title: Epidemiology of third-generation cephalosporin-resistant community-acquired Enterobacteria isolated from elderly patients.
abstract: OBJECTIVE
  This survey was made to study the epidemiology of multiresistant bacteria (MRB) in the French community, among elderly patients 65 years of age or more, carrying third-generation cephalosporin-resistant (3GC-resistant) Enterobacteriaceae, and the co-resistance of prescribed antibiotics.
  
  
  METHODS
  The data was collected in 2009 in the West of France by MedQual, a network of 174 private laboratories.
  
  
  RESULTS
  Two thousand one hundred and sixty strains of the 88,255 identified Enterobacteria strains were 3GC-resistant (2.4%) and 945 of these strains (41.8%) were isolated from elderly patients 65 years of age or more. Escherichia coli was the predominant 3GC-resistant strain (72.7%). 51.4% of the 945 patients in whom a 3GC-resistant strain was isolated produced an extended-spectrum β-lactamase (ESBL). The main risk factors for infection with the 3GC-resistant strain were hospitalization and antibiotic treatment in the previous year (58.2 and 86.9%, respectively). Hospitalization during the previous year was more frequent among elderly patients who lived at home compared with those who lived in nursing homes (P<0.05). The production of ESBL, among the 945 patients who carried the 3GC-resistant strains, was similar among patients who lived at home compared with those who lived in nursing homes (51.4% versus 49.7%).
  
  
  CONCLUSIONS
  Microbiologists should warn family physicians about MRB isolates with a specific antimicrobial resistance pattern (3GC-resistant, fluoroquinolone-resistant, etc.) to prescribe more effective medications.
authors.affiliation: MedQual, hôpital Saint-Jacques, CHU de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France. Electronic address: sonia.thibaut@chu-nantes.fr.
authors.forename: S
authors.initials: S
authors.lastname: Thibaut
authors.affiliation: MedQual, hôpital Saint-Jacques, CHU de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France; EA 3826 « thérapeutiques cliniques et expérimentales des infections », faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Caillon
authors.affiliation: MedQual, hôpital Saint-Jacques, CHU de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France.
authors.forename: A
authors.initials: A
authors.lastname: Marquet
authors.affiliation: MedQual, hôpital Saint-Jacques, CHU de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France.
authors.forename: G
authors.initials: G
authors.lastname: Grandjean
authors.affiliation: MedQual, hôpital Saint-Jacques, CHU de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France; EA 3826 « thérapeutiques cliniques et expérimentales des infections », faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France.
authors.forename: G
authors.initials: G
authors.lastname: Potel
authors.affiliation: MedQual, hôpital Saint-Jacques, CHU de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France; EA 3826 « thérapeutiques cliniques et expérimentales des infections », faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France.
authors.forename: F
authors.initials: F
authors.lastname: Ballereau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018550:Cephalosporin Resistance; D018432:Drug Resistance, Multiple; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D011446:Prospective Studies
keywords: BLSE; Bactéries multirésistantes; Community ecology; ESBL; Enterobacteria; Entérobactéries; Multi-drug resistant strain; Écologie communautaire