[Community- and non-community-acquired bacteremia: correlation between empiric antimicrobial therapy and susceptibility of micro-organisms isolated during 2007 in the Ile-de-France microbiologists network]. / Anti-infectieux empiriques dans les 24-48 premières heures des bactériémies des patients hospitalisés dans les hôpitaux du groupe des microbiologistes d'Ile-de-France en 2007.

AIM OF THE STUDY: To estimate the percentage of empirical treatments adapted in the bloodstream infections of community and not community origin and to determine the main circumstances in which this initial treatment is not adapted. PATIENTS AND METHODS: Surveillance of bloodstream infections from the laboratories of microbiology of the eight hospitals of the Ile-de-France network, during year 2007. The study concerned the patients hospitalised in medicine, surgery, obstetrics, intensive care, following care and rehabilitation, day hospitalisation, hospitalisation at home, who presented one or several episodes of bloodstream infections. RESULTS: During year 2007, 2013 bloodstream infections were analysed. Only 63.9% of bloodstream infections had an adapted initial antibiotic treatment. Among this proportion of bloodstream infections, an adapted empirical treatment concerned mainly the community episodes, the urinary tract, the pulmonary tract, or maternal-foetal episodes and the maternity ward and pediatrics. The percentage of adapted treatments was superior in the bloodstream infections where were isolated an Enterobacteriaceae, Streptococcus pneumoniae or other streptococci. On the contrary, only a quarter of bloodstream infections due to an Enterobacteriaceae producing BLSE or to a MRSA had received an adapted empirical treatment. CONCLUSION: Only two-thirds of the patients developing a bloodstream infection received an adapted initial antibiotic treatment. This proportion was even lower when it was not about a community origin, in spite of the frequent administration of several anti-infectious molecules or with wide spectrum.

[Epidemiology and antimicrobial resistance of Streptococcus pneumoniae strains isolated in Ile de France area during 2001]. / Epidémiologie et résistance aux antibiotiques de Streptococcus pneumoniae en Ile de France en 2001.

OBJECTIVE: The authors wanted to assess the level of Streptococcus pneumoniae antibiotic resistance in Ile de France. METHOD: In 2001, 637 clinical strains of S. pneumoniae were prospectively collected from 32 microbiology laboratories. RESULTS: Fifty one percent of strains were isolated from children under 15 years of age and 49% from adults. In children, 76% of strains came from otitis media, 20% from blood culture, in adults most strains (92%) came from blood culture. The overall prevalence of non-susceptible penicillin pneumococci was 61% higher in children (73%) than in adults (50%). Among the non-susceptible penicillin pneumococci 21.8% were resistant (CMI > 1 mg/l). Strains with decreased susceptibility to amoxicillin and cefotaxime were 38% and 17% respectively. Resistant strains to these two drugs (CMI > 2 mg/l) were rare 2.6% and 0.4% respectively. Among other antimicrobial agents, rate of resistance was 63% to erythromycin, 47% to cotrimoxazole, 40% to tetracycline, and 23% to chloramphenicol. The most frequent serogroups were serogroups 19 and 14, respectively 23% and 18%. Serotypes included in heptavalent vaccine covered 90% of children strains under 2 years of age. CONCLUSIONS: The prevalence of resistance to penicillin was high in children particularly in otitis media pus (76%).