[Surveillance of bacterial antibiotic resistance].
A NEW RESISTANCE MECHANISM FOR E. COLI: E. coli can develop plasmid-transmitted resistance against fluoroquinolones via a specific protection of DNA gyrase. FOR STREPTOCOCCI: Two mechanisms of natural or acquired resistance linked to 2 genes can be considered: ermTR/B leads to the synthesis of methylase, the most frequent mechanism; mef E/A causes active efflux. For S. pyogenes, resistance against macrolides varies from one country to another; it is 9.6% in France. Among the commensal flora of the oropharynx, S. viridans, is the most important reservoir of resistance against macrolides. ANIMAL RESERVOIRS: Both house pets and farm animals constitute a reservoir of resistant bacteria. It is difficult to establish a relationship between the use of antibiotics and the frequency of resistance. The presence of a relationship between animal reservoirs and human infection remains controversial. ANTIBIOTIC USE AND RESISTANCE: Several publications have concluded that, from an individual point of view, there is a quasi-direct relationship between antibiotic use and bacterial resistance to antibiotics. Actually, the methodology of most of these studies can be criticized because they did not follow 3 fundamental rules: selection of controls, date the risk was measured, comorbidity.
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Microbiologie, L'Institut Mutualiste Montsouris, 42, boulevard Jourdan, F 5014 Paris.
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D004197:Disease Reservoirs; D004352:Drug Resistance, Microbial / Q000235:genetics; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics; D005798:Genes, Bacterial; D010957:Plasmids / Q000235:genetics; D013291:Streptococcus / Q000187:drug effects* / Q000235:genetics; D014169:Transformation, Bacterial / Q000235:genetics
D000900:Anti-Bacterial Agents