Introduction: Fluoroquinolones are a frequently prescribed class of antibiotics, which has been blacklisted in recent years because of a growing evidence of the connection with serious undesirable effects, infections Clostridioides difficile, and a connection with the occurrence of multiresistant strains.Methods: In the University Hospital Hradec Kralove in the course of the years 2009-2019, several antibiotic stewardship restrictive and educational interventions were performed by the Antibiotic Centre aiming to decrease quinolone antibiotics administration. The data of the consumption of quinolone antibiotics were retrospectively evaluated and correlated with the development of sensitivity and occurrence of multiresistance of selected bacteria in the hospital.Results: In the period under investigation, consumption of fluoroquinolone antibiotics significantly decreased (p<0.001) in 10 years by 71.8% to 26.7 DDD/1000 patient day. Sensitivity of Escherichia coli and Pseudomonas aeruginosa to fluoroquinolones in the period under investigation increased by 4.8% (respectively by 15%); on the other hand, sensitivity of Staphylococcus aureus decreased by 4.2% to 85.5% share of sensitive strains. The incidence of the multiresistant isolates Pseudomonas aeruginosa decreased by 8.1%, but the occurrence of ESBL-producing Klebsiella pneumoniae was increased in the period under investigation. The occurrence of methicillin-resistant Staphylococcus aureus did not show a stable trend and finally it was moderately increased by 2.9%.Conclusion: Implementation of programmes of antimicrobial stewardship for hospitalized patients resulted in a decrease and a rationalization of fluoroquinolone administration. The reduction of their consumption in our hospital resulted in a statistically insignificant increase in the sensitivity of Escherichia coli and Pseudomonas aeruginosa, but not Staphylococcus aureus.
Rod Bartonella zahrnuje přes 20 druhů kultivačně náročných gramnegativních tyčinek. Jedná se o fakultativně intracelulární bakterie. Pro B. quintana a B. bacilliformis je člověk rezervoárovým hostitelem, pro ostatní dosud popsané druhy je člověk hostitelem náhodným, bartonely tedy patří mezi původce zoonóz. Bartonelové infekce mohou probíhat zcela asymptomaticky, mohou však u člověka působit různá onemocnění. V tomto článku jsou popsány zkušenosti z našeho pracoviště s bartonelovou endokarditidou v období let 2012–2017. Nejefektivnější metodou průkazu bartonelové endokarditidy je PCR průkaz DNA původce z excidované chopenní tkáně. European Society of Cardiology (ESC) ve svých doporučeních z roku 2015 uvádí pro léčbu bartonelové endokarditidy kombinaci doxycyklinu s gentamicinem.
The Bartonella genus comprises more than 20 species of Gram-negative rods which are difficult to culture. These are facultative intracellular bacteria. Humans are reservoir hosts for B. quintana and B. bacilliformis or accidental hosts for other species. Bartonella is a cause of zoonosis. Bartonella infection can be completely asymptomatic or can be linked to various conditions. Our experience with Bartonella endocarditis from 2012–2017 is presented. The most effective diagnostic method for Bartonella endocarditis is PCR detection of DNA of the pathogen from excised valve tissue. The European Society of Cardiology (ESC) in the guidelines from 2015 recommends the combination doxycycline gentamycin for the treatment of Bartonella endocarditis.
- MeSH
- Bartonella MeSH
- dospělí MeSH
- endokarditida * diagnóza mikrobiologie terapie MeSH
- infekce bakteriemi rodu Bartonella * diagnóza mikrobiologie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
