Silviu Epuran, Elena Rusu, Adriana Sbarcea and Simona Musat

REZUMAT

Clostridium difficile este un bacil Gram pozitiv mobil, anaerob, prezent în mod obişnuit în flora bacteriană a colonului la mai mult de 50% dintre copii sub un an, procentul reducându-se la aproximativ 3% la adulţi. La om această bacterie produce diareea asociată tratamentului cu antibiotice şi colita pseudomembranoasă care apar la câteva zile de la începerea unui tratament cu antibiotice sau antineoplazice, prin dezechilibrarea florei bacteriene normale şi înmulţirea în lumenul colonului a tulpinei Clostridium difficile rezistente la antibioticul respectiv (ampicilina, amoxicilina, cefalosporinele, clindamicina metronidazolul şi vancomicina). Principalii factori implicaţi în patogenitatea infecţiilor determinate de specia Clostridium difficile sunt: provenienţa din flora naturală a organismului, deficienţe ale mecanismelor de apărare prin anticorpi, sistem complement, leucocite, polimorfonucleare, răspunsul imun mediat celular, sinergismul cu alte microorganisme, precum si elementele care duc la creşterea virulenţei microorganismului (aderenţă, invazie, toxine, enzime şi spori). Pentru evitarea enterocolitelor determinate de specia Clostridium difficile se recomandă limitarea administrării de lungă durată a antibioticelor care determină un dezechilibru al florei normale intestinale, precum şi renunţarea promptă la medicamentul în cauză odată cu apariţia primelor manifestări digestive. Aproximativ un sfert din persoanele care au prezentat infecţii cauzate de specia Clostridium difficile se îmbolnăvesc din nou, fie pentru că infecţia iniţială nu a fost complet vindecată, fie pentru că vin în contact cu o nouă tulpină. Utilizarea probioticelor poate duce la prevenirea infecţiilor recurente cu specia Clostridium difficile.

Cuvinte cheie: Clostridium difficile, floră bacteriană intestinală, antibiotice

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Elena Rusu, Silviu Epuran, Cristina Cristescu and Manole Cojocaru

ABSTRACT

Objectives. The aim of our study was to determine the urinary infection incidence caused by different microbial species and the sensitivity to the different antibiotics classes.

Materials and methods. We observed a lot of 638 patients which were hospitalized in Gerota Hospital from Bucharest during six weeks for different pathologies (gastroenteritis, cardiovascular disease, pneumonitis, and urinary tract infections).

Results. From the total number of patients, 100 were done positive for urinary tract infections. The predominant species was E. coli (65%) followed by Enterococcus species (15%), Proteus species (10%), Enterobacter species (6%), Pseudomonas aeruginosa (3%) and Staphylococcus aureus (1%). The incidence E. coli species was 57% for women and 23% for men. Six strains were susceptibility only to imipenen and resistant to all antibiotics used (four E. coli strains and two Enterobacter strains). Five of these were from men and one from a woman. Incidence of antibiotic drugs resistance was 45% for gentamicin, 43% for cefaclor, 43% for tetracycline, 21.5% for ciprofloxacin, and 26% for amoxicillin and clavulanic acid for E. coli strains.

Conclusion. Most of identified strains belong to Escherichia coli species and have a great resistance to antibiotic drugs.

Keywords: E. coli, antibiotics, resistance

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Elena Rusu, Ionela Sarbu, Diana Pelinescu, Ioana Nedelcu, Tatiana Vassu, Cristina Cristescu, Simona Musat and Manole Cojocaru

ABSTRACT

Objective. The main goal of our study was to determine the effect that association of nonsteroidal anti-in- flammatory drugs (NSAIDs) with antifungal drugs on viability of Candida (C.) albicans and C. krusei species. Materials and methods. Six yeast strains were isolated from pharyngeal and vaginal secretions (C. albicans and C. krusei). Tests (diffusion and serial microdilutions methods) were carried out in the presence of some NSAIDs by using different concentrations (0.25mg/ml and 1mg/ml). Antifungal drugs were used in lower concentrations than the MIC (1μg/ml). Results. Cell viability of C. krusei strain was of 82% for NSAIDs used and association of these with ketoconazole led to decrease of cell viability of C. krusei strain to 60% as compared to the cells treated with antifungal drugs. In the presence of NSAIDs, cell viability of C. albicans strains, decreased between 6 to 18% for diclofenac and ibuprofen. In the case of simultaneous use of the two classes of drugs, there was observed an increase of antimicrobial activity, especially for diclofenac association, cell viability was reduced up to 60% and respectively 70% as compared to the cells treated only with ketoconazole and fluconazole. Conclusion. We observed a synergistic action of certain NSAIDs with two antifungal drugs used on some Candida species.

Keywords: Candida, Cell viability, NSAID

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