PREVALENCE OF FLUOROQUINOLONE RESISTANCE IN EUROPE

被引:36
作者
KRESKEN, M
HAFNER, D
MITTERMAYER, H
VERBIST, L
BERGOGNEBEREZIN, E
GIAMARELLOU, H
ESPOSITO, S
VANKLINGEREN, B
KAYSER, FH
REEVES, DS
WIEDEMANN, B
ROTTER, M
WEWALKA, G
AICHINGER, W
BREITFELLNER, G
SCHINDLER, J
STRATCHUNSKY, L
LAUWERS, S
OSTERRIETH, P
VERSCHRAEGEN, G
VANLANDYT, H
MERTENS, A
KARTLEVEN, J
POTVLIEGHE, C
FUSSLE, R
LUTTICKEN, R
HOPKEN, MS
FABRICIUS, K
WERNER, H
ULLMANN, U
NICULESCU, ER
LANGMAACK, H
RINGELMANN, R
MACHKA, K
OPFERKUCH, W
DASCHNER, F
MANNHEIM, W
WAGNER, J
ROHR, HP
SCHAFER, V
WITTE, W
KELLER, P
NAUMANN, G
HUOVINEN, P
AVRIL, P
BEBEAR, P
DABERNAT, H
DRUGEON, P
DUVAL, P
FLEURETTE, P
机构
[1] UNIV DUSSELDORF,INST PHARMAKOL,D-40225 DUSSELDORF,GERMANY
[2] UNIV BONN,INST PHARMAZEUT MIKROBIOL,D-53115 BONN,GERMANY
[3] KRANKENHAUS ELISABETHINEN,INST MED MIKROBIOL & HYG,A-4010 LINZ,AUSTRIA
[4] CATHOLIC UNIV LEUVEN,HOSP SINT RAFAEL,B-3000 LOUVAIN,BELGIUM
[5] CHU BICHAT,MICROBIOL LAB,F-75877 PARIS 18,FRANCE
[6] UNIV ATHENS,LAIKO GEN HOSP,SCH MED,DEPT PROPEDEUT MED 1,GR-11527 ATHENS,GREECE
[7] UNIV NAPLES,OSPED GESU & MARIA,INFECT DIS CLIN,I-80135 NAPLES,ITALY
[8] NATL INST PUBL HLTH & HYG,3720 BA BILTHOVEN,NETHERLANDS
[9] UNIV ZURICH,INST MED MIKROBIOL,CH-8028 ZURICH,SWITZERLAND
[10] SOUTHMEAD GEN HOSP,TRUST HEADQUARTERS,BRISTOL BS10 5NB,AVON,ENGLAND
关键词
D O I
10.1007/BF01793572
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
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%).
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页码:S90 / S98
页数:9
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