Περίληψη:
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%).
Συγγραφείς:
KRESKEN, M
HAFNER, D
MITTERMAYER, H
VERBIST, L and
BERGOGNEBEREZIN, E
GIAMARELLOU, H
ESPOSITO, S
VANKLINGEREN,
B
KAYSER, FH
REEVES, DS
WIEDEMANN, B
ROTTER, M and
WEWALKA, G
AICHINGER, W
BREITFELLNER, G
SCHINDLER, J and
STRATCHUNSKY, L
LAUWERS, S
OSTERRIETH, P
VERSCHRAEGEN, G and
VANLANDYT, H
MERTENS, A
KARTLEVEN, J
POTVLIEGHE, C and
FUSSLE, R
LUTTICKEN, R
HOPKEN, MS
FABRICIUS, K
WERNER, H
and ULLMANN, U
NICULESCU, ER
LANGMAACK, H
RINGELMANN, R and
MACHKA, K
OPFERKUCH, W
DASCHNER, F
MANNHEIM, W
WAGNER, J
and ROHR, HP
SCHAFER, V
WITTE, W
KELLER, P
NAUMANN, G
and HUOVINEN, P
AVRIL, P
BEBEAR, P
DABERNAT, H
DRUGEON,
P
DUVAL, P
FLEURETTE, P
GROSSET, P
MONTEIL, H and
SCHEFTEL, JP
THABAUT, P
VERON, M
AVLAMIS, A
KATRACHOURA,
A
KOUMENTAKOU, I
PAPOUTSAKI, L
BARON, F
RIGOLI, R and
DELALLA, F
SCARPELLINI, P
BALDELLI, F
CANZANO, G and
CASERTA, I
ORTISI, T
MAGLIANO, E
ROZENBERGARSKA, M and
WAGENVOORT, JHT
DEGENER, J
VANGRIETHYSEN, AJA
HEINZER, I and
PEDUZZI, R
PIFFORETTI, JC
MUNZINGER, J
ARDER, HP and
SCHOPFER, K
BREER, C
BILLE, J
SIEGRIST, H
AUCKENTHALER,
R
MODDE, H
FREY, R
BODMER, T
WISE, R
SPENCER, R and
FELMINGHAM, D
GOLDIERO, F
