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Journal of Antimicrobial Chemotherapy (2003) 51, 1213-1222
© 2003 The British Society for Antimicrobial Chemotherapy

Frequency of isolation and antimicrobial susceptibility of bacterial pathogens isolated from patients with bloodstream infections: a French prospective national survey

J.-W. Decousser1, P. Pina1, F. Picot1, C. Delalande1, B. Pangon1, P. Courvalin2, P. Allouch1,*,3,§ and the ColBVH study group

1 Centre Hospitalier A. Mignot, Versailles; 2 Institut Pasteur, Paris; 3 Collège de Bactériologie-Virologie Hygiène des Hôpitaux, France

Received 22 November 2002; returned 21 January 2003; revised 30 January 2003; accepted 9 February 2003

All bloodstream strains, total 1463, isolated during a 1 month period in 105 hospitals representing all geographical areas in France were collected to study their antimicrobial susceptibility. The three major species were Escherichia coli, Staphylococcus aureus and coagulase-negative staphylococci. Among the 242 S. aureus, 87 were resistant to methicillin and among those 99% were resistant to ciprofloxacin, 11.5% to gentamicin, 1% to quinupristin/dalfopristin and 8% were heterogeneously resistant to vancomycin. Study of the methicillin-resistant S. aureus indicated that 12 clones had disseminated in French hospitals, six being heterogeneously resistant to vancomycin. Among the Streptococcus pneumoniae, 43% showed decreased susceptibility to the penicillins and 42% to erythromycin. One isolate was highly resistant to fluoroquinolones. Gentamicin, cefotaxime, ciprofloxacin and gatifloxacin resistance was rare in Enterobacteriaceae with 95% of strains susceptible. The incidence of extended-spectrum ß-lactamases was quite low. Moreover more than 25% of Pseudomonas aeruginosa strains were resistant to ciprofloxacin and gentamicin. The magnitude of antibiotic resistance in bloodstream isolates, in particular Gram-positive bacteria, emphasizes the importance of hospital control measures, rational prescribing policies and new vaccine strategies.

Keywords: bloodstream infection, antimicrobial susceptibility, VRSA, Streptococcus pneumoniae, France

* Corresponding author. Tel: +33-1-39-63-91-33; Fax: +33-1-39-63-93-12; E-mail: PALLOUCH{at}ch-versailles.fr

§ The ColBVH study group participants are listed in the Acknowledgements.


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