title: Prevalence of extended-spectrum beta-lactamase producing Escherichia coli in community-onset urinary tract infections in France in 2013.
abstract: OBJECTIVE
  We sought to assess the importance of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae in urinary tract infections in outpatients in France.
  
  
  METHODS
  Retrospective laboratory based survey analysing susceptibility patterns of Escherichia coli and Klebsiella pneumoniae isolates providing from urines collected from outpatients during three months in 2013.
  
  
  RESULTS
  Four hundred and ninety-nine laboratories collected data on 51,643 E. coli and 3495 K. pneumoniae isolates. The overall proportion of ESBL-producing E. coli was 3.3%. The proportion was higher for males (4.8%) than for females (3.0%) and increased with age: 2% for patients <20 years to 5.4% for those aged >80 years. More than 95% of isolates we susceptible to cefixime, fosfomycin, and nitrofurantoin. In nursing homes, the ESBL-producing E. coli proportion was 12.1%. For K. pneumoniae, the proportion of ESBL-positive isolates was 6.6%, and this proportion increased with age. Data from 2010 collected from a subset of the network showed that the ESBL-producing E. coli proportion was 2.0%.
  
  
  CONCLUSIONS
  ESBL-producing isolates were rather frequent in urines in French outpatients in 2013. Males and persons residing in nursing homes were at higher risk of ESBL-positive infection. Despite the increase in ESBL-positive isolates, the susceptibility to antibiotics used to treat cystitis remains high.
authors.affiliation: Observatoire National de l'Epidémiologie de la Résistance Bactérienne aux Antibiotiques (ONERBA), Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Martin
authors.affiliation: BPR Network, Laboratoire Atoutbio, Nancy, France.
authors.forename: S
authors.initials: S
authors.lastname: Fougnot
authors.affiliation: Observatoire National de l'Epidémiologie de la Résistance Bactérienne aux Antibiotiques (ONERBA), Paris, France; EPIVILLE Network, Laboratoire d'Analyses Médicales, La Ferté Bernard, France.
authors.forename: F
authors.initials: F
authors.lastname: Grobost
authors.affiliation: MedQual-Ville Network, Hôpital Saint-Jacques, CHU de Nantes, Nantes, France.
authors.forename: S
authors.initials: S
authors.lastname: Thibaut-Jovelin
authors.affiliation: MedQual-Ville Network, Hôpital Saint-Jacques, CHU de Nantes, Nantes, France.
authors.forename: F
authors.initials: F
authors.lastname: Ballereau
authors.affiliation: Observatoire National de l'Epidémiologie de la Résistance Bactérienne aux Antibiotiques (ONERBA), Paris, France; EPIVILLE Network, Laboratoire Schuh BIO67, Strasbourg, France.
authors.forename: T
authors.initials: T
authors.lastname: Gueudet
authors.affiliation: Observatoire National de l'Epidémiologie de la Résistance Bactérienne aux Antibiotiques (ONERBA), Paris, France; AFORCOPI-BIO Network, LABM Claude-Bernard, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: de Mouy
authors.affiliation: Observatoire National de l'Epidémiologie de la Résistance Bactérienne aux Antibiotiques (ONERBA), Paris, France; Sorbonne Universités, UPMC Univ Paris 06, CR7, INSERM U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, Team E13 (Bacteriology), F-75013, Paris, France; AP-HP Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Bacteriology and Hygiene, F-75013, Paris, France. Electronic address: jerome.robert@psl.aphp.fr.
authors.forename: J
authors.initials: J
authors.lastname: Robert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases
keywords: Community; ESBL; Escherichia coli; Fosfomycin; Klebsiella pneumoniae; Nitrofurantoin; Urinary-tract infection