Lemort M-L, Neuville S, Medus M, Gueudet P, Saada M, Aumaître H, Lecaillon E
Service de microbiologie-hématologie, hôpital Saint-Jean, pôle infectiologie de l'hôpital Saint-Jean, avenue du Languedoc, 66000 Perpignan, France.
Pathol Biol (Paris). 2006 Oct-Nov;54(8-9):427-30. doi: 10.1016/j.patbio.2006.07.007. Epub 2006 Oct 5.
The medical emergency ward makes a link between outpatients and hospitalized ones, so we can study community bacterial ecology. The antibiotic susceptibility in Escherichia coli strains isolated from urinary tract infections (UTI) of patients consulting at emergency ward of our hospital in 2002 and 2004 was determined and compared with the susceptibility of the same strains isolated from UTI of hospitalized patients on the same period. The antibiotic susceptibility was performed with Microscan (Dade Behring). All bacteria were tested against the following antimicrobial agents: amoxicilline (Amx), l'amoxicilline+clavulanic acid (AMC), nalidixic acid (NA), ciprofloxacine (Cip), cotrimoxazole (SXT), nitrofurantoin (Ft). Susceptibility in E. coli strains isolated from outpatients vary from 58 to 54% for Amx, from 88 to 83% for NA, from 96 to 89% for Cip, from 82 to 79% for SXT, from 94 to 96% for Ft and remains at 60% for AMC from 2002 to 2004. Susceptibility in E. coli strains isolated from hospitalized patients vary from 52 to 47% for Amx, 55 to 53% for AMC, from 79 to 70% for NA, from 87 to 79% for Cip, from 74 to 69% for SXT, from 93 to 92% for Ft. Susceptibility in E. coli strains isolated in the community from UTI outpatients is decreasing and it becomes worrying particularly concerning the fluoroquinolones, therefore empiric treatment of pyelonephritis by fluoroquinolones must be assessed again.
医疗急救病房连接了门诊患者和住院患者，因此我们能够研究社区细菌生态学。我们测定了2002年和2004年从我院急救病房就诊患者的尿路感染（UTI）中分离出的大肠杆菌菌株的抗生素敏感性，并与同期从住院患者UTI中分离出的相同菌株的敏感性进行了比较。使用Microscan（达德拜林公司）进行抗生素敏感性检测。所有细菌均针对以下抗菌药物进行测试：阿莫西林（Amx）、阿莫西林+克拉维酸（AMC）、萘啶酸（NA）、环丙沙星（Cip）、复方新诺明（SXT）、呋喃妥因（Ft）。2002年至2004年，从门诊患者中分离出的大肠杆菌菌株对Amx的敏感性从58%降至54%，对NA的敏感性从88%降至83%，对Cip的敏感性从96%降至89%，对SXT的敏感性从82%降至79%，对Ft的敏感性从94%升至96%，对AMC的敏感性保持在60%。从住院患者中分离出的大肠杆菌菌株对Amx的敏感性从52%降至47%，对AMC的敏感性从55%降至53%，对NA的敏感性从79%降至70%，对Cip的敏感性从87%降至79%，对SXT的敏感性从74%降至69%，对Ft的敏感性从93%降至92%。从社区UTI门诊患者中分离出的大肠杆菌菌株的敏感性正在下降，这尤其令人担忧，特别是对于氟喹诺酮类药物，因此必须重新评估用氟喹诺酮类药物对肾盂肾炎进行经验性治疗的方法。
