Infections ostéo-articulaires à Enterobacter spp. au CHU de Nancy (1990–1994)

Summary A descriptive and retrospective study of all cases of osteoarticular infection due to Enterobacter sp. (n = 25) which occured between 1990 to 1994 at the Nancy University Hospital was carried out. Minimal inhibitory concentrations of the following antibiotics: cefotaxime, ceftriaxone, ceftazidime, cefepime, aztreonam, imipenem, gentamicin, tobramycin, amikacin, cotrimoxazole, pefloxacin, ofloxacin, ciprofloxacin, rifampin, and fosfomycin, were determined for all Enterobacter sp. strains responsible for these infections (E. cloacae: n = 22; E. aerogenes: n = 2 and E. sakazakii: n = 1). Among patients studied, 20 presented osteitis, 4 prosthetic joint infection, and 1 spondylodiscitis. The infection was post-operative, post-traumatic, or of another origin (urinary tract infection, perforating ulcer of the foot) in respectively 72 % (18/25), 16 % (4/25) and 12 % (3/25) of the cases. Underlying diseases were observed in 36 % (9/25) of the cases with a predominance of diabetes (5/9). Most of the strains studied (92 %) were susceptible to all β-lactam antibiotics tested. Only 2 strains presented a derepressed cephalosporinase phenotype and were only susceptible to imipenem and cefepime. All strains were resistant to fosfomycin and rifampin, and susceptible to all the other antibiotics tested. Adapted antibiotherapy combined with complementary medical and/or surgical treatment permitted to obtain recovery in 91.3 % of the assessable cases (21/23).