Meropenem resistance in intensive care units in Ukraine

• Autorzy: Oliynyk O. , Slifirczyk A. , Pereviznyk B.

Warianty tytułu

PL

Oporność na lek meropenem u pacjentów oddziałów intensywnej opieki medycznej na Ukrainie

• Języki publikacji: EN

Abstrakty

EN

The article reviews the issue of antibiotic resistance of microorganisms to meropenem in intensive care units in Ukraine. An increase in meropenem inefficiency against microorganisms in intensive care units has been observed in the last years. The data analysis suggests a significant predominance of gram-negative flora: A. baumannii, Р. aeruginosa, К. pneumoniae, E. cloacae, E.coli. On average 30% of microorganisms are resistant to 5 and more basic antibiotics including meropenem. 40-80 % of the gram-negative flora in intensive care units in Ukraine are resistant to meropenem. This can be attributed to the free sale of antibiotics without prescription, patients’ self-treatment, inadequate antibiotic therapy, and failure to comply with sanitary norms on the part of intensive care staff. Microbiological diagnostics of infectious pathogens also needs improvement. Unless proper measures are taken within a few years, meropenem as an antibiotic is likely to disappear in Ukraine.

PL

Artykuł przedstawia kwestię antybiotykooporności drobnoustrojów na lek meropenem u pacjentów szpitalnych oddziałów intensywnej opieki medycznej na Ukrainie. W ostatnich latach na ukraińskich oddziałach intensywnej opieki medycznej zaobserwowano znaczny wzrost oporności drobnoustrojów na meropenem, a tym samym coraz mniejszą skuteczność tego leku. Przeprowadzona analiza danych wskazuje na znaczną przewagę gram-ujemnej flory bakteryjnej oddziałów, w tym szczepów takich jak A. baumannii, Р. aeruginosa, К. pneumoniae, E. cloacae czy E.coli. Odsetek szczepów opornych na działanie pięciu lub więcej podstawowych antybiotyków, w tym leku meropenem, wynosił średio 30%, a odsetek gram-ujemnych szczepów flory bakteryjnej ukraińskich oddziałów intensywnej opieki medycznej opornych na działanie samego meropenemu to aż 40 – 80%. Głównymi czynnikami powstawania antybiotykooporności w tym przypadku mogą być m.in. sprzedaż antybiotyków bez recepty, samoleczenie, niewłaściwa antybiotykoterapia oraz niespełnianie wymogów sanitarnych przez personel medyczny szpitali. Zdecydowanie należałoby również popracować nad diagnostyką mikrobiologiczną drobnoustrojów patogennych. Jeżeli w ciągu kilku kolejnych lat nie zostaną podjęte odpowiednie działania, meropenem prawdopodobnie zniknie z listy antybiotyków stosowanych na Ukrainie.

Słowa kluczowe

EN

microorganism; resistance; meropenem; antibiotic resistance; intensive care unit

• Wydawca: -
• Czasopismo: Health Problems of Civilization
• Rocznik: 2018
• Tom: 12
• Numer: 2
• Opis fizyczny: p.94-98,fig.,ref.

Twórcy

autor

Oliynyk O.

• Bogomolets National Medical University in Kyiv, Kyiv, Ukraine

autor

Slifirczyk A.

• Pope John Paul II State School of Higher Education in Biala Podlaska, Sidorska 95/97, 21-500 Biala Podlaska, Poland

autor

Pereviznyk B.

• I. Horbachevsky Ternopil State Medical University, Ternopil, Ukraine

Bibliografia

• 1. Baraniak A, Izdebski R, Fiett J. KPC-Like Carbapenemase-Producing Enterobacteriaceae Colonizing Patients in Europe and Israel. Antimicrob Agents Chemother. 2015; 60(3): 1912-7. https://doi.org/10.1128/aac.02756-15
• 2. Kittinger C, Lipp M, Baumert R. Antibiotic Resistance Patterns of Pseudomonas spp. іsolated from the River Danube. Front Microbiol. 2016; 7: 586. https://doi.org/10.3389/fmicb.2016.00586
• 3. Salmanov AG, Marievsky VF, Boyko VV. Antibiotic resistance in surgery. NT MT; 2012: 10-45.
• 4. Tolstanov OK, Ponomarenko AM, Salmanov AG. The problem of the antibiotic resistance of pathogens of intra-hospital infections [cited 2018 Jan 24]. Available from: www. zarifacenter.org/articles/article151.pdf
• 5. Order of the Ministry of Health of the USSR No. 380 on April 16, 1975, “About the state and prospects of development of laboratory clinical diagnostic service in the USSR” [cited 2018 Jan 24]. Available from: http://www cl.com.ua/normdocs/3003.htm.
• 6. Order of the Health Ministry of the USSR No. 720 on July 31, 1978 “About Improving of Medical Aid to Patients with Purulent Surgical Diseases and Strengthening Measures to Combat Intrahospital Infection” [cited 2018 Jan 24]. Available from: www.moz.gov.ua/ua/portal/dn_19780731
• 7. Order of the Health Ministry of the USSR No. 535 on April 22, 1985 “About unification of microbiological (bacteriological) methods of research used in clinical and diagnostic laboratories of medical and prophylactic institutions”. [cited 2018 Jan 24]. Available from: www.ask.com
• 8. Order of the Health Ministry of Ukraine on 04.04.2012 No. 236 “About organization of control and prevention of postoperative purulent inflammatory infections caused by micro-organisms resistant to the action of antimicrobial drugs” [cited 2018 Jan 24]. Available from: zakon.rada.gov.ua/go/z0912-12
• 9. Krasij NI, Oliynyk OV. Monitoring of antibiotic susceptibility of microbes isolated from the patients of Ternopil University hospital. Człowiek i Zdrowie. 2012; 3: 23-29.
• 10. WHO’s first global report on antibiotic resistance reveals serious, worldwide threat to public health. 2014; [cited 2018 Jan 24]. Available from: http://www.who.int/mediacentre/news/releases/2014/amr-report/en/
• 11. Narodowy Program Ochrony Antybiotyków [cited 2018 Jan 24]. Available from: http://www.antybiotyki.edu.pl/
• 12. Glumcher FS. The problem of antibiotic resistance in intensive care department. Materials of VIII British-Ukrainian scientific symposium devoted to the memory of professor I.P. Shlapak, Kyiv, April 20-23, 2016 [cited 2018 Jan 24]. Available from: www.anaesthesiaconference.kiev.ua 20
• 13. Lazorishinets VV, Marievsky VF, Salmanov AG. Antibiotic resistance of nosocomial strains of Pseudomonas aeruginosa in surgical hospitals of Ukraine in 2009. Кharkiv surgical school. 2010; 6(44): 71-75.
• 14. Salmanov AG, Marievsky VF, Doan SI. Antibiotic resistance of clinical strains of Escherichia coli in surgical hospitals of Ukraine in 2009. Experimental and Clinical Medicine. 2010; 3(48): 137-143.
• 15. State Institution “Ukrainian Center of Monitoring and Disease Control of Health Ministry of Ukraine” 2011 [cited 2018 Jan 24]. Available from: http://www.moz.gov.ua
• 16. Kharchenko LA . АuRuМ-Ukrainian experience of monitoring of antibiotic resistance. Health of Ukraine. 2011; 3: 1-3.
• 17. Nesterenko OM, Vorobyova TI. Clinical and microbiological substantiation of tactics of antimicrobial therapy of surgical sepsis. Pain, Anesthesia and Intensive Care. 2012; 1: 360-364.
• 18. Nestrenko OM. Degree of antibiotic resistance of pathogens as a dominant motivational factors of choice of antibiotic therapy tactics in sepsis. Kharkiv Surgical School. 2013; 3: 97-102.
• 19. Kreniov KYu. Microbiologic landscape dynamics in anesthesiology and intensive therapy department of Khmelnytskiy regional hospital in 2013–2016. Hospital Surgery. 2016; 1: 100-105.
• 20. Hrabák J, Študentová V, Adámková V. Report on a transborder spread of carbapenemase-producing bacteria by a patient injured during Euromaidan, Ukraine Mikrobiol Z. 2014; 76(3): 36-41.
• 21. Nesterenko AN , Khrypachenko IA. Local microbiological monitoring of hospital pathogens of surgical infection: substantiation of the initial empirical antibiotic therapy. Medicine of Urgent States. 2016; 4: 205.

Identyfikatory

DOI

10.5114/hpc.2018.75492