[Epidemiology of Acinetobacter and resistance to antibiotics at hospitals. A 5-year evaluation]

The growing number of Acinetobacter strains in hospitals and the rapid increase of their resistance to antibiotics have prompted us to undertake a long-term epidemiological study of this resistance at the Bichat hospital, Paris. Between 1971 and 1984, the resistance of Acinetobacter to antibiotics had already progressed, with only some antibiotics (imipenem, ceftazidime, tobramycin and amikacin) remaining active. During the following 5 years (1984-1988) a study of 1056 strains demonstrated a further increase of resistance and showed how serious the problem was in intensive care units. During the last few years, there has been a considerable increase in the proportion of multiresistant strains, reaching 84 per cent with beta-lactam antibiotics and 64 per cent with aminoglycosides. At present, in most cases the only effective treatment is imipenem, and no antibiotic is active in 5.5 per cent of the cases. Studies of lysotypes, enzymes and phenotypic resistance of bacterial strains completed the epidemiological approach, showing the presence of dominant lysotypes. Two predominant lysotypes are associated with multiresistance of Acinetobacter strains responsible for nosocomial infections.