État actuel de la sensibilité à dix antibiotiques des bactéries isolées d'infections non urinaires en médecine de ville: enquête multicentrique Épiville 1997–1998

[Staphylococci resistant to antibiotic therapy]

Increasing frequency in antibiotic resistance in Staphylococcus aureus is worrying. In this review, we briefly describe the mechanisms of resistance to antibiotics in staphylococci and we report the current incidence of antibiotic resistance in France. Methicillin-resistance is mostly confined to hospitals. However, spread of multiply resistant strains of staphylococci to the community is a putative threat. Strains with diminished susceptibility to glycopeptides are rare but possibly underestimated because of the in vitro difficulties to detect glycopeptide resistance. A continuous resistance survey is necessary. The problem of multiresistance is different for hospital and community staphylococci. The later strains still remain susceptible to many antibiotics, apart from some exceptions. By contrast, incidence of multiply resistance in hospitals remains high. After a recent decrease, incidence of oxacillin resistance seems to be stabilized. A new and recent feature is the great variety of resistance phenotypes which can be found in methicillin-resistant strains, in particular with gentamicin susceptibility.