Sensibilité aux antibiotiques de souches d' Escherichia coli isolées en 1998 et 1999: résultats d'une enquête multicentrique française
Seven hospital lab departments were enrolled in this study in order to update and analyse data on E. coli susceptibility to antibiotics in 1998 and 1999.
Material and methods
1,114 strains were randomly selected for analysis, a large number of which had been obtained from female (65,7%) and elderly patients, and essentially from urinary samples (56%) and blood cultures (23%).
It was observed that resistance rates (R+I) were elevated for amoxicillin (44%), ticarcillin (42%), co-amoxiclav (31%) and cephalothin (36%), moderate for nalidixic acid (8%), ciprofloxacin (5%) and gentamicin (2%), and very low for ceftazidime (1%) and ceftriaxone (0.8%); 2 strains only (0.2%) were ESBL producers. Finally, it was noteworthy that pediatry units were providers of strains significantly more resistant to amoxicillin, co-amoxiclav, ticarcillin and cephalothin than strains from other units; no other risk-factor of resistance was detected. While the previous 1114 randomised strains presented MIC50 and 90 of 0.125 and 0.25 μg/mL for ceftazidime and 0,03 and 0,06 μg/mL for ceftriaxone, a complementary analysis carried out on a pool of 76 ESBL producers and 137 strains resistant (R+I) to ceftazidime and/or to cefotaxime/cetriaxone (but ESBL−) revealed that these value were increased of 7 to 9 dilutions for the 76 ESBL+ strains and of 5 to 6 for the 137 ESBL− strains in comparison with susceptible strains. Moreover these strains were observed to present elevated rates of co-resistance (R+I) to nalidixic acid, ciprofloxacin and gentamicin: 52%, 37% and 41% respectively for ESBL+ strains and 43%, 21% and 16% respectively for ESBL− strains.
- Journal of Antimicrobial Chemotherapy 06/2001; 47(5):725-6. DOI:10.1093/oxfordjournals.jac.a002695 · 5.44 Impact Factor
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ABSTRACT: Objective - This study was performed in order to describe the trends and epidemiology of antimicrobial resistance in Enterobacteriaceae isolated in the community. Materiel and methods - In 1993, 1997 and 2000, 9290 strains of Enterobacteriaceae were isolated in community lab settings and their susceptibility to antibiotics evaluated by the disk method according to the French recommendations (CA-SFM). Epidemiological data concerning medical history of patients were simultaneously collected. Results - Samples are essentially provided from urinary tract (88.7 %) and from women (79.5 %). 88.2 % of the strains are Escherichia coli and Proteus mirabilis. Over the three studies, we observe an increasing resistance to penicillins, coamoxiclav and cotrimoxazole for E. coli, to coamoxiclav for P. mirabilis and to penicillins for Salmonella sp. Ceftriaxone, gentamicin and ciprofloxacin retain a very good activity. Producers of extended-spectrum beta -lactamase are detected for a rising number of species, but strains remain rare (0.5%). Analysing, by logistic regression, the risk factors for adults to be infected by a resistant strain of E. coli, lead to observe a narrow association of antimicrobial resistance with prior antibiotherapy and a relative specificity between the family of prior antibiotics and the compound affected by bacterial resistance. Prior hospitalisation is preferentially linked to multiresistance and age > 60 years is associated with cefixime and quinolone resistance and with multiresistance. Resistance of E. coli to penicillins is more elevated in children than in adults, and is also linked to a prior antibiotic use by children. Some comparable results are provided in univariate analysis for P. mirabilis and Salmonella sp. (C) 2001 Editions scientifiques et medicales Elsevier SAS.MÃ©decine et Maladies Infectieuses 10/2001; 31(10):622-628. DOI:10.1016/S0399-077X(01)00285-2 · 0.91 Impact Factor