ABSTRACT
Of 53 documented cases of Yersinia enterocolitica septicemia reported to the French national registry between 1985 and 1991, 43 files contained sufficient information on antibiotic treatment to be analyzed retrospectively. All patients had at least two positive cultures of blood collected before the initiation of treatment. All strains were susceptible in vitro to the antibiotics that are usually active against gram-negative rods except for older beta-lactam agents (i.e., aminopenicillins and first-generation cephalosporins). No multiresistant strain was isolated. Only four (7.5%) of the 53 patients died. Aminopenicillins, first-generation cephalosporins, and--when prescribed alone--amoxicillin/clavulanate were not effective. Third-generation cephalosporins, most often used in combination with other antibiotics, were successful in 85% of cases. Fluoroquinolones--alone or in combination--cured all of 15 infections, with patients improving rapidly and becoming apyretic within 1-4 days. These agents therefore seem to constitute the best treatment.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Yersinia Infections/drug therapy , Yersinia enterocolitica/drug effects , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Retrospective Studies , Yersinia enterocolitica/isolation & purificationABSTRACT
The MICs of 21 beta-lactam antibiotics were measured against 126 clinically significant and epidemiologically unrelated Yersinia enterocolitica isolates. The most active antimicrobial agents tested (geometric means of MICs) were ceftriaxone, cefotaxime, ceftizoxime, and cefmenoxime (0.06 to 0.08 micrograms/ml). Mezlocillin (1.36 micrograms/ml) and piperacillin (1.57 micrograms/ml) were the most active penicillins. Aztreonam and imipenem had MICs of 0.44 and 0.24 micrograms/ml. All isolates exhibited some degree of resistance against ampicillin (MICs, greater than or equal to 4 micrograms/ml) and cephalothin (MICs, greater than or equal to 8 micrograms/ml). Cephalosporinase or penicillinase activities were expressed by all isolates. A principal component analysis of MIC data separated the major serotypes (O3, O9, O8, and O5,27). The MCBs of 14 newer beta-lactams were measured against 10 clinical isolates. On the basis of the ratio of MBC to MIC (expressed in dilution factors), a real bactericidal activity was only observed for imipenem (MBC/MIC = 1). For the other newer beta-lactams, the ratios ranged from 4 to 8.
