RESUMO
The aim of the study was to analyse the changes in occurence of microorganisms and antibiotic usage in tertiary care hospital over 3 years. We analysed the results of microbiological records from laboratory inforation systems from 2001 to 2003. Over the study period there was about 40% increase of specimens received in the laboratory mainly due to another hospital incorporation. The relations between different groups of microorganisms was stable, Gram negatives 44,4%-46,3%, Gram positives 37,3%-40,3%, yeasts 7,0%-8,1%. There was a decrease in MRSA from 0,6% to 0,2% and carbapenem resistant Pseudomonas aeruginosa (CRPA) isolations from 2,0% to 0,7%, however the reverse was true for VRE, increase from 0,3% to 2%. ESBL-producing bacteria were isolated from about 4% of Enterobacteriaceae throughout the study. The analysis of blood cultures revealed over 60% deacrease in P. aeruginosa bacteremia and stable incidence of Escherichia coli (7%) and Staphylococcus aureus (6,5%) bacteremia. Increased usage of cephalosporins and fluoroquinolones was accompanied by the decrease in carbapenems and penicillins. In most cases there were no significant changes in occurence of main groups of microorganisms. Some multidrug resistant bacteria like MRSA and CRPA are no longer a problem in our hospital. Others like VRE, ESBL and Acinetobacter still cause concern due to high colonisation or infection rate. The usage of some antibiotic groups increased, another decreased and finally some like aminoglicosides and glicopeptides remained stable.