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

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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.

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Acknowledgments

We thank all the GPs and their patients. We thank Pr Richard Bonnet, National reference centre for ESBL for ESBL analysis.

Author information

Authors and Affiliations

  1. Département de Médecine Générale, UPMC Univ Paris 06, 27 Rue Chaligny, 75012, Paris, France

    Louise Rossignol & Roxane Barlier

  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, Roxane Barlier & Thierry Blanchon

  3. INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France

    Louise Rossignol, Roxane Barlier, Thierry Blanchon & Thomas Hanslik

  4. Institut de Veille Sanitaire, 12, Rue du Val d’Osne, 94415, Saint-Maurice Cedex, France

    Sophie Vaux, Sylvie Maugat, Alexandre Blake, Yann Le Strat & Bruno Coignard

  5. Hopital Universitaire Ambroise Paré AP-HP, 9, Avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France

    Beate Heym & Thomas Hanslik

  6. Université Versailles-Saint-Quentin-en-Yvelines, 55 Avenue de Paris, 78000, Versailles, France

    Beate Heym & Thomas Hanslik

Authors
  1. Louise Rossignol
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  2. Sophie Vaux
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  6. Beate Heym
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  10. Bruno Coignard
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Corresponding author

Correspondence to Louise Rossignol.

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Conflict of interest

The authors declare that they have no competing interests.

Funding

Authors report grants from The French Institute for Public Health Surveillance (Institut de veille sanitaire, InVS), grants from Health General Direction of France (DGS), grants from Corporate foundation GPM, grants from French Urology Association during the conduct of the study. They had no role in the study design, data collection, analyses, decision to publish or preparation of the manuscript.

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Rossignol, L., Vaux, S., Maugat, S. et al. Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study. Infection 45, 33–40 (2017). https://doi.org/10.1007/s15010-016-0910-2

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  • DOI: https://doi.org/10.1007/s15010-016-0910-2

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