3rd generation cephalosporins (C3G) are the antibiotics recommended in probabilistic in most
enteric infections in France including pyelonephritis and bacteraemia.
However, the prevalence of resistance of Enterobacteriaceae including E. coli to C3G is
continuously increasing for several years. In 2012, in France, the proportion of E. resistant
or intermediate coli categorized to C3G is 10 to 25% (EARSS data).
Antibiotics not adapted early in severe sepsis is responsible for worse prognosis for
patients in terms of morbidity and mortality and unnecessary prolongation of the DMS.
At St. Joseph's Hospital on enterobacteria levels of resistance to C3G is 15.4%.
To avoid overuse of carbapenems for probabilistic antibiotic and to quickly prescribe
antibiotics adapted to the resistance of the bacteria, it is interesting to use a rapid test
for detection of resistance to C3G.
The Lacta ™ test could be used in this indication. This is a rapid test diagnostic
orientation detecting hydrolysis of a substrate (chromogenic cephalosporin) by the enzymatic
action of ESBL, cAMP-type cephalosporinases and carbapenemases. This test was initially
marketed for rapid detection of resistance to C3G enterobacteria from isolated bacterial
colonies in culture.