[Aetiology and antibiotic sensitivity of the most frequent outpatient infections]. / Etiología y sensibilidad antibiótica de las infecciones extrahospitalarias más frecuentes.

The diffusion of the outlines of antibiotic sensitivity is a practice that is recommended for improving the prescription of antibiotics and for controlling the appearance and spread of resistances. During the years 2003 and 2004, data was gathered on the sensitivity to antibiotics of the main bacteria isolated in outpatient urine cultures, coprocultures, faringoamygdal and otic smears in the Pamplona health area, which attends to a population of approximately 400,000 inhabitants. Of the 9,495 uropathogens isolated, 90% were sensitive to amoxicillin-clavulanate, 96.4% to 2nd generation cephalosporins, 95.3% to phosphomycin and 97.7% to nitrofurantoin. One point eight percent (1.8%) of the strains of Escherichia coli isolated in urine were producers of extended spectrum b-lactamases, while 0.5% of the urinary isolations of Klebsiella pneumoniae were producers of this type of b-lactamases. Ninety-six point five percent of the 797 isolations of Salmonella serotipo Enteritidis were sensitive to cotrimoxazol, and 97.5% of the 1,057 isolations of Campylobacter jejuni were sensitive to eritromycine. Of the 319 bacteria isolated in otitis media, 96.5% were sensitive to amoxyline. The Gram negative bacillae producers of otitis externa showed a sensitivity above 90% to ciprofloxacin, gentamycin and polimixin B. Twenty-nine point seven percent of the isolations of Streptococcus pyogenes were resistant to eritromycine. Fourteen point three percent and 17.4% of the Staphylococcus aureus isolated in the years 2003 and 2004 respectively were resistant to methicillin. Knowledge of the map of antibiotic sensitivity of the microorganisms in circulation in each geographical area is information that is necessary for the empirical choice of antibiotic treatment.

Etiología y sensibilidad antibiótica de las infecciones extrahospitalarias más frecuentes / Aetiology and antibiotic sensitivity of the most frequent outpatient infections

La difusión de los perfiles de sensibilidad antibiótica es una práctica recomendada para mejorar la prescripción de antibióticos y controlar la aparición y diseminación de resistencias. Durante los años 2003 y 2004, se recogieron los datos de sensibilidad a antibióticos de las principales bacterias aisladas de urocultivos, coprocultivos, frotis faringoamigdalares y óticos extrahospitalarios, en el área de salud de Pamplona que atiende a una población aproximada de 400.000 habitantes. De los 9.495 uropatógenos aislados, el 90% fueron sensibles a amoxicilina-clavulánico, el 96,4% a cefalosporinas de 2ª generación, el 95,3% a fosfomicina y el 97,7% a nitrofurantoína. El 1,8% de las cepas de Escherichia coli aisladas en orina fueron productores de b-lactamasas de espectro extendido, mientras que el 0,5% de los aislamientos urinarios de Klebsiella pneumoniae fueron productores de este tipo de b-lactamasas. El 96,5% de los 797 aislamientos de Salmonella serotipo Enteritidis fueron sensibles a cotrimoxazol y el 97,5% de los 1057 aislamientos de Campylobacter jejuni fueron sensibles a eritromicina. De las 319 bacterias aisladas en otitis media, el 96,5% fueron sensibles a amoxicilina. Los bacilos Gram negativos productores de otitis externa presentaron una sensibilidad superior al 90% para ciprofloxacino, gentamicina y polimixina B. El 29,7% de los aislamientos de Streptococcus pyogenes fueron resistentes a la eritromicina. El 14,3% y el 17.4% de los Staphylococcus aureus aislados durante los años 2003 y 2004 respectivamente fueron resistentes a la meticilina.El conocimiento del mapa de sensibilidad antibiótica de los microorganismos circulantes en cada área geográfica es una información necesaria para la elección empírica del tratamiento antibiótico

The diffusion of the outlines of antibiotic sensitivity is a practice that is recommended for improving the prescription of antibiotics and for controlling the appearance and spread of resistances. During the years 2003 and 2004, data was gathered on the sensitivity to antibiotics of the main bacteria isolated in outpatient urine cultures, coprocultures, faringoamygdal and otic smears in the Pamplona health area, which attends to a population of approximately 400,000 inhabitants. Of the 9,495 uropathogens isolated, 90% were sensitive to amoxicillin-clavulanate, 96.4% to 2nd generation cephalosporins, 95.3% to phosphomycin and 97.7% to nitrofurantoin. One point eight percent (1.8%) of the strains of Escherichia coli isolated in urine were producers of extended spectrum b-lactamases, while 0.5% of the urinary isolations of Klebsiella pneumoniae were producers of this type of b-lactamases. Ninety-six point five percent of the 797 isolations of Salmonella serotipo Enteritidis were sensitive to cotrimoxazol, and 97.5% of the 1,057 isolations of Campylobacter jejuni were sensitive to eritromycine. Of the 319 bacteria isolated in otitis media, 96.5% were sensitive to amoxyline. The Gram negative bacillae producers of otitis externa showed a sensitivity above 90% to ciprofloxacin, gentamycin and polimixin B. Twenty-nine point seven percent of the isolations of Streptococcus pyogenes were resistant to eritromycine. Fourteen point three percent and 17.4% of the Staphylococcus aureus isolated in the years 2003 and 2004 respectively were resistant to methicillin. Knowledge of the map of antibiotic sensitivity of the microorganisms in circulation in each geographical area is information that is necessary for the empirical choice of antibiotic treatment

[Antibiotic sensitivity and treatment recommendations for Streptococcus pneumoniae]. / Sensibilidad antibiótica y recomendaciones de tratamiento para Streptococcus pneumoniae.

The aims of present paper were to determine the susceptibility of the strains to the most usual antibiotics in clinical practice and to review the current recommendations to guide the most appropriate treatment. During the period october 2000 to september 2002, the patient's data (age and sex), source of the sample, diagnosis and antibiotic susceptibility were collected on Streptococcus pneumoniae isolates from microbiology laboratories in the Navarra region (555.829 inhabitants). Four hundred and sixty five isolates were identified (166 from invasive infections). Generally, isolates from ear swabs were the most resistant to the antimicrobials tested, while those from blood culture were the most susceptible. Of the Streptococcus pneumoniae tested, 43% were resistant to penicillin, 6.1% to amoxicillin and 6.6% to cefotaxime. Of the 36.3% of Streptococcus pneumoniae isolates that were resistant to erythromycin, 85.45% exhibited the MLSB phenotype while the remaining 14.55% presented with the M phenotype. Multiple-resistance was detected in 32.3% of the strains. The antibiotic resistance rates to beta-lactams (specially penicillin, amoxicillin and cefotaxime/ceftrixone) in Streptococcus pneumoniae don't prevent its clinical use for the most of Streptococcus pneumoniae isolated in our area, except for pneumococcal meningitis.