Abstract
Introduction There is an urgent need for a surveillance system of regular monitoring of specific bacteria inducing various types of osteomyelitis to identify resistant isolates and optimize the use of antibiotics. Objective: monitoring of specific gram-negative bacteria and analysis of the antibiotic resistance of the strains isolated from osteomyelitis patients over a three-year period. Results and discussion P. aeruginosa was the first most common pathogen among gram-negative microorganisms isolated from the patients between 2017 and 2019. Prevalence of the isolates identified in 2019 decreased by 9.6 % as compared to 2017. Next frequently encountered clinical isolates were Enterobacter sp., Acinetobacter sp., Klebsiella sp. There was a twofold increase in K. pneumoniae strains isolated in 2019. Analysis of antibiotic susceptibility testing data revealed multiresistance of the Acinetobacter sp. strains in 2019 despite the total decrease in resistant isolates in 2017 and 2018. Among non-fermenting gram-negative rods, the species being resistant to imipenem were shown to increase by 5.4 times. Overall antibiotic resistance was on rise. Increased antimicrobial resistance to beta-lactam antibiotics also combined with BLaC inhibitors was observed in Enterobacteriaceae population. Meropenem was found to be effective against most bacteria with growing drug resistance observed as compared with recent years. The antibiotic resistance profiles of Klebsiella sp. strains appeared to be high at antimicrobial testing. Conclusion Diverse bacterial morphology of gram-negative species and increasing proportion of drug-resistant strains isolated in osteomyelitis cases have necessitated regular monitoring of multiresistant clinical isolates for adjustment of empirical antibiotic therapies.
Highlights
IntroductionObjective: monitoring of specific gram-negative bacteria and analysis of the antibiotic resistance of the strains isolated from osteomyelitis patients over a three-year period
There is an urgent need for a surveillance system of regular monitoring of specific bacteria inducing various types of osteomyelitis to identify resistant isolates and optimize the use of antibiotics
A total of 664 bacterial isolates of gram negative rods were identified in 2018 with decreased proportion of P. aeruginosa strains by 4.5 %, A. baumanni by 19.4 %, Proteus sp. by 18.6 % and increased K. pneumoniae by 17.9 % and species of Enterobacteriaceae family by 44.4 %
Summary
Objective: monitoring of specific gram-negative bacteria and analysis of the antibiotic resistance of the strains isolated from osteomyelitis patients over a three-year period. Among non-fermenting gram-negative rods, the species being resistant to imipenem were shown to increase by 5.4 times. Increased antimicrobial resistance to beta-lactam antibiotics combined with BLaC inhibitors was observed in Enterobacteriaceae population. Non-fermenting gram-negative bacteria (NFGNB) are normally multiresistant [7] due to primary non-susceptibility to antimicrobial agents and acquired mechanisms of resistance [4, 7, 8]. The clinical effect of antibiotics against organisms can be very limited because of the global emergence of multi-drug resistant isolates that are complicating the treatment of chronic osteomyelitis. There is an urgent need for a surveillance system of regular monitoring of specific bacteria inducing various types of osteomyelitis to identify resistant isolates and optimize the use of antibiotics
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