title: [Bacteriological analysis of more than 600 febrile urinary infections managed in a community health network].
abstract: Community-acquired febrile urinary tract infections (UTI) in adult has received little attention in the literature. The objective of our study was to determinate the distribution of bacterial strains isolated from adults with community-acquired febrile UTI and antibiotic susceptibility patterns of Escherichia coli.
  
  
  METHODS
  We studied the SPHERES's databank. SPHERES is a Parisian medical community network aimed at securing and facilitating the ambulatory management of potentially serious acute illnesses. Each patient is included in the network according to specific clinical criteria and standardized medical data are recorded. We retrospectively studied the medical records of all patients treated for a pyelonephritis or a prostatitis between April 2005 and October 2008.
  
  
  RESULTS
  Five hundred and sixty-eight patients were enrolled: 410 women and 158 men. The overall bacteria's distribution was similar to that observed in previous strictly microbiological studies with a more prominent role of E. coli (87.5%) to the detriment of other species. The overall susceptibility of E. coli to antibiotics recommended in the empiric treatment of pyelonephritis and prostatitis was preserved: ciprofloxacin (95.8%), cefotaxime (98%), gentamicin (99.4%). In women over 65 years, the susceptibility of E. coli to systemic fluoroquinolones fell up 89.7%. This could affect the empiric oral treatment of pyelonephritis in older women.
  
  
  CONCLUSIONS
  We report the bacterial distribution and the resistance pattern of bacteria implicated in febrile urinary infections diagnosed and treated in a health network. It seems that E. coli resistance increased more in women more than 65 years than in men.
authors.affiliation: Service d'urologie, CHRU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France; Université François-Rabelais, PRES centre Val-de-Loire, 37044 Tours, France. Electronic address: f.bruyere@chu-tours.fr.
authors.forename: F
authors.initials: F
authors.lastname: Bruyère
authors.forename: M
authors.initials: M
authors.lastname: Vidoni
authors.forename: Y
authors.initials: Y
authors.lastname: Péan
authors.forename: J A
authors.initials: JA
authors.lastname: Ruimy
authors.forename: R
authors.initials: R
authors.lastname: Elfassi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003153:Community Health Services; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016208:Databases, Factual; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005602:France / Q000453:epidemiology; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D011472:Prostatitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011704:Pyelonephritis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D012737:Sex Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacteriology; Bactériologie; Infection urinaire; Prostatite; Prostatitis; Pyelonephritis; Pyélonéphrite; Urinary infection; Urologie; Urology