Hospital antibiotic resistance from 1993 to 1997 in Reunion.

Objectives - The "Sud-Reunion" Center is a 1,000-bed facility in Reunion. T his study examines the evolution of antibiotic-resistant bacteria over a fi ve year period. Results - The first strain of pneumococci with decreased susceptibility to penicillin was isolated in 1993 in the Reunion, many years later than in ot her countries. Since 1993 the prevalence of such strains has increased. In this study, the hospital-acquired antibiotic-resistant, especially health t hreatening, bacteria was followed. The evolution of resistance was variable . The percentage of methicillin-resistant Staphylococcus aureus decreased b etween 1993 and 1997 without correlated change in control procedures. Only the surveillance was increased. The rate of extended-spectrum beta-lactamas es remained at the same low level even though isolation was impossible. Onl y hygienic precautions were taken. The rate of imipenem-resistant Acinetoba cter baumanni in intensive care units was high. Nevertheless, surveillance of antibiotic-resistant bacteria and nosocomial infection was rigorous in t hese units. These three cases demonstrate that the rates of resistant bacte ria depend on many factors. In hospitals with identical regulations to redu ce the dissemination of antibiotic-resistant bacteria, the results may vary greatly (C) 1999 Elsevier, Paris.