MedQual, hôpital Saint-Jacques, CHU de Nantes, rue Saint-Jacques, Nantes cedex 1, France.
Med Mal Infect. 2010 Feb;40(2):74-80. doi: 10.1016/j.medmal.2009.01.011. Epub 2009 Oct 17.
The aim of this study was to determine the susceptibility of bacterial strains identified in community-acquired infections. Surveillance was made by a network of 32 medical analysis laboratories in the five departments of the French Region "Pays de la Loire".
All Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) strains isolated in these laboratories over a 4-year period, from January 2004 to December 2007, were included in the investigation.
Eighty-four thousand and twenty-nine strains were collected: 90.6% of E. coli and 9.4% of S. aureus. E. coli isolates were mainly isolated from urine (97.2%). S. aureus isolates were more frequently isolated from pus (42.30%), from urinary samples (19.53%), or genital tract samples (14.36%). This study confirms the worrying E. coli evolution of resistance to quinolones. Indeed, during the study period, ofloxacin or norfloxacin susceptibility decreased gradually and the susceptibility rate to ciprofloxacin decreased slightly during and after 2006 (94.01% in 2005; 92.81% in 2006, and 91.62% in 2007). One thousand four hundred and thirty-five methicillin-resistant S. aureus (MRSA) strains were isolated. We observed a decrease of resistance to oxacillin: 20.73% in 2004 and 16.65% in 2006 (p<0.01). In 2007, this resistance to oxacillin seemed to increase (18.26%).
Our data confirms the serious need to monitor transmission of these strains between community and hospitals. A better knowledge of the epidemiological behavior of these BMR will contribute to better-adapted antibiotics strategies.
本研究旨在确定社区获得性感染中鉴定的细菌菌株的敏感性。监测由法国卢瓦尔河地区五个部门的 32 个医学分析实验室网络进行。
在 2004 年 1 月至 2007 年 12 月的四年期间，从这些实验室分离的所有大肠杆菌（E. coli）和金黄色葡萄球菌（S. aureus）菌株均包括在调查中。
收集了 84029 株菌株：90.6%的 E. coli 和 9.4%的 S. aureus。E. coli 分离株主要从尿液中分离（97.2%）。S. aureus 分离株更频繁地从脓液（42.30%）、尿液样本（19.53%）或生殖道样本（14.36%）中分离。本研究证实了令人担忧的大肠杆菌对喹诺酮类药物耐药性的演变。事实上，在研究期间，氧氟沙星或诺氟沙星的敏感性逐渐降低，环丙沙星的敏感性在 2006 年期间和之后略有下降（2005 年为 94.01%；2006 年为 92.81%；2007 年为 91.62%）。分离出 1435 株耐甲氧西林金黄色葡萄球菌（MRSA）。我们观察到对苯唑西林的耐药性下降：2004 年为 20.73%，2006 年为 16.65%（p<0.01）。2007 年，这种苯唑西林耐药性似乎有所增加（18.26%）。
我们的数据证实了迫切需要监测这些菌株在社区和医院之间的传播。更好地了解这些 BMR 的流行病学行为将有助于制定更好的抗生素策略。
