title: [Resistance to third generation cephalosporins in Sfax hospitals, Tunisia (1999-2005)].
abstract: OBJECTIVE
  The authors wanted to assess the prevalence and to monitor the trends of resistance to broad-spectrum cephalosporins among various species of enterobacteria in the region of Sfax (Tunisia).
  
  
  METHODS
  A retrospective study was carried out in the microbiology laboratory at the Habib-Bourguiba Teaching Hospital in Sfax. Data concerning a seven-year period (1999-2005) were analyzed with the Whonet 5.4 software. All clinical isolates of enterobacteria were identified with the API 20 E system. Antimicrobial susceptibilities were determined by disk diffusion on Mueller Hinton agar according to CA-SFM recommendations.
  
  
  RESULTS
  During the study period, 24,702 non-duplicate clinical strains of enterobacteria were identified. Fifteen percent (3,826) clinical isolates showed acquired resistance to third generation cephalosporins (3rdGC). The overall frequency of resistance increased from 10% in 1999 to 18% in 2005. This increase was statistically significant. High prevalence rates of 3rdGC resistance have been observed in intensive care units (48%), hematology and oncology wards (27%) and pediatric wards (25%). Klebsiella pneumoniae, Indole positive Proteus and Enterobacter showed high prevalence rates of broad-spectrum cephalosporin resistance.
  
  
  CONCLUSIONS
  This study revealed a high rate of 3rdGC resistance enterobacteria in our region, particularly in intensive care units. The frequency of acquired resistance to broad-spectrum cephalosporins seemed to be increasing. Implementation of infection control measures and identification of the mechanism responsible for third generation cephalosporins resistance are necessary to limit the spreading of these resistant enterobacteria in hospitals and community settings.
authors.affiliation: Laboratoire de microbiologie, CHU Habib-Bourguiba, route El Ain Km 0,5, 3029 Sfax, Tunisie.
authors.forename: D
authors.initials: D
authors.lastname: Mkaouar
authors.forename: F
authors.initials: F
authors.lastname: Mahjoubi
authors.forename: S
authors.initials: S
authors.lastname: Mezghani
authors.forename: A
authors.initials: A
authors.lastname: Znazen
authors.forename: S
authors.initials: S
authors.lastname: Ktari
authors.forename: A
authors.initials: A
authors.lastname: Hammami
mesh_terms: D002511:Cephalosporins / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D004754:Enterobacter / Q000187:drug effects* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy*; D006801:Humans; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D013492:Suppuration / Q000382:microbiology; D014416:Tunisia
chemical_list: D002511:Cephalosporins