@article{3046121, title = "PREVALENCE OF FLUOROQUINOLONE RESISTANCE IN EUROPE", author = "KRESKEN, M and HAFNER, D and MITTERMAYER, H and VERBIST, L and and BERGOGNEBEREZIN, E and GIAMARELLOU, H and ESPOSITO, S and VANKLINGEREN, and B and KAYSER, FH and REEVES, DS and WIEDEMANN, B and ROTTER, M and and WEWALKA, G and AICHINGER, W and BREITFELLNER, G and SCHINDLER, J and and STRATCHUNSKY, L and LAUWERS, S and OSTERRIETH, P and VERSCHRAEGEN, G and and VANLANDYT, H and MERTENS, A and KARTLEVEN, J and POTVLIEGHE, C and and FUSSLE, R and LUTTICKEN, R and HOPKEN, MS and FABRICIUS, K and WERNER, H and and ULLMANN, U and NICULESCU, ER and LANGMAACK, H and RINGELMANN, R and and MACHKA, K and OPFERKUCH, W and DASCHNER, F and MANNHEIM, W and WAGNER, J and and ROHR, HP and SCHAFER, V and WITTE, W and KELLER, P and NAUMANN, G and and HUOVINEN, P and AVRIL, P and BEBEAR, P and DABERNAT, H and DRUGEON, and P and DUVAL, P and FLEURETTE, P and GROSSET, P and MONTEIL, H and and SCHEFTEL, JP and THABAUT, P and VERON, M and AVLAMIS, A and KATRACHOURA, and A and KOUMENTAKOU, I and PAPOUTSAKI, L and BARON, F and RIGOLI, R and and DELALLA, F and SCARPELLINI, P and BALDELLI, F and CANZANO, G and and CASERTA, I and ORTISI, T and MAGLIANO, E and ROZENBERGARSKA, M and and WAGENVOORT, JHT and DEGENER, J and VANGRIETHYSEN, AJA and HEINZER, I and and PEDUZZI, R and PIFFORETTI, JC and MUNZINGER, J and ARDER, HP and and SCHOPFER, K and BREER, C and BILLE, J and SIEGRIST, H and AUCKENTHALER, and R and MODDE, H and FREY, R and BODMER, T and WISE, R and SPENCER, R and and FELMINGHAM, D and GOLDIERO, F", journal = "INFECTIOUS DISEASES NOW", year = "1994", volume = "22", number = "2", pages = "S90-S98", publisher = "MMW MEDIZIN VERLAG GMBH", doi = "10.1007/BF01793572", abstract = "Since 1984, when the first fluoroquinolone, norfloxacin, was marketed in Europe, there has been a marked increase in the usage of this class of drugs. In order to evaluate the influence of this drug usage on the prevalence of resistance to fluoroquinolones in clinical isolates of the family Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcuss aureus, coagulase-negative staphylococci and Enterococcus faecalis we reviewed the susceptibility data from four collaborative surveys conducted between 1983 and 1990 by the Study Group ‘Bacterial Resistance’ of the Paul-Ehrlich-Society for Chemotherapy. All participating laboratories used the same standardized methods. Miminal inhibitory concentrations were determined by the broth microdilution method. More than 20,000 bacterial strains were tested. The results are presented for ciprofloxacin, which is regarded as the representative of the fluoroquinolones. Using greater than or equal to 4 mg/l as a breakpoint for resistance to ciprofloxacin, the prevalence of resistant strains of the family Enterobacteriaceae in Central Europe between 1983 and 1990 remained below 1%. In contrast, the resistance rates in P. aeruginosa were 0.7%, 1.0%, 3.8% and 7.0%, in S. aureus 0%, 0.5%, 6.6% and 6.8%, and in E. faecalis 2.2%, 0.7%, 4.9% and 7.7% in 1983, 1986, 1989 and 1990, respectively. The latest study carried out in cooperation with 78 laboratories from 12 European countries revealed great differences in the prevalence of resistance to fluoroquinolones from one species to another ranging from 0% with Proteus vulgaris and Salmonella spp. to 26.7% with Providencia stuartii. The highest rates of resistance were recorded for oxacillin-resistant strains of S. aureus (70.6%) and oxacillin-resistant coagulase-negative staphylococci (51.2%). Resistance levels for individual species varied between countries, but they were consistently higher in Southern Europe than in Northwest and Central Europe. Resistance in S. aureus and E. faecalis was more prevalent in isolates from intensive care patients than in isolates from patients on normal wards. In addition, S. aureus isolates displayed a considerable difference in the resistance rates for blood (9.3%) and urine (34.4%)." }