Bacterial epidemiology and antibiotic resistance rates in male urinary tract infections in France, 2019-2023

Abstract

Aim: The aim of this study was to describe the bacterial epidemiology and antibiotic resistance rates of bacterial isolates collected from urine specimens in male patients with suspected urinary tract infection (UTI).

Methods: This retrospective multicenter study included routine data from midstream urine cultures of adult male patients with suspected UTI admitted to the emergency departments of 15 hospitals from 2019 to 2023. Urinalysis was performed according to the recommendations of the French Society for Microbiology and bacterial identification was carried out using MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed by disk diffusion or semi-automated methods and interpreted according to the CA-SFM/EUCAST guidelines.

Results: Overall, 38,279 bacterial isolates were detected among 33,113 male patients (mean age = 70.7 years). The most frequently encountered pathogen was E. coli (40.0 %) followed by E. faecalis (13.2 %), K. pneumoniae (7.8 %) and P. mirabilis (5.8 %). Overall prevalence of ESBL-E was 9.0 %, represented mainly by K. pneumoniae (22.8 %), E. cloacae complex (19.3 %) and E. coli (8.4 %). Prevalence of resistance to fluoroquinolones and cotrimoxazole was high (usually > 15-20 %). The resistance rates in E. coli were very low (around 1 %) for fosfomycin and nitrofurantoin, as was the overall prevalence of carbapenemase-producing Enterobacterales (0.1 %). In S. aureus, 20.4 % of isolates were resistant to methicillin, and only three vancomycin-resistant enterococci (<0.01 %) were detected.

Conclusion: This original study provides recent, nationwide and helpful data on bacterial epidemiology and antibiotic resistance rates of isolates recovered from urines in male patients with suspected UTIs.

Keywords: Epidemiology; Men; Prostatitis; Resistance; UTI.