Development of quinolone-resistant strains of Escherichia coli in stools of patients with cirrhosis undergoing norfloxacin prophylaxis : clinical consequences.
Norfloxacin prophylaxis decreases the incidence of bacterial infections in high-risk cirrhotic patients, but may promote the development of quinolone-resistant gram-negative bacteria in stools, and eventually lead to infections due to these bacteria.
The aim of the study was to evaluate the prevalence of quinolone-resistant strains of E. coli in stools on admission, and the characteristics of any nosocomial infections.
Eighty-three consecutively hospitalized cirrhotic patients were included in this prospective study.
The presence of quinolone-resistant strains of E. coli in stools on admission, and the characteristics of any nosocomial infections were recorded.
Fourteen out of 83 patients (16.8%) showed quinolone-resistant E. coli in stools (Group I), and 69 did not (Group II).
Thirteen out of 14 from Group I (92.8%) and 17/69 (24.6) from Group II had received primary or secondary prophylaxis with norfloxacin (p<0.001).
During hospitalization, 12/12 (100%) of patients from Group I and 25/66 (37.8%) of patients from Group II underwent norfloxacin prophylaxis.
Three bacterial infections in patients from Group I, 3 from Group II patients receiving norfloxacin and 16 from Group II patients not receiving norfloxacin were recorded (p<0.05).
No infections due to quinolone-resistant E. coli were observed in patients colonized with these bacteria.
Treatment with norfloxacin induced the development of quinolone-resistant E. coli in 6/14 (42. (...)
Mots-clés Pascal : Cirrhose, Foie, Chimioprophylaxie, Ascite, Antibactérien, Norfloxacine, Résistance traitement, Escherichia coli, Enterobacteriaceae, Bactérie, Infection nosocomiale, Epidémiologie, Homme, Appareil digestif pathologie, Foie pathologie, Abdomen pathologie, Epanchement
Mots-clés Pascal anglais : Cirrhosis, Liver, Chemoprophylaxis, Ascites, Antibacterial agent, Norfloxacin, Negative therapeutic reaction, Escherichia coli, Enterobacteriaceae, Bacteria, Nosocomial infection, Epidemiology, Human, Digestive diseases, Hepatic disease, Abdominal disease, Effusion
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0451367
Code Inist : 002B13C03. Création : 22/03/2000.