Résistances aux antibiotiques Situation à la Réunion en 2011

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Rsistances aux antibiotiques Situation la Runion en 2011. Dr C. Simac CHU site GHSR. Enjeux. Une histoire dj ancienne 1942 : mise disposition de la pnicilline G 1947 : Pnicillinase Mais les rsistances se multiplient Au sein dune mme espce - PowerPoint PPT Presentation

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  • Rsistances aux antibiotiquesSituation la Runion en 2011Dr C. SimacCHU site GHSR

  • EnjeuxUne histoire dj ancienne1942 : mise disposition de la pnicilline G1947 : PnicillinaseMais les rsistances se multiplientAu sein dune mme espceDe plus en plus despces rsistantesDes souches qui diffusent de plus en plus facilementQui conduisent des impasses thrapeutiques

  • SurveillancesDiffrentes mthodologies - Diffrents rseauxRseaux europens ECDC - EFSARseaux nationaux RAISIn, ONERBARseau rgional - FLINSurveillance tablissement (tableau de bord)

  • EARSS SARM BLSEProportion of 3rd gen. cephalosporins (R+I) resistant Escherichia coli isolates in participating countries in 2010

    Proportion of Methicillin resistant Staphylococcus aureus (MRSA) isolates in participating countries in 2010

  • Donnes nationales BMR Raisin 2010 - SARM0,1824me / 25 rgions

  • Donnes nationales BMR Raisin 2010 - EBLSE0,593me / 25 rgions

  • Rseau FLIN : Rsistance dans lespce 20116 laboratoires ( 96 % des lits MCO de la Runion)

    Entrobactries BLSE 8 % (Enterobacter sp, E.coli, K.pneumoniae) Enterobactries rsistantes aux FQ : 12 % S. aureus rsistant la mticilline 12 % P. aeruginosa rsistant la Ceftazidime 10 % A. baumannii rsistant limipenme 20 %

  • Rsistance dans lespce par tablissement 2011 (8ES)

    Graph1

    0063318.8

    3.3012.735.719.5

    2.203.8115.3

    3.2091913

    6.61.41127.711.6

    8.2010.62518.9

    7.74.310.44513

    p25

    mini

    med

    max

    p75

    CHFG

    CHUFGNbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2011% de resistance dans l'espce anne 2010% de resistance dans l'espce anne 2009% de resistance dans l'espce anne 2007% de resistance dans l'espce anne 2006

    Acinetobacter baumanniiCeftazidime298335.0%34.9397590361

    Imipenem166425.0%16

    cefotaxime14838038.9%65

    ciprofloxacine8317647.2%66

    Enterobacter spImipenem53721.3%47

    BLSE6531120.9%49

    cefotaxime8412166.9%980.0%6.568

    ciprofloxacine144121011.9%1450.0%11.2

    Escherichia coliImipenem012150.0%0.0%0

    BLSE6612165.4%820.0%6.2

    cefotaxime5344711.9%1470.0%18.9

    ciprofloxacine424469.4%1320.0%14

    Klebsiella pneumoniaeImipenem14470.2%0.0%0.2

    BLSE4744710.5%

    enterobactries Ciflox R269183214.7

    Ceftazidime4946210.6%950.0%9.3

    Pseudomonas aeruginosaCiprofloxacin6046013.0%1030.0%15.1

    Imipenem7446216.0%1610.0%13.5

    Staphylococcus aureusOxacillin6854112.6%68

    GHSR

    GHSRNbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2011% de resistance dans l'espce anne 2010% de resistance dans l'espce anne 2009% de resistance dans l'espce anne 2008% de resistance dans l'espce anne 2007% de resistance dans l'espce anne 2006

    Acinetobacter baumanniiCeftazidime4050809891.56872.741.1

    Imipenem650129.411.919.67.51.8

    Enterobacter spcefotaxime81245333138.227.72929.1

    ciprofloxacine3724515.121.222.317.718.118.4

    Imipenem024500.700.40.40

    BLSE2824511.485.95.454.5

    Escherichia colicefotaxime46115143.44.21.90.60.8

    ciprofloxacine7411496.48.28.25.85.23.5

    Imipenem01151000000

    BLSE3211512.81.92.61.30.50.6

    Klebsiella pneumoniaecefotaxime7037318.810.17.37.23.83.8

    ciprofloxacine7937321.213.510.211.67.210.3

    Imipenem13730.300.4000

    BLSE5037313.47.12.64.72.43.4

    enterobactries Ciflox R190176710.8

    Pseudomonas aeruginosaCeftazidime243307.35.54.710.916.711

    Ciprofloxacin313309.412.714161313.8

    Imipenem4433013.313.81219.613.46.9

    Staphylococcus aureusOxacillin4744110.713.411.913.219.810.7

    CHGM

    GMNbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2011% de resistance dans l'espce anne 2010% de resistance dans l'espce anne 2009% de resistance dans l'espce anne 2008% de resistance dans l'espce anne 2007% de resistance dans l'espce anne 2006

    Acinetobacter baumanniiCeftazidime293387.9%95.0%69.2898862

    Imipenem113333.3%5.0%7.711350

    cefotaxime407057.1%45.0%21.43.23524.3

    ciprofloxacine167022.9%27.0%17.728.616.716.2

    Enterobacter spImipenem77010.0%1.0%1.2010

    BLSE257035.7%32.6%69,6*2.71.3

    cefotaxime558936.2%5.0%2.4222.3

    ciprofloxacine758938.4%8.7%13.46.65.73.8

    Escherichia coliImipenem18930.1%0.0%0000

    BLSE468935.2%4.3%4.11.410.6

    cefotaxime4023217.2%3.7%4.53.63.61

    ciprofloxacine4523219.4%7.0%7.757.23.2

    Klebsiella pneumoniaeImipenem02320.0%0.0%1.3000

    BLSE3023212.9%3.7%4.53.66.121.1

    enterobactries Ciflox R136119511.4

    Ceftazidime121428.5%13.4%8.78169

    Pseudomonas aeruginosaCiprofloxacin2414216.9%16.5%16.3212017

    Imipenem121428.5%8.7%6828

    Staphylococcus aureusOxacillin2827610.1%9.0%9.111.314.315.2

    CSC

    Nbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2011

    Acinetobacter baumanniiCeftazidime060.0%

    Imipenem1616.7%

    cefotaxime136819.1%

    ciprofloxacine86811.8%

    Enterobacter spImipenem0680.0%

    BLSE3684.4%

    cefotaxime51902.6%

    ciprofloxacine121906.3%

    Escherichia coliImipenem01900.0%

    BLSE51902.6%

    cefotaxime5677.5%

    ciprofloxacine5677.5%

    Klebsiella pneumoniaeImipenem0670.0%

    BLSE5677.5%

    enterobactries Ciflox R253257.7

    Ceftazidime43810.5%

    Pseudomonas aeruginosaCiprofloxacin43810.5%

    Imipenem2385.3%

    Staphylococcus aureusOxacillin51104.5%

    CSV

    Nbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2011

    Acinetobacter baumanniiCeftazidime010.0%

    Acinetobacter baumanniiImipenem010.0%

    Enterobacter spcefotaxime050.0%

    Enterobacter spciprofloxacine050.0%

    Enterobacter spImipenem050.0%

    Enterobacter spSynergie amox+ac clav. + cphalo 3050.0%

    Escherichia colicefotaxime0200.0%

    Escherichia coliciprofloxacine1205.0%

    Escherichia coliImipenem0200.0%

    Escherichia coliSynergie amox+ac clav. + cphalo 30200.0%

    Klebsiella pneumoniaecefotaxime070.0%

    Klebsiella pneumoniaeciprofloxacine070.0%

    Klebsiella pneumoniaeImipenem070.0%

    Klebsiella pneumoniaeSynergie amox+ac clav. + cphalo 3070.0%

    enterobactries Ciflox R1323.1

    Pseudomonas aeruginosaCeftazidime2825.0%

    Pseudomonas aeruginosaCiprofloxacin080.0%

    Pseudomonas aeruginosaImipenem080.0%

    Staphylococcus aureusOxacillin1234.3%

    CRFYY CT

    CRYY Ct CFNbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2010

    Acinetobacter baumanniiCeftazidime030%

    Imipenem030%

    Enterobacter spcefotaxime71644%

    ciprofloxacine71644%

    Imipenem0160%

    BLSE31619%

    Escherichia colicefotaxime86213%

    ciprofloxacine66210%

    Imipenem0620%

    BLSE76211%

    Klebsiella pneumoniaecefotaxime235244%

    ciprofloxacine235244%

    Imipenem0520%

    BLSE95217%

    enterobactries Ciflox R3613027.7

    Pseudomonas aeruginosaCeftazidime0200%

    Ciprofloxacin0200%

    Imipenem0200%

    Staphylococcus aureusOxacillin143145%

    CJAO

    CJAoNbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2010

    Acinetobacter baumanniiCeftazidime010.0%

    Imipenem010.0%

    Enterobacter spcefotaxime21711.8%

    ciprofloxacine1175.9%

    Imipenem0170.0%

    BLSE0170.0%

    Escherichia colicefotaxime11051.0%

    ciprofloxacine11051.0%

    Imipenem01050.0%

    BLSE11051.0%

    Klebsiella pneumoniaecefotaxime0160.0%

    ciprofloxacine0160.0%

    Imipenem0160.0%

    BLSE0160.0%

    enterobactries Ciflox R21381.4%

    Pseudomonas aeruginosaCeftazidime1425.0%

    Ciprofloxacin040.0%

    Imipenem040.0%

    Staphylococcus aureusOxacillin2238.7%8.6956521739

    GHER

    GHERNbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2011

    Acinetobacter baumanniiCeftazidime31520.0%

    Imipenem0150.0%

    cefotaxime347943.0%

    ciprofloxacine227927.8%

    Enterobacter spImipenem0790.0%

    BLSE117913.9%

    cefotaxime193655.2%

    ciprofloxacine353659.6%

    Escherichia coliImipenem03650.0%

    BLSE173654.7%

    cefotaxime9929.8%

    ciprofloxacine9929.8%

    Klebsiella pneumoniaeImipenem0920.0%

    BLSE4924.3%

    enterobactries Ciflox R6653612.3

    Ceftazidime148316.9%

    Pseudomonas aeruginosaCiprofloxacin6837.2%

    Imipenem6837.2%

    Staphylococcus aureusOxacillin139114.3%

    total

    totalNbre de souches ResistantesNbre de souches isoles% de resistance dans l'espce anne 2011

    Acinetobacter baumanniiCeftazidime10119252.6%

    Imipenem3417319.7%

    cefotaxime32588036.9%

    ciprofloxacine17467625.7%

    Enterobacter spImipenem128721.4%

    BLSE13581116.6%

    cefotaxime21840025.4%enterobactries BLSE454

    ciprofloxacine34839948.7%7.8305963699

    Escherichia coliImipenem140010.0%

    BLSE17440024.3%

    cefotaxime200128615.6%

    ciprofloxacine203128515.8%

    Klebsiella pneumoniaeImipenem212860.2%

    BLSE145128611.3%

    enterobactries Ciflox R725595512.2%

    Pseudomonas aeruginosaCeftazidime10410879.6%

    Ciprofloxacin125108511.5%

    Imipenem139110212.6%

    Staphylococcus aureusOxacillin177151311.7%

    quartile

    chfgchsrchgmCSCcsvCRFYY CTcjaogherquartile calculminip25medp75max

    AB IMI R25123316.700000.00.06.018.833.0

    EBLSE20.911.435.74.4019013.90.03.312.719.535.7

    ecol BLSE5.42.85.22.601114.70.02.23.85.311.0

    KP BLSE10.513.412.97.501904.30.03.29.013.019.0

    EB R Q11.210.811.47.73.127.71.412.31.46.611.011.627.7

    PARC10.67.38.510.52502516.90.08.210.618.925.0

    SARM12.610.710.14.54.3458.714.34.37.710.413.045.0

    Quartile grapheAB IMI REBLSEecol BLSEKP BLSEEB R F