Survey of the phenotypes of susceptibility to beta-lactams in Enterobacteriaceae at the Pitie-Salpetriere Hospital.

The phenotypes of susceptibility to ampicillin, carbenicillin, cephalothin, cefamandole, cefoxitin and cefotaxime were determined by the disc-diffusion method in 10,994 Enterobacteriaceae consecutively isolated from in-patients during 18 months. The susceptible phenotypes were much more frequent among Escherichia coli, Proteus mirabilis and Klebsiella (67.4 to 84.8%) than among Serratia, Enterobacter and Citrobacter (8.8 to 35.5%). In all species the most common resistance phenotypes were to ampicillin and carbenicillin: E. coli (28%), Pr. mirabilis (15.2%), Klebsiella (23.8%), indole-positive Proteus (33.3%), Serratia (74.4%), Enterobacter (61.4%) and Citrobacter (74.8%). Among E. coli 4.6% of the strains were resistant to ampicillin and cephalothin but susceptible to carbenicillin. Among E. coli, Pr. mirabilis and Klebsiella the strains susceptible only to cefotaxime represented 0.3 to 5% and no cefotaxime-resistant strain was isolated; whereas among Serratia, Enterobacter and Citrobacter the former represented 28.3 to 58.3% and the latter 7.5 to 18.5%. Some important differences in the distribution of the phenotypes according to the type of ward were observed.