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Emergence of antibiotic resistance amongst hospital-acquired urinary tract infections and pharmacokinetic/pharmacodynamic considerations [Article de Revue]

[Emergence d'antibiorésistance lors des infections urinaires nosocomiales et considérations pharmacocinétiques / pharmacodynamiques]
Wagenlehner, Florian ME ; WEIDNER W ; NABER KG
The Journal of hospital infection. 2005/07; 60(3) : 191-200
Summary: Cet article rapporte les résultats d'études de surveillance nationale et internationale portant sur le spectre bactérien et l'antibiorésistance des pathogènes bactériens responsables d'infections urinaires nosocomiales. Cette revue porte sur le spectre bactérien des infections urinaires nosocomiales en Amérique du Nord, en Europe et dans un hôpital allemand sur une période de 10 ans, sur les principes de base de l'antibiothérapie et l'augmentation de la résistance aux antibiotiques dans les infections urinaires nosocomiales qui nécessitent un usage prudent des antibiotiques avec un choix et un dosage appropriés.

Bacterial urinary tract infections (UTIs) are frequent infections in the nosocomial setting. Nosocomial UTIs are almost exclusively complicated UTIs, although the complicating factors may be very heterogenous. The bacterial spectrum of nosocomial UTIs is broad and antibiotic resistance is common. The results of international and national surveillance studies on the bacterial spectrum and antibiotic resistance of nosocomial uropathogens are provided. The treatment of nosocomial UTIs encompasses treatment of the complicating factors as well as antimicrobial chemotherapy. At least in serious UTIs, adequate initial antibiotic therapy results in lower mortality. Therefore, the initial antibiotic regimen must provide sufficient antibiotic cover. However, this can only be achieved if the bacterial spectrum and antibiotic resistance patterns of uropathogens in the institution are followed continuously. Provisional microbiological findings, such as reports on Gram stain or certain biochemical results, can lead to early stratification of pathogens and allow more tailored empiric antibiotic therapy. Antibiotic therapy of nosocomial UTIs has to consider two different aspects: (1) therapeutic success in the individual patient; and (2) prevention of emergence of antibiotic-resistant mutants. The emergence of resistance can possibly be lowered by adequate drug selection and dosing. Increasing antibiotic resistance requires more prudent use of antimicrobial drugs(RESUME D'AUTEUR)



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The Journal of hospital infection

ID notice

Location Call number Status Date due Barcode
CClin Est
CHU de Nancy - Hôpitaux de Brabois
Rue du Morvan
54511 Vandoeuvre le Nancy Cedex
Tél :
CClin Ouest
CHU Hôtel Dieu
CS 26419
35064 Rennes Cedex 2
Tél :
CCLIN Paris Nord
CClin Paris-Nord
96 rue Didot
75014 Paris
Tél :
CClin Sud-Est
Hospices Civils de Lyon
Hôpital Henry Gabriel
20 route de vourles
69230 Saint-Genis-Laval
Tél :
CCLIN Sud-Ouest
CClin Sud-Ouest
CHU de Bordeaux
Hôpital Pellegrin - Bâtiment Le Tondu
33076 Bordeaux
Tél :

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