RESUMO
Nationwide surveys of antimicrobial susceptibility of bacteria isolated from bloodstream infections are required to fit empiric therapy to recent trends and detect emerging resistance. We report the results of a French national prospective survey based on the College of Bacteriology-Virology and Hygiene study group network performed each October during the 1996 to 2007 period, with focus on Enterobacteriaceae (7708 isolates) and Staphylococcus aureus (2271 isolates). The most relevant antimicrobial susceptibilities trends were i) a decrease in fluoroquinolones susceptibility among Enterobacteriaceae (96-90%, P < 0.0001) and Escherichia coli isolates (98-89%, P < 0.0001), respectively, ii) the slight but significant decrease in cefotaxime susceptibility among E. coli (P = 0.016), and iii) the significant increase in gentamicin susceptibility among S. aureus strains (P = 0.016). This survey reports antibiotic susceptibility of bloodstream pathogens in France. The empiric use of fluoroquinolones in severe infections should be cautiously monitored by thorough clinical and microbiologic follow-up.
Assuntos
Antibacterianos/farmacologia , Bacteriemia/microbiologia , Enterobacteriaceae/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/uso terapêutico , Bacteriemia/sangue , Bacteriemia/tratamento farmacológico , Distribuição de Qui-Quadrado , Farmacorresistência Bacteriana Múltipla , Enterobacteriaceae/isolamento & purificação , Infecções por Enterobacteriaceae/sangue , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Enterobacteriaceae/microbiologia , França , Humanos , Testes de Sensibilidade Microbiana , Vigilância da População , Estudos Prospectivos , Infecções Estafilocócicas/sangue , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificaçãoRESUMO
Among 10,872 isolates of Enterobacteriaceae from a nationwide study of 88 French hospitals in 2005, 169 (1.7%) expressed an extended-spectrum beta-lactamase. The most prevalent species were Escherichia coli (48.5%), Enterobacter aerogenes (23.7%), and Klebsiella pneumoniae (14.8%). Molecular analysis underlined the polyclonal spread of CTX-M-expressing E. coli, primarily isolates of the CTX-M-1 subgroup.
