[Bacterial resistance to antibiotics in the Czech Republic. The Working Group for Monitoring Resistance in the Czech Republic].

In 1991 the authors made an investigation on the resistance of clinically important bacteria. Seventeen antibiotic centres in the Czech Republic participated in the investigation. The resistance to antibiotics of 32,567 strains of twelve bacterial species isolated from hospitalized patients depends on 1. the type of bacteria and antibiotics, 2. the source (specimen of pathological material) and 3. the locality (hospital). The resistance of Staphylococcus aureus to oxacillin with the exception of one hospital is not more than 6%, in rare instances also resistance to vancomycin was encountered. The frequency of resistance of gram-negative rods to so-called reserve antibiotics (cephalosporins of the third generation, quinolones and amikacin) depends markedly on the type of bacteria, being highest in typical causal agents of hospital infections--Enterobacter cloacae, Serratia marcescens, Providencia rettgeri and Pseudomonas aeruginosa. With the exception of cephalosporins the resistance of gram-negative rods and Pseudomonas aeruginosa isolated from urine is much greater than in strains from other clinical materials. The frequency of resistance in faculty hospitals which concentrate patients with more serious diseases is high, the highest resistance was, however, recorded in the North Bohemian area--in pneumococci against penicillin (13%) and in haemophili against ampicillin (17%). Every hospital is a closed ecological niche with a typical bacterial population and resistance rate. A competent estimate of an adequate and probably effective antibiotic for immediate initiation of treatment of an urgent infection can thus be made only by somebody with close and steady knowledge of the state of resistance in a given hospital.