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Original Articles
NUMBER 3-4 YEAR 2011
Trends in Bacterial Pathogens of Lower Respiratory Tract Infections in Children
1 Louis Turcanu Children Emergency Hospital, Timisoara,
2 Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, Timisoara

Correspondence to:
Giorgiana-Flavia Brad, MD, Louis Turcanu Children Emergency Hospital,
1-3 Dr. Iosif Nemoianu Str., 300011, Timisoara,
Tel. +40-256-201975
Email: giorgiana.brad@gmail.com
REZUMAT
Introducere: Infectiile tractului respirator inferior (ITRI) la copii sunt o problema de sanatate publica, uneori cu o evolutie mortala. Obiective: Obiectivele acestui studiu au fost identificarea agentilor patogeni responsabili de aparitia ITRI la copii si determinarea sensibilitatii bacteriilor izolate la diferite antibiotice. Material si metode: S-au analizat foile de observatie si antibiogramele copiilor (0-18 ani) internati in Spitalul de Copii Louis Turcanu, Timisoara, in perioada decembrie 2007 - martie 2009. Identificarea bacterilor s-a facut din sputa, aspirat traheal sau bronsic si lichid pleural, iar testarea sensibilitatii la antibiotice s-a realizat conform metodelor standard. Rezultate: S-au izolat 120 de tulpini bacteriene de la 69 de copii (43 baieti si 26 fete). Au fost 22 (31,88%) nou-nascuti, 18 (26,08%) copii mici (<3 ani), iar restul copii (>3 ani) si adolescenti. S-au izolat 77,5% bacterii Gram negative, 20% bacterii Gram pozitive, iar restul tulpini Gram negative non-fermentative. Majoritatea bacteriilor Gram negative izolate au fost Pseudomonas aeruginosa (31,11%), Klebsiella pneumoniae (23,65%) si Enterobacter (12,90%), pe când Staphylococcus aureus (79,1%) si Stafilococcus Coagulazo-Negativ (12,5%) au fost cele mai frecvente bacterii Gram pozitive identificate. Colistin a fost cel mai eficient antibiotic asupra bacteriilor Gram negative, urmat de Levofloxacin si Imipenem. Toate tulpinile Gram pozitive au fost sensibile la Vancomicina si Linezolid. Concluzii: Diagnosticul bacteriologic si supravegherea rezistentei bacteriilor la antibiotice sunt indispensabile pentru un management eficient al ITRI.

ABSTRACT
Introduction: Lower respiratory tract infections (LRTIs) in children remain an important public health problem, with potential life-threatening complications. Objectives: The objectives of this study were to identify bacterial pathogens of LRTIs in children and to study their antibiotic susceptibility. Material and methods: We reviewed the medical charts and microbiological reports of children (0-18 years) with LRTIs admitted to Louis Turcanu Children Emergency Hospital Timişoara from December 2007 to March 2009. Bacterial pathogens were isolated from sputum, tracheal or bronchial aspirates and pleural effusion, and their susceptibility was tested using standard bacteriological techniques. Results: One hundred twenty bacterial strains were isolated from 69 children (43 males and 26 females). There were 22 (31.88%) newborns, 18 (26.08%) toddlers, and the rest children and adolescents. Gram-negative bacteria represented 77.5% of isolates, 20% were Gram-positive and the rest were Non-fermenting Gram-negative strains. From Gram-negative strains, Pseudomonas aeruginosa (31.11%), Klebsiella pneumoniae (23.65%) and Enterobacter (12.90%) were the majority. Staphylococcus aureus (79.1%) and Coagulase negative Staphylococci (12.5%) were the dominants from Gram-positive cocci. Colistin was the most efficient antibiotic active on Gram-negative bacteria, followed by Levofloxacin and Imipenem. All Gram-positive isolates were susceptible to Vancomycin and Linezolid. Conclusions: Bacteriological diagnosis and antibiotic resistance surveillance are indispensable in the effective management of LRTIs.


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