Clinical trials and experimental
ANTIBIOTICS RESISTANCE PHENOTYPES OF THE BACTERIAL STRAINS ISOLATED FROM LEG ULCERS DURING 5 YEARS IN A DERMATOLOGY DEPARTMENT

Antibiotics resistance is a real problem at the international level. Recent epidemiological data show a higher incidence of infections with multiresistant hospital microorganisms in Romania than in the other European countries. The delayed healing of the leg ulcers causes frequent hospitalizations and the repeated antibiotic treatments increase the risk of developing resistance. In order to identify the antibiotic sensitivity phenotypical profile of the microorganisms that were isolated from leg ulcers, a study was performed retrospectively at the Dermatology Department of the Emergency University Hospital „Elias“ from January 2011 to December 2015. 340 patients were diagnosed with leg ulcers (venous, arterial, diabetics or with mixed etiology). 227 bacteriological examinations had a positive result with the identification of 257 bacterial strains. The antibiotic sensitivity profile was tested according to the guide of the Clinical and Laboratory Standards Institute (CLSI) and by using automated systems (Vitek2C/Phoenix BD). A D-test was performed as well. Out of a total of 22 bacterial species,(121 strains, 47%) and Pseudomonas aeruginosa (51 strains, 19.8%). The association of these species in a sample was more frequent than other microbial associations. Almost half of the S. aureus strains showed an antibiotic multiresistant phenotype (56 strains, 46.3%), and 35.5% were methicillin- resistant (MRSA). There was a higher resistance towards macrolides, lincosamides and streptogramin B for the MRSA strains (69.7%) than for the methicillin-sensitive S. aureus strains. During the study an increasing resistance towards methicillin was observed. Moreover, a high incidence of antibiotic resistance of the isolated strains was detected. The results of this study highlight the importance of monitoring the antibiotic sensitivity, which allows the administration of an adequate treatment and the epidemiological control of the nosocomial infections.