Lactic acid bacteria have long been considered as protective microflora, able to displace and kill different pathogens. Twenty vaginal strains, pre-selected as probiotics, were additionally characterized as effective antagonists against human pathogens. Four clinical reference strains-Staphylococcus aureus ATCC 25923, Staphylococcus aureus (MRSA) ATCC 39592, Pseudomonas aeruginosa ATCC 27853 and E. coli ATCC 25922 were used as test-cultures in initial screening procedure. The active strains belonging to the species L. fermentum, L. gasseri and L. salivarius were tested against 10 antibiotic-resistant and problematic clinical isolates. In vitro the growth inhibition of two Acinetobacter baumannii and two Pseudomonas aeruginosa out-patient strains was observed. The active antimicrobials were the lactic acid and hydrogen peroxid produced during the cultivation of ten vaginal strains, in combination with termo and proteinase-sensitive bacteriocin-like metabolites. Our results provide a promising base for further characterization of active compounds synthesized from Bulgarian vaginal Lactobacillus strains.
We introduce Bulgarian Surveillance Tracking Antimicrobial Resistance (BulSTAR) and make the first report on surveillance data for 2003. This longitudinal surveillance programme monitors the isolation and antimicrobial susceptibility of all clinically significant microorganisms isolated from blood cultures, cerebrospinal fluid, upper and lower respiratory tract, urine and wound samples in the participating microbiology laboratories. Twenty eight public, 45 hospital and 6 private laboratories from all 28 counties of the Republic of Bulgaria participated in BulSTAR 2003. The total number of isolates from monitored sources during the surveillance period was 98 929. Seven microorganisms represented 72% of all isolated bacteria in BulSTAR 2003: Escherichia coli, Staphylococcus aureus, Proteus-Providencia-Morganella group, Klebsiella spp., Pseudomonas spp, Streptococcus pneumoniae and Streptococcus pyogenes. Generally the resistance of clinically significant Gram positive and Gram negative bacteria in Bulgaria was estimated to be at a medium level when compared with many other surveillance sources worldwide. A unique 32-year experiment on the population by treating all severe infections with an ampicillin/gentamicin combination resulted in twofold higher levels of resistance to amynoglycosides compared with other countries worldwide. This is due to the extremely conservative treatment schemes used in the former socialist countries, based on national directives and cheap domestic production of gentamicin and ampicillin. The forthcoming introduction of a computer network and improvements in detecting mistakes are expected to increase the sensitivity and the significance of BulSTAR surveillance system - an indispensable tool in the combat against increasing worldwide antibiotic resistance.
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