Pseudomonas aeruginosa: etude multicentrique de la resistance aux antibiotiques [1999-2000]

A retrospective multicentric study was carried out over a period of 2 years [1999-2000]. 2659 strains of pseudomonas aeruginosa were collected from 4 university hospitals [charles Nicolle Hospital, pediatric Hospital and national center of Bone Marrow Transplantation in Tunis, Habib Bourguiba Hospital in Sfax]. Epidemiological profile and antibiotic susceptibility were analyesd. All bacteria were identified by conventional methods and antibiotic susceptibility tests were performed according to CA-SFM guidelines. The strains were recovered essrntially from surgical wards [33%] and intensive care units [22%]. Pseudomonas aeruginosa was isolated mainly from pus [36%] urine [32%]and respiratory samples [18%]. 25% of strains were resistant to ticarcilline, 18% to cefsulodine, 9% to ceftazidime, 14% to imipenem and amikacin and 25% to ciprofloxacin. Moreover, the resistance rates varied from hospital to hospital and from unit to another. The resistant strains were isolated particularly from urology and intensive care units: respectively 62% and 39% for ticarcilline; 26% and 13% for ceftazidime. The acquired resistance to b-lactams seems largely due to penicillinase production. The frequency of resistance to ceftazidime was the lowest and seem associated to chromosomal cephalosporinase over production

[Infective endocarditis caused by enterococcus isolate resistant to glycopeptides]

Enterococci are an important cause of infective endocarditis. Their resistance to most of the antibiotics involve real therapeutic problems. We report the first clinical isolate of glycopeptide resistant enterococus from blood culture of patient with a prostetic valve endocarditis. The strain is an E.faecium with a high level of resistance to vancomycin and teicoplanin [MlC>256mg/I],a low level of resistance to gentomycin [MIC=6mg/l] and susceptibile to ampicillin [MIC=1.5mg/I]. Therapeutic failure was observed leading to a surgical treatment. Therapy of such infection caused by multiresistant Enterococcus must be based on the study of bactericidal activity of antibiotic associations. In order to control the spread of this emerging resistance, the implementation of control measures is necessary