title: Risk factors for resistance in urinary tract infections in women in general practice: A cross-sectional survey.
abstract: OBJECTIVE
  In 2012 and 2013, a cross-sectional survey was conducted in women visiting a general practitioner for a urinary tract infection (UTI) to i) describe the patterns of antibiotic resistance of Enterobacteriaceae involved in community-acquired UTIs and ii) identify the factors associated with UTIs due to a multi-drug-resistant Enterobacteriaceae (MDREB).
  
  
  METHODS
  Urine analyses were performed systematically for all adult women presenting with signs of UTI. Characteristics of women with UTI due to MDREB were compared to those with UTI due to non-MDREB. Weighted logistic regressions were performed to adjust for the sampling design of the survey.
  
  
  RESULTS
  Significant factors associated with MDREB included the use of penicillin by the patient in the last three months (OR = 3.1; [1.2-8.0]); having provided accommodation in the previous 12 months to a resident from a country at high risk for drug resistance (OR = 4.0; [1.2-15.1]); and the consumption of raw meat within the previous three months (OR = 0.3; [0.1-0.9]).
  
  
  CONCLUSIONS
  In the community, antibiotic use and exposure to a person returning from an area with a high risk of drug resistance are associated with UTIs due to MDREB. The potentially protective role of raw meat consumption warrants further study.
authors.affiliation: Département de Médecine Générale, UPMC Univ Paris 06, 27 rue Chaligny, 75012 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, boulevard Vincent Auriol, CS 81393, 75646 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, boulevard Vincent Auriol, CS 81393, 75646 Paris, France. Electronic address: louise.rossignol@upmc.fr.
authors.forename: Louise
authors.initials: L
authors.lastname: Rossignol
authors.affiliation: Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415 Saint-Maurice cedex, France. Electronic address: s.maugat@invs.sante.fr.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Maugat
authors.affiliation: Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415 Saint-Maurice cedex, France. Electronic address: blake.alexandre@hotmail.fr.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Blake
authors.affiliation: Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415 Saint-Maurice cedex, France. Electronic address: s.vaux@invs.sante.fr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Vaux
authors.affiliation: Hopital universitaire Ambroise Paré AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Université Versailles-Saint-Quentin-en-Yvelines, 55 Avenue de Paris, 78000 Versailles, France. Electronic address: beate.heym@apr.aphp.fr.
authors.forename: Beate
authors.initials: B
authors.lastname: Heym
authors.affiliation: Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415 Saint-Maurice cedex, France. Electronic address: y.lestrat@invs.sante.fr.
authors.forename: Yann
authors.initials: Y
authors.lastname: Le Strat
authors.affiliation: INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, boulevard Vincent Auriol, CS 81393, 75646 Paris, France. Electronic address: solen.kerneis@cch.aphp.fr.
authors.forename: Solen
authors.initials: S
authors.lastname: Kernéis
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, boulevard Vincent Auriol, CS 81393, 75646 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, boulevard Vincent Auriol, CS 81393, 75646 Paris, France. Electronic address: thierry.blanchon@upmc.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Blanchon
authors.affiliation: Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415 Saint-Maurice cedex, France. Electronic address: b.coignard@invs.sante.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Coignard
authors.affiliation: INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, boulevard Vincent Auriol, CS 81393, 75646 Paris, France; Hopital universitaire Ambroise Paré AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Université Versailles-Saint-Quentin-en-Yvelines, 55 Avenue de Paris, 78000 Versailles, France. Electronic address: thomas.hanslik@apr.aphp.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hanslik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000382:microbiology*; D005247:Feeding Behavior; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010406:Penicillins / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins
keywords: Antibiotic resistance; Epidemiology; General population; General practitioner; Risk factors; Urinary tract infection