Antimikrobna osjetljivost sojeva kampilobaktera na kinolone i makrolide u hospitaliziranih bolesnika s kampilobakteriozom

master's thesis

• Title (english): Antimicrobal susceptibility of campylobacter strains to quinolones and macrolides in hospitalized patients with campylobacteriosis
• Author: Paula Šupraha
• Mentor: Mirjana Balen Topić (mentor)
• Committee member: Dalibor Vukelić (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Mirjana Balen Topić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Kampilobakterioza spada među najčešće bakterijske gastroenteritise u ljudi koju se, kada za to postoji indikacija, preporuča antimikrobno liječiti lijekovima iz skupine makrolida ili kinolona. U posljedenje vrijeme bilježi se porast antimikrobne neosjetljivosti sojeva kampilobaktera na spomenute lijekove, što se povezuje s njihovom primjenom u veterinarskoj medicini, dok je uloga njihove primjene u humanoj medicini u razvoju neosjetljivosti manje jasna. Cilj ovog istraživanja je bio prikazati kretanje antimikrobne osjetljivosti sojeva C. jejuni i C. coli na kinolone i makrolide u razdoblju od 1994.-2014. godine u promatranoj populaciji te ispitati kretanje neosjetljivosti s obzirom na dob bolesnika i prema sezoni razbolijevanja. Ovim retrospektivnim istraživanjem su obuhvaćene 2781 osobe s dokazanom kampilobakteriozom hospitalizirane u Klinici za infektivne bolesti „Dr. Fran Mihaljević“ u razdoblju od 1994-2014. godine kojima je iz uzorka stolice izolirana vrsta C. jejuni ili C. coli te je učinjen antibiogram. Podaci o bolesnicima su prikupljeni iz Odsjeka za medicinsku dokumentaciju Klinike, dok su podaci o vrsti kampilobaktera i antimikrobnoj osjetljivosti sojeva prikupljeni iz dokumentacije Zavoda za kliničku mikrobiologiju Klinike. Rezultati su pokazali da je u promatranom razdoblju antimikrobna neosjetljivost na kinolone sojeva kampilobaktera značajno porasla (p<0,001), a kretala se u rasponu od 0% godine 1995. do 53,4% godine 2009. Neosjetljivost sojeva kampilobaktera se prema kalendarskom mjesecu hospitalizacije kretala u rasponu od 16,3% u travnju i svibnju do 29,1% u studenom te je bila značajno viša u razdoblju od studenog do siječnja u odnosu na ostatak godine (p<0,001). Prema promatranim dobnim skupinama se neosjetljivost na kinolone kretala u rasponu od 9,2% u djece stare 3-5 godina do 24,1% u osoba ≥60 godina te je bila signifikantno viša u odraslih nego u djece <18 godina (p=0,016). Antimikrobna neosjetljivost sojeva kampilobaktera na makrolide je bila 6/2769; 0,2%. Značajno veća antimikrobna neosjetljivost promatranih sojeva na kinolone u odraslih osoba te tijekom hladnih mjeseci u godini kada je općenito veća i upotreba antibiotika u ljudi, upućuje na utjecaj primjene kinolona u humanoj medicini na razvoj neosjetljivosti sojeva kampilobaktera.

Abstract (english)

Campylobacteriosis is one of the most common bacterial gastroenteritis in humans. In certain indications, antimicrobial therapy using macrolides or quinolones may be of clinical benefit. In the last few decades, the emergence of antimicrobial resistance to macrolides and/or quinolones has been observed in Campylobacter strains, that is mainly consequence of their broad usage in veterinary medicine. The influence of their usage in human medicine on the development of Campylobacter resistance is less clear. The aim of this research was to investigate trends in the antimicrobial resistance on quinolones and macrolides in C. jejuni and C. coli strains during the 1994-2014 period, as well as the influence of the patient’s age and seasonality. This retrospective study included 2781 patients with confirmed campylobacteriosis that were hospitalized at the University Hospital for Infectious Diseases „Dr. Fran Mihaljević“ during the 1994-2014 period. In all patients with campylobacteriosis the antimicrobial susceptibility tests were done. The patient’s data were extracted from medical records while the data about the antimicrobial susceptibility were collected from the Department of Clinical Microbiology of the Hospital. Antimicrobial resistance on quinolones in Campylobacter strains increased significantly in the observed period (p<0.001), ranging from 0% in the year 1994 to 53.4% in the year 2009. The seasonal resistance of Campylobacter strains, ranged from 16.3% in April and May to 29.1% in November and was significantly higher from November until January compared to the rest of the year (p<0.001). In addition, the resistance on quinolones ranged from 9.2% in children 3-5 years of age to 24.1% in persons ≥60 years of age and it was significantly higher in adults than in children <18 years age (p=0.016). Antimicrobial resistance on macrolides in Campylobacter strains was 6/2769; 0.2%. Significantly higher antimicrobial resistance on quinolones in the observed strains in adults as well as during the cold months of the year when the usage of antibiotics in humans is generally higher, indicates the influence of antimicrobial usage in human medicine on the antimicrobial resistance development.

• Keywords: Campylobacter; antimikrobna osjetljivost; kinoloni; makrolidi
• Keywords (english): Campylobacter; antimicrobial susceptibility; quinolones; macrolides
• Language: croatian
• URN:NBN: urn:nbn:hr:105:739196
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-07-07 09:28:07