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Výskyt antimikrobiální rezistence u streptokoků (převážně beta-hemolytických) z ran pacientů
Kuropata, Daniel
Recently, a frequent occurrence of antibiotic resistance has been observed, and is still increasing. Therefore, it is important to constantly monitor this resistance, which was the aim of this work for Streptococcus genera. The literature review is focused on the selected species of streptococci (S. agalactiae, S. dysga-lactiae subsp. equisimilis, S. pyogenes, S. mitis and S. oralis), antibiotics, including their mechanism of action, and antibiotic resistance with an emphasis on its emergence, spread, mechanisms, determining genes and the risks it presents. In the experimental part, the occurrence of resistance in streptococci (especially beta-haemolytic) isolated from patients’ wounds at the Trauma Hospital in Brno was monitored. For this purpose, determination of the minimum inhibitory concentration (MIC), analysis of the resistance phenotype to macrolides, lincosamides and streptogramin B (MLS) using the D-test and resistance gene screening by polymerase chain reaction (PCR) were used. Among the 31 clinical isolates the prevalence of resistance to cotrimoxazole (96.8%), ciprofloxacin (71%), tetracycline (29%), erythromycin (25.5%), clidamycin (16 .1%), ampicillin (3.2%) and oxacillin (3.2%) was found by using MIC. Resistance to chloramphenicol, gentamicin, vancomycin, teicoplanin, linezolid, tigecycline and nitrofurantoin has not been detected. The D-test was performed with erythromycin-resistant isolates. The constitutive (cMLS) phenotype was detected in 62.5% of erythromycin-resistant isolates, inducible (iMLS) in 25% and M phenotype in 12.5%. The PCR method confirmed the presence of selected resistance genes, namely ermA (16.1%), ermB (6.5%), mefA (3.2%), tetO (3.2%), tetM (25.8%) and intTn (32.3%). This study demonstrated that all streptococcal isolates from patients’ wounds are resistant to some of the tested antibiotics. Moreover, multiresistance was detected in some isolates.
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Resistances of Escherichia coli to selected antibiotics in a district of Písek for the year 2016
BROMOVÁ, Karolína
Resistance to antibiotics is becoming a global problem. In my work I focused on the resistance of Escherichia coli in the Písek district in 2016. Escherichia coli is the most common cause of urinary tract infections. On average, every second woman and every fifth male will experience urinary tract infection. Resistance problems have met for many years. Previously effective antibiotics are now ineffective. Often they have to go beyond wide-spectrum antibiotics that have a number of side effects (diarrhea, yeast infections), are more expensive and have an impact on the economy. In the Czech Republic, we do not yet have the same level of resistance as in other countries, In Greece. Therefore, we should take an example from other countries and avoid massive use of antibiotics. The objectives of my work were to collect information on Escherichia coli resistance, to compare the differences between adult and pediatric patients and to determine the degree of ESBL strains in the Písek district in 2016. I compare the results of my research with the results of the urinalysis study of NRL SZÚ in Prague for 2016. In the theoretical part, I have dealt mainly with antibiotic characteristics, antibiotic resistance methods and briefly describe Escherichia coli. In its practical part, methods of identifying bacteria (ENTERO test 24N) are described. Principles of biochemical tests (VP test, INDOL test) to help us determine what type of bacteria might be. I also describe the principles and use of sensitivity assays (Disk diffusion test, M.I.C. microdilution test). Using the ESLB MAST test, I discovered the extent to which ESBL beta-lactamase-producing strains with extended spectrum of effect, which cause multi-resistance, were found in the Písek district. Furthermore, the practical part contains evaluation of resistance statistics on selected antibiotics, which I processed from data from the clinical microbiology of Písek Hospital. For my observation of Escherichia coli resistance, I chose 5 types of antibiotics used in the treatment of urinary tract infections - Amoxicillin, amoxicillin + clavulanate, nitrofurantoin, cefotaxim, and gentamicin. The results of my work demonstrate that resistance to selected antibiotics is relatively high. It appears that women have more resistant strains than men, which can be explained by the fact that women are more likely to have urinary infections and more ESBL strains are present. No ESBL strains are present in pediatric patients (0 - 19 years). It also follows that girls are more likely to suffer from urinary infections than boys, with the only exception being girls and boys aged 0-3 years old, according to my research with urinary infections suffer more boys than girls.
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