Professional paper
https://doi.org/10.21860/medflum2018_203562
Antibiotic resistance in Croatia
Arjana Tambić Andrašević
; Klinika za infektivne bolesti “Dr. Fran Mihaljević”, Zagreb, Hrvatska
Sandra Lucić
; Klinika za infektivne bolesti “Dr. Fran Mihaljević”, Zagreb, Hrvatska
Tera Tambić
; Akademija medicinskih znanosti Hrvatske, Zagreb, Hrvatska
Abstract
Aim: Resistance to antibiotics is one of the leading problems of medicine today. The goal of this study was to analyse antibiotic resistance in most important pathogens in Croatia in 2016.
Materials and methods: Resistance data are collected from 38 centers. Antibiotic sensitivity testing was done by disk diffusion and determination of minimal inhibitory concentrations (MIC) (Etest, bioMérieux; MIC Test Strip, Liofilchem) according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards.
Results: Among respiratory pathogens there were 16325 group A streptococci (GAS) isolates, 1971 pneumococcal isolates and 1444 Haemophilus influenzae isolates. Penicillin resistance in GAS is not described and in pneumococci it is dose dependent: oral penicillin is effective in 77% pneumococci, parenteral penicillin with 4x1.2g (4x2MIU) dosing in 89%, with 4x2.4g (4x4MIU) or 6x1.2g (6x2MIU) dosing in 94%, and with 6x2.4g (6x4MIU) dosing in 97% of isolates. Resistance to oral amoxicillin (with 3x500mg dosing) is 12% in pneumococci and 24% in H.influenzae. Macrolide resistance is 7% in GAS and 36% in pneumococci. Resistance in the most common urinary tract pathogen Escherichia coli is 10% for co-amoxiclav, 8% for ceftriaxone, 19% for ciprofloxacin, 9% for gentamicin, 27% for co-trimoxazole and 3% for nitrofurantoin. Among nosocomial pathogens non-susceptibility to carbapenems is 20% in Pseudomonas aeruginosa and 87% in Acinetobacter baumannii. Methicillin resistant Staphylococcus aureus (MRSA) rate is 16%, and vancomycin resistant Enterococcus faecium (VRE) rate is 17%.
Conclusions: Antibiotic resistance surveillance is the first step in rationalizing antibiotic prescribing. On behalf of the intergenerational solidarity we are obliged to preserve and if possibly restore efficacy of antibiotics.
Keywords
antibiotics; resistance; surveillance
Hrčak ID:
203562
URI
Publication date:
1.9.2018.
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