Dinamic of resistance to antibiotics for the most frequent potential pathogen bacterial isolates in 'Dr. V. Babes' Clinical Hospital of Infectious and Tropical Diseases (2000-2015)

Objective. Analyzing the dynamycs of global antibiotic resistance of some bacterial species isolated from patients admitted to the „Dr. V. Babes” Hospital for Infectious and Tropical Diseases, between the years 2000 to 2015. Material and methods. Antibiotic resistance profiles of bacteria isolated from inpatients, were identified by the standard diffusion method and MIC values by VITEK2C and E-test methods. (CLSI and EUCAST standards). Screening of carbapenemases – producing isolates were performed by phenotipic methods, and the confirmation by RealTimePCR: “MasterPure™ Complete DNA and RNA Purification Kit” (Epicentre), „Primer Design™ Kit” (blaOXA48; blaKPC, blaNDM, blaVIM)/ LightScanner 32 Instrument/LS32 (Idaho Technology), and GeneXpert. Internal quality control: Staphylococcus aureus ATCC29213, Streptococcus pneumoniaeATCC49619, E. coli ATCC25922, Pseudomonas aeruginosa ATCC27853. Results. The incidence of St. aureus meticilino-rezistent (MRSA) highlights an increase from 12.2% (2002) to 40.4% (2015). In the past 3 years SVB microbiology lab found a sharp increase in the incidence of erytromycin resistant strains of Streptococcus pyogenes. In 2015 we registered 20.3% of macrolide resistant strains. Global resistance to penicillin G for Str. pneumoniae (non-meningeal infections) was 45.3%- 54.5% until 2009, and 2.7% in 2013. Enterococcus faecium strains showed 0% resistance to vancomycin between 2000 and 2012. A significant growth was recorded in 2015 of 11%. Isolation rate of Klebsiella pneumoniae ESBL producing strains has increasewd progressively from 17.6 in 2000 to 57% in 2015. Carbapenems – resistant K. pneumoniae isolated strains were 18,8% in 2015. Carbapenemases types identified by phenotypic and genetic methods where: 35/ Oxa48, 8 KPC and 21/MBL (NDM-1). Resistance to carbapenems recorded an upward trend: 23.9% in 2004 to 37.9% in 2015, and for Acinetobacter baumannii 69%. Conclusions. Antibiotic resistance of bacteria is a major challange for public healts. Therapeutic solutions are extremely limited.