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No global increase in resistance to antibiotics: a snapshot of resistance from 2001 to 2016 in Marseille, France

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Abstract

Since effective empirical antibiotic therapy is a key factor for survival, local antibiotic resistance epidemiology is critical. We aimed to identify current trends in antibiotic resistance for key antibiotics obtained over 16 years (2001–2016) for invasive infections corresponding to empirical treatment in a large hospital centre in Marseille, France.

From January 2014 to December 2016, we have collected all data on antibiotic susceptibility from public laboratory hospitals, and a retrospective analysis was performed on key antibiotics in blood cultures since 2001. A total of 99,932 antibiotic susceptibility testings (ASTs) were analysed, and proportion of pan-drug resistant (PDR = resistant to all antibiotics tested) and extensively drug-resistant (XDR = resistant to all except for two classes) strains were < 0.03 and 0.5%, respectively. Between 2001 and 2016, we found an increase of resistance to third-generation cephalosporins for E. coli invasive strains (0% vs 17.8%; p < 10−5) and K. pneumoniae (8% vs 35.4%; p = 0.001) along with a decrease of methicillin-resistant S. aureus strains (31% vs 19.8%; p = 0.006). Moreover, during the 3-year period, a significant increase of wild-type strains, susceptible to all antibiotics tested, was observed in invasive infections. Regarding bacteraemia involving Enterobacteriaceae and S. aureus, empirical therapy is effective in > 99% cases. Active epidemiological surveillance is necessary because antibiotic resistance remains unpredictable.

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Acknowledgments

We are very grateful to IHU Méditerranée Infection and AJE for English corrections.

Funding

This work has benefited from French State support managed by the “Agence Nationale pour la Recherche,” including the “Programme d’Investissement d’avenir” under the reference Méditerranée Infection 10-IAHU-03. This work was also supported by Région Provence Alpes Côte d’Azur and Fonds Européen de Développement Regional—Plateformes de Recherche et d’Innovation Mutualisées Méditerranée Infection (FEDER PRIMI).

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Authors and Affiliations

  1. IRD, AP-HM, MEPHI, Aix Marseille Univ, Marseille, France

    Stéphanie Le Page, Gregory Dubourg, Sophie Alexandra Baron, Jean-Marc Rolain & Didier Raoult

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  1. Stéphanie Le Page
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  2. Gregory Dubourg
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  3. Sophie Alexandra Baron
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  4. Jean-Marc Rolain
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  5. Didier Raoult
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Correspondence to Didier Raoult.

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Table S1

Critical diameters used for AST in this study. (DOCX 16 kb)

Table S2

Presentation of the different bacterial species for which an AST was performed with prevalence. (DOCX 43 kb)

Table S3

Presentation of the percentage of resistance to all antibiotics tested for blood samples and other samples between 2014 and 2016 for the 10 most common Gram-negative bacteria. (DOCX 54 kb)

Table S4

Presentation of the percentage of resistance to all antibiotics tested for blood samples and other samples between 2014 and 2016 for the 10 most common Gram-positive bacteria. (DOCX 30 kb)

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Le Page, S., Dubourg, G., Baron, S.A. et al. No global increase in resistance to antibiotics: a snapshot of resistance from 2001 to 2016 in Marseille, France. Eur J Clin Microbiol Infect Dis 38, 395–407 (2019). https://doi.org/10.1007/s10096-018-3439-8

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  • DOI: https://doi.org/10.1007/s10096-018-3439-8

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