[E. coli: resistance to quinolones and beta-lactams of clinical strains isolated in the Franche-Comté region of France].
OBJECTIVE
Numerous European studies have reported an increase of resistance to quinolones among E. coli. We conducted a regional study to update our knowledge on this evolution.


METHODS
We evaluated the resistance phenotype and genotype of 115 clinical strains of E. coli. We collected data on individual treatment with fluoroquinolones, and the evolution of the use of these antimicrobial agents.


RESULTS
Resistance to nalidixic acid and ciprofloxacin was 13.0 and 6.9, respectively. The frequency of resistance increased from 1999 to 2001, from 7.5% to 13.0% for nalidixic acid and from 5.4% to 6.9% for fluoroquinolones. Resistance to quinolones was significantly associated to beta-lactams resistance and was slightly higher for nosocomial isolates compared to community-acquired isolates. Previous treatment with fluoroquinolones was the major risk factor associated to E. coli resistance. From 1997 to 2001, fluoroquinolones use has increased in our hospital and particularly in the community. Analysis of molecular epidemiology shows a large clonal diversity among E. coli isolates.


CONCLUSIONS
This study confirms the evolution through resistance to quinolones of E. coli isolates. This observation is not due to dissemination of resistant clonal strains and the selective pressure exerted by fluoroquinolones influences this evolution. Therapeutic alternatives, surveillance, and restriction of fluoroquinolones use are needed to control this spread of resistance.
Talon
D
D
Réseau Franc-Comtois de lutte contre les infections nosocomiales, centre hospitalier universitaire Jean-Minjoz, 25030 Besançon cedex, France.
Lallemand-De-Conto
S
S
Thouverez
M
M
Bertrand
X
X
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002442:Ceftazidime / Q000494:pharmacology; D002512:Cephalothin / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D019818:Clavulanic Acid / Q000494:pharmacology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004363:Drug Utilization; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology*; D005602:France / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009268:Nalidixic Acid / Q000494:pharmacology; D010641:Phenotype; D012641:Selection, Genetic; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology; D018440:beta-Lactam Resistance / Q000235:genetics; D047090:beta-Lactams / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D024841:Fluoroquinolones; D047090:beta-Lactams; D019818:Clavulanic Acid; D009268:Nalidixic Acid; D002939:Ciprofloxacin; D000658:Amoxicillin; D002442:Ceftazidime; D002512:Cephalothin