Antibiotic resistance in croatia

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, bioMérieu x; 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 4 × 1.2g (4 × 2MIU) dosing in 89 %, with 4 × 2.4g (4 × 4MIU) or 6 × 1.2g (6 × 2MIU) dosing in 94 %, and with 6 × 2.4g (6 × 4MIU) dosing in 97 % of isolates. Resistance to oral amo x icillin (with 3 × 500mg 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-amo x iclav, 8 % for ceftria x one, 19 % for ciproflo x acin, 9 % for gentamicin, 27 % for co-trimo x azole 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.