Louise Rossignol1,2,3, Sophie Vaux4, Sylvie Maugat4, Alexandre Blake4, Roxane Barlier5,6,7, Beate Heym8,9, Yann Le Strat4, Thierry Blanchon6,7, Thomas Hanslik7,8,9, Bruno Coignard4. 1. Département de Médecine Générale, UPMC Univ Paris 06, 27 Rue Chaligny, 75012, Paris, France. louise.rossignol@iplesp.upmc.fr. 2. Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France. louise.rossignol@iplesp.upmc.fr. 3. INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France. louise.rossignol@iplesp.upmc.fr. 4. Institut de Veille Sanitaire, 12, Rue du Val d'Osne, 94415, Saint-Maurice Cedex, France. 5. Département de Médecine Générale, UPMC Univ Paris 06, 27 Rue Chaligny, 75012, Paris, France. 6. Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France. 7. INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France. 8. Hopital Universitaire Ambroise Paré AP-HP, 9, Avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France. 9. Université Versailles-Saint-Quentin-en-Yvelines, 55 Avenue de Paris, 78000, Versailles, France.
Abstract
PURPOSE: In 2012-2013, a cross-sectional survey was conducted in women visiting a general practitioner for urinary tract infection (UTI), to estimate the annual incidence of UTIs due to antibiotic-resistant Escherichia coli (E. coli). METHODS: A sampling design (stratification, stages and sampling weights) was taken into account in all analyses. Urine analyses were performed for each woman and centralised in one laboratory. RESULTS: Among 538 included women, urine culture confirmed UTI in 75.2 % of cases. E. coli represented 82.8 % of species. Among E. coli, resistance (I + R) was most common to amoxicillin [38 % (95 % confidence interval 31.1-44.5)] and to trimethoprim/sulfamethoxazole [18.1 % (12.0-24.1)]. Resistance to ciprofloxacin and cefotaxime was lower [1.9 % in both cases, (0.3-3.5)], as it was for nitrofurantoin [0.4 (0-1.0)] and fosfomycin (0). Extended-spectrum β-lactamase (ESBL) represented 1.6 % of E. coli (0.2-2.9). Annual incidence rate of confirmed UTI was estimated at 2400 per 100,000 women (1800-3000). Incidence rates of UTI due to fluoroquinolone-resistant and ESBL-producing E. coli were estimated at 102 per 100,000 women (75-129) and at 32 (24-41), respectively. CONCLUSIONS: ESBL had been found in a community population, and even though the rate was low, it represents a warning and confirms that surveillance should continue.
PURPOSE: In 2012-2013, a cross-sectional survey was conducted in women visiting a general practitioner for urinary tract infection (UTI), to estimate the annual incidence of UTIs due to antibiotic-resistant Escherichia coli (E. coli). METHODS: A sampling design (stratification, stages and sampling weights) was taken into account in all analyses. Urine analyses were performed for each woman and centralised in one laboratory. RESULTS: Among 538 included women, urine culture confirmed UTI in 75.2 % of cases. E. coli represented 82.8 % of species. Among E. coli, resistance (I + R) was most common to amoxicillin [38 % (95 % confidence interval 31.1-44.5)] and to trimethoprim/sulfamethoxazole [18.1 % (12.0-24.1)]. Resistance to ciprofloxacin and cefotaxime was lower [1.9 % in both cases, (0.3-3.5)], as it was for nitrofurantoin [0.4 (0-1.0)] and fosfomycin (0). Extended-spectrum β-lactamase (ESBL) represented 1.6 % of E. coli (0.2-2.9). Annual incidence rate of confirmed UTI was estimated at 2400 per 100,000 women (1800-3000). Incidence rates of UTI due to fluoroquinolone-resistant and ESBL-producing E. coli were estimated at 102 per 100,000 women (75-129) and at 32 (24-41), respectively. CONCLUSIONS: ESBL had been found in a community population, and even though the rate was low, it represents a warning and confirms that surveillance should continue.
Entities:
Keywords:
Antibiotic resistance; Escherichia coli; General population; General practitioner; Incidence; Urinary tract infection
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