Jm. Scheftel et M. Weber, RESISTANCE TO 16 ANTIBIOTICS IN 3,876 GRA M-NEGATIVE AEROBES ISOLATESISSUED FROM 39 INTENSIVE-CARE UNITS (ICU) IN FRANCE (1991), Medecine et maladies infectieuses, 24(3), 1994, pp. 255-262
The Minimal Inhibitory Concentrations (MIC's) in a liquid medium of im
ipenem (IPM) and 15 other antibiotics (ampicillin, amoxicillin-clavula
nic acid, mezlocillin, piperacillin (PIP), cefazoline, cefuroxime, cef
oxitin, cefotaxime (CFT), ceftriaxone (CAX), ceftazidime (CAZ), aztreo
nam (AZT), gentamicin, tobramycin (TOB), amikacin, ciprofloxacin (CP))
were determined towards 3.876 Gram negative aerobes isolated serially
from bacteriological swabs obtained from patients hospitalised in Int
ensive Care Units in 39 centres during 1991. The organisms recruited c
omprised 2.773 ''initial'' isolates and 593 ''repeat'' isolates (%). P
seudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, Kleb
siella pneumoniae and Proteus mirabilis represented 68 % of the ''init
ial'' isolates ; P. aeruginosa alone represented nearly one-half of th
e ''repeat'' isolates. Taking all the ''initial'' isolates together, t
he rate of antibiotic resistance (%) was as follows : IPM 9, CAZ 23, C
AX 46, AZT 34, PIP 50, CP 29. Eighty percent of the strains resistant
to IPM came from the species P. aeruginosa, Xanthomonas maltophilia, a
nd Pseudomonas cepacia. The percentage of P. aeruginosa resistant to I
PM varied from 0 to 65 % depending on the center, the resistance of K.
pneumoniae to CAZ varied from 0 to 75 %, that of E. cloacae and A. ba
umannii to CAZ from 0 to 100%. Versus bacterial species other than P.
aeruginosa, the resistance to CAZ, CAX, AZT, CFT, and PIP was higher t
han with IPM. This resistance was seen mainly in A. baumannii, extende
d-spectrum beta-lactamase producing K. pneumoniae, and enterobacteriac
eae capable of producing high levels of cephalosporinase, organisms wh
ich were frequently found in numerous centers. Among the ''repeat'' is
olates, there was a very significant increase in resistance, in partic
ular in P. aeruginosa. These results show a very wide diversity in the
distribution of bacterial strains and the incidence of bacterial resi
stance in France.