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CP-146 The pharmacotherapeutic management of parapneumonic pleurisy
  1. CI Staicus1,
  2. D Calina2,
  3. L Rosu3,
  4. AF Rosu3,
  5. O Zlatian3
  1. 1University of Medicine and Pharmacy, Faculty of Medicine, Craiova, Romania
  2. 2Faculty of Pharmacy, Clinical Pharmacy Department, Craiova, Romania
  3. 3Faculty of Medicine, Microbiology Department, Craiova, Romania

Abstract

Background Confirmation of infectious aetiology of pleurisy requires a complete microbiological diagnosis. An antibiogram is mandatory for correct and effective treatment.

Purpose To investigate the resistance pattern of the flora involved in parapneumonic pleurisy.

Material and methods We attempted to identify possible causative organisms and their sensitivity to antibiotics in the pleural fluids collected from 150 patients hospitalised between 01.05.2010 and 01.05.2014.

Results In 43.33% of pleural fluids germs were detected such as: Pseudomonas spp., anaerobic bacteria, non-fermentative Gram negative rods, Staphylococcus aureus, MRSA, Escherichia coli, Klebsiella, Streptococcus pyogenes, Enterococcus, Candida albicans.

Pseudomonas strains were 100% resistant to ampicillin, amoxicillin, cefpirome, ceftriaxone (91.67%), penicillin (90.00%), cefuroxime (87.50%), ceftazidime (85.00%), amoxicillin with clavulanic acid (75.00%), gentamicin (73.33%) cefepime (71.43%), teicoplanin (9.09%) and linezolid (11.11%).

Staphylococcus aureus was 100% resistant to ampicillin, amoxicillin, amoxicillin with clavulanic acid, cefuroxime, cefepime, cefpirome (90.91%), ceftriaxone (87.50%), ceftazidime (87.50%), penicillin (80.00%), amikacin (11.1%) and rifampicin (20.00%). No resistance to linezolid, teicoplanin or piperacillin with tazobactam was observed.

Non-fermentative Gram-negative rods were 100% resistant to ampicillin and amoxicillin, cefuroxime (90.91%), cefpirome (88.89%), amoxicillin with clavulanic acid (75.00%), ceftriaxone (75.00%). We found low resistance to piperacillin with tazobactam (20.00%), amikacin (25.00%), and tigecycline (33.33%).

Klebsiella pneumoniae was 100% resistant to ampicillin, amoxicillin, clavulanic acid, amoxicillin, ceftazidime, gentamycin, cefpirome, cefuroxime, penicillin (75.00%), rifampicin [JM1] (75.00%), oxacillin (66.67%), tigecycline (66.67%). All strains were 100% susceptible to linezolid, meropenem and teicoplanin.

These resistance patterns show the nosocomial potential of these strains.

In the evolution of pleurisy, especially due to Pseudomonas, there was a correlation between prolonged hospitalisation and rapid development of resistance to drug treatment once it has started.

Conclusion It is recommended to research and evaluate the effectiveness of strategies to prevent the emergence of microbial strains resistant to drug treatment in the case of parapneumonic pleurisy.

References and/or Acknowledgements [JM1]

No conflict of interest.

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