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Infection. 2017 Feb;45(1):33-40. doi: 10.1007/s15010-016-0910-2. Epub 2016 May 27.

Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study.

Author information

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.

KEYWORDS:

Antibiotic resistance; Escherichia coli; General population; General practitioner; Incidence; Urinary tract infection

PMID:
27234045
DOI:
10.1007/s15010-016-0910-2
[Indexed for MEDLINE]

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