Évolution de la sensibilité de Streptococcus pneumoniae aux antibiotiques : résultats de l'observatoire du pneumocoque Alsace (année 2005) Evolution of antibiotic resistance of Streptococcus pneumoniae: results of Alsace observatory in 2005 Author's perso

Abstract

Résumé But de l'étude. -Entre le 1 er janvier et le 31 décembre 2005, les participants à l'Observatoire régional du pneumocoque (ORP) Alsace (un centre hospitalier universitaire, sept centres hospitaliers non universitaires et 12 laboratoires privés) ont collecté 232 souches supposées pathogènes et non redondantes de Streptococcus pneumoniae pour étudier leur sensibilité vis-à-vis des bêtalactamines. Méthode. -Les concentrations minimales inhibitrices (CMI) de la pénicilline G, de l'amoxicilline et du céfotaxime ont été déterminées par la méthode E-test et par la méthode de dilution en milieu gélosé (Steers). Les résultats ont été interprétés selon les recommandations du CA-SFM. Les sensibilités à d'autres molécules ont été étudiées. Abstract Objectives. -Between 1st January 2005 and 31st December 2005, 232 strains of Streptococcus pneumoniae were collected in the Alsace county from participating laboratories (one from university hospital, 7 from general hospitals and 12 private laboratories) to assess their susceptibility to penicillin and evaluated serogroups of strains. Method. -The coordinating centre performed MICs by the reference agar dilution test, interpreted according to CA-SFM breakpoints. Others antibiotics (erythromycin, cotrimoxazole, tetracycline…) were tested by agar diffusion, ATB-PNEUMO gallery or VITEK gallery (BioMérieux, France) by each participating laboratory. Data were processed, using 4th dimension software. Results. -Strains were collected from 151 blood samples, 38 ear pus, 11 cerebrospinal fluids, 8 pleural liquids and 24 representative pulmonary samples. The prevalence of pneumococci with decreased susceptibility to penicillin G (PDSP) is 35.1% (pulmonary samples excluded). The rate of PNSP decreases for all types of samples compared with other years of surveillance 2003 (44.0%). The rate of blood samples decreases for first time between the creation of Pneumococcal Observatory. The high-level resistance tend to decrease and began low. The PDSP are rather resistant to erythromycin, cotrimoxazole and fosfomycin. Among the PDSP, the most prevalent serotypes were 14, 19, 6 and 9. Conclusion. -Among pneumococcal strains, the rate of PDSP tend however to decrease in 2005 compared with 2003. The rate stays inferior to the observed rates in other French counties where the same decreasing is described