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. 2022 Mar 15;11(3):356.
doi: 10.3390/pathogens11030356.

Antimicrobial Resistance in Enterobacterales Recovered from Urinary Tract Infections in France

Eric Farfour  1 , Laurent Dortet  2 , Thomas Guillard  3 , Nicolas Chatelain  4 , Agathe Poisson  5 , Assaf Mizrahi  6   7 , Damien Fournier  8 , Rémy A Bonnin  2 , Nicolas Degand  9 , Philippe Morand  10 , Frédéric Janvier  11 , Vincent Fihman  12 , Stéphane Corvec  13 , Lauranne Broutin  14 , Cécile Le Brun  15 , Nicolas Yin  16   17 , Geneviève Héry-Arnaud  18 , Antoine Grillon  19 , Emmanuelle Bille  20 , Hélène Jean-Pierre  21   22 , Marlène Amara  23 , Francoise Jaureguy  24 , Christophe Isnard  25 , Vincent Cattoir  26 , Tristan Diedrich  27 , Emilie Flevin  28 , Audrey Merens  29 , Hervé Jacquier  30 , Marc Vasse  1 , On Behalf Of The Gmc Study Group
Affiliations

Antimicrobial Resistance in Enterobacterales Recovered from Urinary Tract Infections in France

Eric Farfour et al. Pathogens. .

Abstract

In the context of increasing antimicrobial resistance in Enterobacterales, the management of these UTIs has become challenging. We retrospectively assess the prevalence of antimicrobial resistance in Enterobacterales isolates recovered from urinary tract samples in France, between 1 September 2017, to 31 August 2018. Twenty-six French clinical laboratories provided the susceptibility of 134,162 Enterobacterales isolates to 17 antimicrobials. The most frequent species were E. coli (72.0%), Klebsiella pneumoniae (9.7%), Proteus mirabilis (5.8%), and Enterobacter cloacae complex (2.9%). The overall rate of ESBL-producing Enterobacterales was 6.7%, and ranged from 1.0% in P. mirabilis to 19.5% in K. pneumoniae, and from 3.1% in outpatients to 13.6% in long-term care facilities. Overall, 4.1%, 9.3% and 10.5% of the isolates were resistant to cefoxitin, temocillin and pivmecillinam. Cotrimoxazole was the less active compound with 23.4% resistance. Conversely, 4.4%, 12.9%, and 14.3% of the strains were resistant to fosfomycin, nitrofurantoin, and ciprofloxacin. However, less than 1% of E. coli was resistant to fosfomycin and nitrofurantoin. We identified several trends in antibiotics resistances among Enterobacterales isolates recovered from the urinary tract samples in France. Carbapenem-sparing drugs, such as temocillin, mecillinam, fosfomycin, cefoxitin, and nitrofurantoin, remained highly active, including towards ESBL-E.

Keywords: ESBL; Enterobacterales; carbapenem; fosfomycin; nitrofurantoin; pivmecillinam; temocillin; urinary tract infection (UTI).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Rate of ESBL-E according to the bacterial species.
Figure 2
Figure 2
Rate of ESBL-E according to region.
Figure 3
Figure 3
Rate of ESBL-E according to ward of sampling.
Figure 4
Figure 4
Rate of resistance to 9 β-lactam antibiotics according to bacterial species. (a) Penicillin and (b) cephalosporin and monobactam.
Figure 4
Figure 4
Rate of resistance to 9 β-lactam antibiotics according to bacterial species. (a) Penicillin and (b) cephalosporin and monobactam.
Figure 5
Figure 5
Rate of resistance to 8 non-β-lactam antibiotics according to bacterial species. (a) Cotrimoxazole, Fosfomycin, and nitrofurantoin, (b) gentamicin and amikacin, and (c) nalidixic acid, ofloxacin, and ciprofloxacin.
Figure 5
Figure 5
Rate of resistance to 8 non-β-lactam antibiotics according to bacterial species. (a) Cotrimoxazole, Fosfomycin, and nitrofurantoin, (b) gentamicin and amikacin, and (c) nalidixic acid, ofloxacin, and ciprofloxacin.
See this image and copyright information in PMC

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