Bacterial profile and antibiotic resistance in patients with trophic ulcers
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BALAN, Greta, PUŞCAŞ, Nicolae, LOZAN-TYRSHU, K., ZARICIUC, Elena, RUDIK, V.. Bacterial profile and antibiotic resistance in patients with trophic ulcers. In: Microbial Biotechnology, Ed. 4, 11-12 octombrie 2018, Chișinău. Chișinău, Republica Moldova: Institutul de Microbiologie şi Biotehnologie, 2018, Ediția 4, p. 27. ISBN 978-9975-3178-8-7.
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Microbial Biotechnology
Ediția 4, 2018
Conferința "Microbial Biotechnology"
4, Chișinău, Moldova, 11-12 octombrie 2018

Bacterial profile and antibiotic resistance in patients with trophic ulcers


Pag. 27-27

Balan Greta1, Puşcaş Nicolae1, Lozan-Tyrshu K.1, Zariciuc Elena1, Rudik V.12
 
1 ”Nicolae Testemițanu” State University of Medicine and Pharmacy,
2 Institute of Microbiology and Biotechnology
 
Disponibil în IBN: 17 februarie 2019



Teza

Trophic ulcer is a very common problem, occurring mainly in older people. Particularly at risk of chronic ulcers are overweight people with heart failure or diabete suffering persons. The microflora of trophic ulcers is usually polymicrobial. Staphylococcus aureus and coagulasenegative staphylococci have been the predominant organisms isolated from both prospective, purpose-collected samples and retrospective analysis of clinical investigations. Pseudomonas aeruginosa is another frequently identified organism and has been found in 7–33% of ulcers. A number of other aerobic species have also been reported, including Escherichia coli, Enterobacter cloacae, Klebsiella species, Streptococcus species, Enterococcus species and Proteus species. Material and methods: Totally, 108 isolates were collected from the 57 patients in different wards of the Republican Clinic Hospital. All the specimens were sampled to the microbiology laboratory within 48 h after hospital admission. No antimicrobial agent or antiseptic was introduced into the ulcer before specimen collection. The specimens were placed into sterile transport containers and sent to the microbiology laboratory for aerobic culturing within 30 minutes. Anaerobic culturing was not performed in this study. Antimicrobial susceptibility was determined using the disk diffusion method in accordance with the performance standards, recommended by the EUCAST (European Committee on Antimicrobial Susceptibility Testing). Results: A total of 108 isolates were detected from the 57 specimens, including 98 (90,7%) bacteria and 10 (9,3%) funguses. In the bacterial infection, the proportion of Gram-negative bacteria (55,6%, 60/108) was higher than Gram-positive bacteria (44,4%, 48/108). Enterobacteriaceae was the main Gram-negative bacteria (71,7%, 43/60), mainly including Escherichia coli, Enterobacter cloacae, and Klebsiella pneumonia. Proteus (18,3%, 11/60) and Pseudomonas (13,3%, 8/60) followed. Staphylococcus spp. (66,7%, 32/48) is the predominant pathogen of Gram-positive bacteria, main of which was Staphylococcus aureus (45,8%, 22/48), followed by Enterococcus (18,7%, 19/48). Candida was the main pathogen in fungal infection, accounted for 90,0% (9/10). MDR (multiple-drug resistance) isolates were broadly distributed in the 108 bacteria isolated from trophic ulcers (42,6%, 46/108). High resistance rates to the common antibiotics were detected in Enterobacteriaceae. Almost all the isolates were resistant to the ampicillin (90,0%, 54/60), followed by the first/second generation cephalosporin, including cefazolin (78,3%, 47/60) and cefuroxime (65,0%, 39/60). Low resistance rates were detected to carbapenem (8,3%, 5/60), cefoperazone-sulbactam (13,3%, 8/60), the fourth generation cephalosporin (15,0%, 9/60), and tobramycin (16,7%, 10/60). As the representative of Gram-positive cocci, Staphylococcus aureus showed a high resistance rate to common antibiotics. High resistance rate to oxicillin was detected (91,7%, 44/48), followed by the tetracycline 60,4%, 29/48). The low level of resistance shown by the P. aeruginosa isolates to ceftazidime (a third generation cephalosporin), ciprofloxacin and gentamicin indicates that these three drugs are still effective in our country compared to other studies which showed, for example, that P. aeruginosa is highly resistant to gentamicin. Conclusions: Different bacterial profiles and antibiotic sensitivity were found in trophic ulcers. Clinician should try to stay updated in antibiotic resistance pattern of common pathogens in their area, especially when practice on the empirical antibiotic use.