Clinical Microbiology and Antimicrobial Chemotherapy. 2008; 10(4):368-380
The aim of the study was to determinate the structure of bacterial pathogens and their antimicrobial resistance in adult patients with community-acquired pneumonia (CAP). A total of 57 adult patients from Smolensk and Yartsevo hospitals with severe CAP were included in the study. Immediate autopsy samples (blood, lung, liver and spleen tissues) were obtained for histological examination and quantitative cultures. Clinically significant bacterial pathogens were isolated in 52 patients; among them single microorganism were found in 39 patients, ≥2 – in 13. K. pneumoniae, S. aureus, S. pneumoniae and H. influenzae were the most frequent isolates (31.4%, 28.6%, 12.9 and 11.4% of all strains, respectively). The best in vitro activity against K. pneumoniae show amoxicillin/clavulanate, III–IV generation cephalosporins, fluoroquinolones and carbapenems, against E. coli – III– IV generation cephalosporins and carbapenems. Among 20 strains of S. aureus 2 were resistance to oxacillin; the best activity against S. aureus show vancomycin, linezolid, trimethoprim/sulfamethoxazole, fuzidic acid and clindamycin. All S. pneumoniae strains were susceptible to all antimicrobials tested. III–IV generation cephalosporins and fluoroquinolones were the most active against H. influenzae. III-IV generation cephalosporins and carbapenems can be considered as the drugs for empiric therapy of severe CAP in Smolensk, amoxicillin/clavulanate, carbapenems and fluoroquinolones – in Yartsevo.