Sensibilité aux antibiotiques de Escherichia coli isolé d'hémocultures et d'examens cyto-bactériologiques des urines réalisés dans 15 hôpitaux généraux du Sud-Ouest de la France

Delarbre, J.-M.; Grasmick, C. P.; Coumenges, P.; Danjean, M.P.; Dubourdieu-Arlabosse, B.; Courrege, A.; Heche, X.; F, Labonne; Lafargue, J.P.; Larrouy, P.; Melon, M.; Jean, D.; Rougier, C.; Sanchez, Rony

doi:10.1016/s0399-077x(05)81262-4

Cited by 6 publications

(1 citation statement)

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“…39,2001 RISK FACTORS FOR ANTIBIOTIC-RESISTANT E. COLIand 18%, respectively, in 1993 for outpatient populations. These rates are lower than others published since 1990, which were frequently about 25 to 30% (2,9,27,29,33,34) and which could reach 40% or more (22,25,41). These data were collected for hospitalized patients.…”

Section: Discussionmentioning

confidence: 81%

Risk Factors for Antibiotic-Resistant Escherichia coli Isolated from Hospitalized Patients with Urinary Tract Infections: a Prospective Study

Sotto¹,

Boever²,

Fabbro‐Peray³

et al. 2001

J Clin Microbiol

113

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we prospectively evaluated the prevalence of resistance to penicillins, cephalosporins, carbapenem, quinolones, aminoglycosides, and trimethoprim-sulfamethoxazole (SXT) in 320 Escherichia coli isolates isolated from hospitalized patients with acute urinary tract infections (UTIs). We also studied for these strains risk factors for resistance to amoxicillin-clavulanic acid (AMC), fluoroquinolones (FQs), and SXT. Resistance rates were consistent with those from major recent studies reported in the literature. Multivariate analyses selected the following factors as being significantly associated with E. coli resistance: (i) for resistance to AMC, prior (1 year) UTI (odds ratio [OR] ‫؍‬ 2.71, P ‫؍‬ 0.006), prior (1 year) urinary catheter (OR ‫؍‬ 2.98, P ‫؍‬ 0.0025), and prior (6 months) antibiotic exposure (OR ‫؍‬ 2.68, P ‫؍‬ 0.005); (ii) for resistance to FQs male sex (OR ‫؍‬ 3.87, P ‫؍‬ 0.03), with a trend toward significance for age >65 years (OR ‫؍‬ 7.67, P ‫؍‬ 0.06) and prior (1 year) UTI (OR ‫؍‬ 2.98, P ‫؍‬ 0.07); and (iii) for resistance to SXT, male sex (OR ‫؍‬ 1.91, P ‫؍‬ 0.046), hospitalization in an intermediate-term-care unit (OR ‫؍‬ 2.18, P ‫؍‬ 0.008), and prior (1 year) UTI (OR ‫؍‬ 2.03, P ‫؍‬ 0.03). Ours results suggest that prior UTI is a common risk factor for resistance to the different antibiotics tested. Although few studies on risk factors for E. coli resistance to antibiotics have been published, careful interpretation of their findings, taking into consideration the population, infection site, and period studied, should contribute to the formulation of a better strategy that can be used to overcome antibiotic resistance.Escherichia coli, the most common member of the family Enterobacteriaceae implicated in human infectious diseases, has not been spared acquisition of antibiotic resistance, a complex therapeutic problem (7,15,38). The evolution of this microorganism's antibiotic resistance patterns identified from clinical isolates has been reported in many studies on amoxicillin (AMZ), amoxicillin-clavulanic acid (AMC), fluoroquinolones (FQs), and trimethoprim-sulfamethoxazole (SXT). Also, the intimate mechanisms of E. coli antibiotic resistance have been studied and explained in numerous publications (23,24,26,35,39). Unfortunately, few analyses of the demographic, epidemiological, and clinical data for patients with E. coli infection for determination of risk factors for resistance to antimicrobial agents have been reported (1,10,13,17,27,31).To evaluate the prevalence of resistance to a panel of antibiotics, including penicillins, cephalosporins, carbapenem, quinolones, aminoglycosides, and SXT, of E. coli strains isolated from hospitalized patients with acute urinary tract infections (UTIs) and to identify the risk factors for E. coli resistance to AMC, FQs, and SXT, which are routinely used to treat these infections, we conducted a prospective study in our hospital over a 3-month period. We discuss our observations, taking into consideration the most recent major studies on E. coli resist...

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