Détection et surveillance épidémiologique des résistances bactériennes aux antibiotiques en milieu communautaire

Abstract

The monitoring of bacterial resistance to antibiotics in non-hospitalized patients is essential. More than 80% of antibiotics are prescribed in the community and many patients can carry multiresistant bacteria after hospitalization. In addition to its role in the diagnosis and assistance in the treatment of the community acquired infections, the biologist can integrate a surveillance network of bacterial resistance to antibiotics. This monitoring must consider historical and medical informations concerning the patients. Previous antibiotic treatment, or hospitalization are factors of major concern in the variation of resistance to antibiotics and species of the bacteria isolated from urinary tract infections in the community. Previous hospitalization is frequently found among patients carrying methicillin resistant Staphylococcus aureus. Recent antibiotic treatment is related to an important prevalence of Streptococcus pneumoniae presenting a decreased susceptibility to penicillin G. The notion of re-infection in often found when Haemophilus influenzae producing β-lactamase are isolated. The monitoring of the evolution of resistance to fluoroquinolones in Neisseria gonorrhoeae, and Salmonella Hadar and the survey of resistance to macrolides in β-haemolytic streptococci are also important objectives.