RESISTANCE TO CIPROFLOXACIN IN PATHOGENIC ENTEROBACTERIACEAE IN ENGLAND AND WALES IN 1996

In 1996, 6% of Escherichia coli from extraintestinal infections were r esistant to ciprofloxacin with minimum inhibitory concentrations (MICs ) greater than or equal to 2 mg/l (high level resistance). Low level r esistance (MIG 0.125-1 mg/l) was also identified in 7% of Salmonella t yphi, 4% of S paratyphi A, and 4% of non-typhoidal salmonellas. Howeve r, resistance to ciprofloxacin was rarely identified in shigellas. For E coli, physicians should be aware that treatment occur when patients with illness are treated with ciprofloxacin before the results of lab oratory sensitivity tests are available. For salmonellas an increasing number of treatment failures have been recorded for patients infected with strains with low level resistance. Because of the increasing inc idence of Enterobacteriaceae with low level resistance to ciprofloxaci n, it is recommended that for this group of organisms a breakpoint of 0.125 mg/l should be included in laboratory sensitivity tests.