D Chervet1, O Lortholary2, J-R Zahar3, A Dufougeray4, B Pilmis5, H Partouche6. 1. Groupe hospitalier Paris Saint-Joseph, Service d'accueil des urgences, 75014 Paris, France; Université Paris XII, Hôpital Henri-Mondor, SAMU-SMUR, 94000 Créteil, France. Electronic address: dchervet@hpsj.fr. 2. Université Paris Descartes, Hôpital Necker Enfants Malades, Centre d'infectiologie Necker-Pasteur, IHU Imagine, 75015 Paris, France. Electronic address: olivier.lortholary@aphp.fr. 3. Université Paris XIII, GH Paris Seine Saint-Denis, Département de microbiologie, Unité de contrôle et prévention de l'infection, 93022 Bobigny, France. Electronic address: JeanRalph.ZAHAR@aphp.fr. 4. Groupement de laboratoires LCD, Service de microbiologie, 93100 Saint-Denis, France. Electronic address: alice.dufougeray@gmail.com. 5. Université Paris Descartes, Hôpital Necker Enfants malades, Service de maladies infectieuses et tropicales, Paris, France; Groupe Hospitalier Paris Saint-Joseph, Équipe mobile de microbiologie clinique, 75014 Paris, France. Electronic address: bpilmis@gmail.com. 6. Département de médecine générale, Faculté de médecine, Université Paris Descartes, 75014 Paris, France. Electronic address: henri.partouche@parisdescartes.fr.
Abstract
BACKGROUND: Urinary tract infection (UTI) is one of the most frequent community-acquired infection. Escherichia coli resistance has been on the rise since 2000s. METHODS: We conducted a prospective multicenter cohort study including adults who had a positive urine cytobacteriological examination (UCBE) performed in our Parisian suburb laboratory platform from October 2014 to March 2015. RESULTS: A total of 1223 patients were included: 995 (81.4%) women and 228 (18.6%) men. Gram-negative bacilli were isolated in 91% of cases: E. coli accounted for 69.4% of cases. Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) prevalence was 4.2%. Resistance of ESBL-producing E. coli strains to amoxicillin, fluoroquinolones, nitrofurantoin, and fosfomycin was respectively 100%, 80%, <5%, and <10%. Risk factors for bacteriuria caused by ESBL-PE were older age (OR=3.7 [1.99-14.4]; P=0.02), recurrent UTI (OR=3.7 [1.9-7.2]; P=0.05), immunosuppression (OR=9.2 [4.1-19.47]; P=0.01), recent hospitalization within the last three months (OR=4.5 [2.3-8.3]; P=0.05), and recent antibiotic therapy (OR=13.4 [6.29-31.9]; P<0.01). CONCLUSION: The prevalence of ESBL-PE bacteriuria seems to be 4%. Older age, immunosuppression, recurrent UTI, recent hospitalization, and antibiotic therapy are the main risk factors associated with ESBL-PE community-acquired UTI.
BACKGROUND:Urinary tract infection (UTI) is one of the most frequent community-acquired infection. Escherichia coli resistance has been on the rise since 2000s. METHODS: We conducted a prospective multicenter cohort study including adults who had a positive urine cytobacteriological examination (UCBE) performed in our Parisian suburb laboratory platform from October 2014 to March 2015. RESULTS: A total of 1223 patients were included: 995 (81.4%) women and 228 (18.6%) men. Gram-negative bacilli were isolated in 91% of cases: E. coli accounted for 69.4% of cases. Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) prevalence was 4.2%. Resistance of ESBL-producing E. coli strains to amoxicillin, fluoroquinolones, nitrofurantoin, and fosfomycin was respectively 100%, 80%, <5%, and <10%. Risk factors for bacteriuria caused by ESBL-PE were older age (OR=3.7 [1.99-14.4]; P=0.02), recurrent UTI (OR=3.7 [1.9-7.2]; P=0.05), immunosuppression (OR=9.2 [4.1-19.47]; P=0.01), recent hospitalization within the last three months (OR=4.5 [2.3-8.3]; P=0.05), and recent antibiotic therapy (OR=13.4 [6.29-31.9]; P<0.01). CONCLUSION: The prevalence of ESBL-PE bacteriuria seems to be 4%. Older age, immunosuppression, recurrent UTI, recent hospitalization, and antibiotic therapy are the main risk factors associated with ESBL-PE community-acquired UTI.
Authors: Chiara Fulgenzio; Marco Massari; Giuseppe Traversa; Roberto Da Cas; Gianluigi Ferrante; Richard Aschbacher; Verena Moser; Elisabetta Pagani; Anna Rita Vestri; Orietta Massidda; Peter Konstantin Kurotschka Journal: Antibiotics (Basel) Date: 2021-04-16