culture media used for antibiotics susceptibility testing by the disk diffusion method. Results:. There were analyzed results of the bacteriological study of sputum with the first-time identified Ps.aeruginosa in comparison with examinations of the follow-up samples of the same patients while antibiotics resistance was developing (in average). The study of the antibiotic susceptibility in the first group and in follow – up samples showed a continuous high level of antibiotic susceptibility to carbapenems and aminoglycosides. There was noticed a moderate decrease of susceptibility to 1st and 2nd generation of cephalosporins and marked decrease of susceptibility to synthetic penicillins. Conclusion: Ps.aeruginosa in patients with cystic fibrosis showed resistance pattern to 1st and 2nd generations of cephalosporins, along with the antibiotic resistance to penicillins. The antibiotic resistance inevitably increased with repeated courses of therapy.

In studiul au fost incluse 63 probe ale secretului bronhopulmonar (obţinut de la pacienţii cu fibroza chistică confirmată), care au fost analizate la spectrul de sensibilitate la antibiotice a Ps.aeruginosa. Materialul colectat a fost inoculat pe medii de cultură corespunzătoare pentru izolarea culturilor pure, care ulterior vor fi testate la sensibilitate vis-a-vis de antibiotice. Au fost evaluate rezultatele examenului bacteriologic al sputei la copii cu infecţia piocianică primar determinată comparativ probelor bacteriologice efectuate în dinamică la etapa dezvoltării antibiorezistenţei (peste 2,4 ani). S-a constatat, că spectrul de sensibilitate antibacteriană la pacienţii cu bacilul piocianic evaluaţi primar şi în dinamică, este la nivelul înalt pentru grupele carbopenemelor şi aminoglicozidelor, în acelaşi timp se observă o majorarea a rezistenţei către cefalosporinele de generaţia I şi a II şi o rezistenţă marcată la antibioticele din grupul penicilinelor antipiocianice.