[Gram-positive cocci isolated from urocultures of ambulatory and hospitalized patients with surgical risk]. / Coci Gram-pozitivi izolati din uroculturi provenite din ambulator si sectii cu risc chirurgical.

OBJECTIVES: We propose a comparative study of sensitivity to antibiotics of Gram-positive germs isolated in urocultures from patients in ambulatory and two wards with surgical risk (urology and obstetrics-gynaecology), and also to establish the resistance phenotypes of these strains. MATERIAL AND METHOD: 124 strains of Gram-positive cocci were studied: 28 S. aureus strains, 24 strains of coagulase-negative staphylococcus (CNS), 23 Streptococcus aglactiae strains, 1 Streptococcus anginosus strain and 48 Enterococcus spp. strains. The isolated strains came from 4398 urocultures (1889--ambulatory, 1871--urology, 629--obstetrics-gynaecology). Testing of antibiotic sensitivity was performed through Kirby-Bauer disk-diffusion method, with automatic phenotyping (Osiris Evolution system). RESULTS: In ambulatory, the wild phenotype was predominant in all isolated strains (33.33% S. aureus, 50% CNS, 100% Streptococcus aglactiae, 60% Enterococcus spp.). In the urology ward, the following multiresistant strains were isolated: 9 MRSA strains (47.36%), 1 MRSE strain (100%), 1 VRE strain (4.34%). In the obstetrics-gynaecology ward, 7 strains showed multiple antibiotic resistance: 4 MRSA strains (66.66%), 2 MRSE strains (50%), 1 VRE strain (6.66%). CONCLUSIONS: Multiresistant strains were isolated in hospital environment, which can be explained by the improper use of antibiotics, the instrumental approach of the urinary tract, and the existence of risk factors in the patients admitted in the above-mentioned wards. Enforcement of efficient nosocomial infection control measures is advisable, as well as a policy for rational antibiotic use.

[Antibiotic resistance patterns in Acinetobacter spp. strains isolated from hospital environment]. / Pattern-uri de rezistenta la antibiotice ale unor tulpini de Acinetobacter spp. izolate din mediul spitalicesc.

INTRODUCTION: The Acinetobacter species are ubiquitary germs isolated more and more frequently, Acinetobacter baumannii being currently considered the second strictly aerobic microorganism involved in the ethiology of severe nosocomial infections. Acinetobacter baumannii is usually encountered in surgery and intensive care units, especially in patients with depressed immunity, in which various locations are possible, the most frequvent being the respiratory tract infections, urinary tract infections and bacteriemia. MATERIAL AND METHOD: The study used 52 strains of Acinetobacter spp. isolated from 1131 biological samples (bronchial aspirat, urine, wound secretion, blood, pus, CFS) obtained from the patients of the Timisoara Country Hospital. Identification of germs was performed using the API (BioMerieux) system, and the antibiotics sensitivity testing was made by disk diffusion testing (Kirby-Bauer), with automatic reading and phenotyping through the Osiris Evolution (BioRad) system. RESULTS: The study of resistance to beta-lactamines has pointed out the predominance of penicillinase and cephalosporinase producing strains, 55.77% of the tested ones being part of this phenotype. 90.38% of the strains were resistant to one or more aminoglycosides. Of the tested strains 76.93% were resistant to fluoroquinolones, 86.54% to trimethoprim-sulphamethoxazole, and only 21.15% to tethracycline. CONCLUSIONS: Among the emerging pathogens involved in the nosocomial infections, Acinetobacter baumannii strains have become, in the past decades, a real health issue, due to the variety and seriousness of clinical symptoms. Through the constant increase of the cases number, and the difficulty of applying an effective treatment, the above-mentioned strains showed a multiple resistance to antibiotics.

[A comparative study of resistance phenotypes in E. coli strains isolated in urine from hospitalized and ambulatory patients]. / Studiu comparativ al fenotipurilor de rezistenta a tulpinilor de E. coli izolate din uroculturi provenite de la pacienti internati si din ambulator.

112 strains of E coli from 620 urocultures of hospitalized and ambulatory patients where isolated between March-June 2002. Our purpose was to make a comparative study of the susceptibility to antibiotics of 31 strains of E coli isolated in hospital (County Clinical Hospital Nr. 1 Timisoara--Urology Clinic and Intensive Care Unit) and 81 strains collected from ambulatory patients. Identification of germs was performed using the automatic API system, and the susceptibility tests were performed using disc-diffusion and the agar dilution test. By analyzing the extended antibiograms we categorized the germs considering their phenotypes of resistance and remarked a high percentage of E coli strains from hospitalized showing multiple resistance to antibiotics.