Épidémiologie de la résistance du pneumocoque aux antibiotiques

Abstract

Streptococcus pneumoniae may be considered like multiresistant bacteria, responsible for non-nosocomial infections. In France during 1999, 44 % of the strains were non-susceptible to penicillin G (PNSP) (with 12 % of resistant strains), 26 % were non-susceptible to amoxicilline (with 1,8 % of resistant strains) and 17,1% were non-susceptible to cefotaxime (with 0,4 % of resistant strains). The percentage of resistant strains was 1.8 % for amoxicilline and 0.4 % for cefotaxime. The PNSP's percentage was variable with regions, from 32 % in the “Pays de Loire” to 60 % in “Brie”. It was higher for children (52.7 %) than for adults (39.8 %). It was also a function of sample's site and age (child/adult): bloodstream 41.8 % / 37.2 %, broncho-pulmonary sample 54.2 % / 41.4 %, and cerebrospinal fluid 45.5 % / 37.5 %. These PNSP were often poly-resistant : 30.1 % of penicillin susceptible pneumococci but 82.2 % of the PNSP were resistant to erythromycin's. In children, the percentage of erythromycin's resistant pneumococci was about 73.2 % for ears, 66 % for broncho-pulmonary, 50.2 % for bloodstream and 56.3 % in cerebrospinal fluid. The most common serotype for PNSP strains was the 23 serotype. Lastly, for anti-pneumococci fluoroquinolones, few resistant strains have been mentioned.