We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis.Urinary tract infections (UTIs) are bacterial infections (cystitis or pyelonephritis) frequently observed during pregnancy. Urinary tract colonization or asymptomatic bacteriuria (ABU) refers to situations where microorganisms are present at a significant rate (bacteriuria Ն10 5 CFU/ml) in the urinary tract without clinical signs. This situation is very common during pregnancy (3 to 8%), with a peak incidence between the 9th and 17th weeks (26). Escherichia coli is the main pathogen found in this situation (27). Several concepts are based on acquired facts about ABU. First, microorganisms are the same in terms of species and virulence compared to ABU in nonpregnant women (24). Second, the main risk of the ABU is the occurrence of pyelonephritis in 30 to 40% of cases (10,23). Therefore, the ABU must be systematically sought because of the risks of upper tract infection and fetal damage, mainly in the form of premature delivery (17,25). A properly treated pyelonephritis will heal in a few days without sequelae. Finally, if ABU is not supported in time, it may progress to septic shock and/or a progressive deterioration of renal function to renal failure itself (9, 28). Proof of links between ABU and pyelonephritis are weak and based primarily on observational data. To date, few studies have focused on the virulence of E. coli isolated from UTIs or ABU in pregnant women (8,24). This work has been conducted to assess the in vitro and in vivo virulence of uropathogenic E. coli (UPEC) isolated from pregnant women in different situations (ABU, acute cystitis, acute pyelonephritis, and urosepsis).The prospective study was initiated on 1 January 2007 and carried out until 31 December 2007 in a French university hospital. During the follow-up of pregnancy, all women with a first episode of an ABU, an acute cystitis, an acute pyelonephritis, or an urosepsis in whom E. coli was detected were included. ABU was defined as urine specimens with an E. coli culture of Ն10 5 CFU/ml without clinical signs. The cystitis and pyelonephritis strains have been isolated in monocultures from urine specimens of patients diagnosed with acute cystitis and acute pyelonephritis, respectively. The urosepsis isolates were cultured from the blood of patients suffering from UTI-derived sepsis. The genus and species were determined biochemically with the Vitek 2 identification card (bioMérieux, Marcy l'Etoile, France). Susceptibility to antimicrobial agents was tested by using the Vitek 2 card (bioMérieux). Strains were classified as susceptible, intermediately resistant, or resistant to the antibiotics tested according to the recommendations of the Antibiotic Susceptibility Testing Commi...

In February 2011, the CARB-LR group was created as a sentinel laboratory-based surveillance network to control the emergence of carbapenem-resistant Gram-negative bacilli (CR GNB) in a French Southern Region. We report the epidemiological results of a 2-year study. All the Gram-negative bacilli isolates detected in the different labs (hospital and community settings) of a French Southern Region and with reduced susceptibility to ertapenem and/or imipenem were characterised with regard to antibiotic resistance, bla genes content, repetitive sequence-based polymerase chain reaction (rep-PCR) profiles and multilocus sequence typing (MLST). A total of 221 strains were analysed. Acinetobacter baumannii was the most prevalent carbapenemase-producing bacteria, with a majority of OXA-23 producers (n = 37). One isolate co-produced OXA-23 and OXA-58 enzymes. Klebsiella pneumoniae was the most frequent carbapenemase-producing Enterobacteriaceae (CPE) (OXA-48 producer: n = 29, KPC producer: n = 1), followed by Escherichia coli (OXA-48 producer: n = 8, KPC producer: n = 1) and Enterobacter cloacae (OXA-48 producer, n = 1). One isolate of Pseudomonas aeruginosa produced a VIM-1 carbapenemase. A clonal diversity of carbapenemase-producing K. pneumoniae and E. coli was noted with different MLSTs. On the other hand, almost all OXA-23-producing A. baumannii strains belonged to the widespread ST2/international clone II. The link between the detection of CR GNB and a foreign country was less obvious, suggesting the beginning of a local cross-transmission. The number of CR GNB cases in our French Southern Region has sharply increased very recently due to the diffusion of OXA-48 producers.

This first study on enterococci isolated in Algeria shows the low prevalence of VRE, but the presence of clonal complexes linked to VRE and vancomycin-sensitive enterococci associated with hospital infections. Moreover the high level of macrolide resistance and/or ampicillin resistance in E. faecium suggests close monitoring of the epidemiology of these strains.