title: Study of family physicians' practices in case of urinary tract infections caused by enterobacteriaceae secreting extended-spectrum-beta-lactamase.
abstract: BACKGROUND
  Urinary tract infections caused by enterobacteriaceae secreting extended-spectrum beta-lactamase (EESBL) is an issue for most family physicians. The aim of our study was to evaluate their practice in case of EESBL discovered after urinalysis and culture (U/C).
  
  
  METHODS
  This epidemiological and retrospective study was conducted from the January 1, to December 31, 2012, in 5 laboratories of Savoie and Isere. Results of U/C prescribed by family physicians and positive for EESBL were collected. The data collected with questionnaires, concerned characteristics of the infection, antibiotic treatment adequateness, the implementation of specific hygiene measures, and risk factors for EESBL infection.
  
  
  RESULTS
  One hundred and three U/C out of 19,494 were considered, and 56 questionnaires were collected. The rate of EESBL positive U/C was 0.60%. The antibiotic treatment was adequate for 35 patients (62.5%). Specific hygiene measures were implemented for 22 patients (32.3%). Both antibiotic treatment and specific hygiene measures were initiated for 13 patients (23.2%). Fourteen cases of community-acquired infections (25%) were reported. Five patients (8.9%) had traveled to an endemic zone in the previous 6 months.
  
  
  CONCLUSIONS
  The concomitant initiation of both antibiotic treatment and specific hygiene measures in case of U/C positive for EESBL is insufficient when managed by family physicians. It could be improved by offering tools for the management of these infections, by developing EESBL networks between hospital and family physicians, and epidemiological surveillance in community settings.
authors: Les terrasses de Bonne, 4, rue des Jardins, 05000 Gap, France. Electronic address: coralie.miclot@gmail.com.
authors: C
authors: C
authors: Miclot
authors: Laboratoire d'analyses médicales Bio Médica, Labazur, 7, rue Davat, 73100 Aix-les-Bains, France. Electronic address: g.antoniotti@gsante.fr.
authors: G
authors: G
authors: Antoniotti
authors: Service de maladies infectieuses et de médecine interne, centre hospitalier de Chambéry, place Lucien-Biset, BP 31125, 73011 Chambéry cedex, France. Electronic address: emmanuel.forestier@ch-chambery.fr.
authors: E
authors: E
authors: Forestier
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000032:analysis*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D005602:France / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000032:analysis*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases
keywords: Bêta-lactamase à spectre étendu; Enterobacteriaceae; Entérobactéries; Extended-spectrum-beta-lactamase (ESBLE); Infections urinaires; Urinary tract infections (UTIs)