title: Resistance and virulence potential of uropathogenic Escherichia coli strains isolated from patients hospitalized in urology departments: a French prospective multicentre study.
abstract: We characterized antibiotic resistance and virulence of uropathogenic Escherichia coli (UPEC) strains isolated from urinary tract infections (UTIs) in patients hospitalized in urology departments. A prospective multicentre study was initiated from March 2009 and lasted until February 2010 in French urology units. All patients with asymptomatic bacteriuria (ABU), acute cystitis, acute pyelonephritis or acute prostatitis in whom UPEC was detected were included. Antimicrobial resistance and virulence factors were compared among the different groups. To identify independent associations between virulence markers and the risk of UTI, we used a multivariate logistic regression. We included 210 patients (mean age: 65.8 years; 106 female). Episode of UTI was community acquired in 72.4 %. ABU was diagnosed in 67 cases (31.9 %), cystitis in 52 cases (24.7 %), pyelonephritis in 35 cases (16.7 %) and prostatitis in 56 cases (26.7 %). ABU was more frequent in patients with a urinary catheter (76.1 vs 23.9 %, P<0.001). The resistance rate was 7.6 and 24.8 % for cefotaxime and ciprofloxacin, respectively. UPEC isolated from infections belonged more frequently to phylotypes B2 and D (P =0.07). The papG allele II and papA, papC, papE, kpsMTII and iutA genes were significantly more frequent in infecting strains (P<0.05). In multivariate analysis, strains susceptible to ciprofloxacin were significantly associated with papG allele II (P=0.007), kpsMTK1 (P<0.001) and hlyA (P<0.001) compared with the ciprofloxacin-resistant strains. To the best of our knowledge, this is the first study evaluating the antibiotic resistance and virulence features of UPEC isolated from patients hospitalized in urology departments. High resistance rates were observed, notably for ciprofloxacin, highlighting the importance of a reinforced surveillance in this setting.
authors.affiliation: INSERM, U1047, Université Montpellier, UFR de Médecine, 30908 Nîmes Cedex 2, France.|Service de Microbiologie, Groupe Hospitalo-Universitaire de Carémeau, 30029 Nîmes Cedex 9, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lavigne
authors.affiliation: Service d'Urologie, Centre Hospitalier Régional Universitaire Bretonneau, 37044 Tours cedex 1, France.|Université Francois Rabelais de Tours, PRES Centre-Val de Loire Université, 37000 Tours, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Bruyère
authors.affiliation: Université Francois Rabelais de Tours, PRES Centre-Val de Loire Université, 37000 Tours, France.|Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional Universitaire Bretonneau, 37044 Tours Cedex 1, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Bernard
authors.affiliation: Division of Clinical Epidemiology, Geneva University Hospital, University of Geneva, Geneva, Switzerland.
authors.forename: Christophe
authors.initials: C
authors.lastname: Combescure
authors.affiliation: Laboratoire de Bactériologie, AP-HP Raymond Poincaré, 92380 Garches, France.
authors.forename: Esthel
authors.initials: E
authors.lastname: Ronco
authors.affiliation: Service de Bactériologie-Virologie, Centre Hospitalier Régional Universitaire Bretonneau, 37044 Tours Cedex 1, France.|Equipe Bactéries et risque materno-fœtal, Université François Rabelais de Tours, UMR1282 ISP, 37032 Tours, France.|Equipe Bactéries et risque materno-fœtal, INRA, UMR1282 ISP, 37380 Nouzilly, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lanotte
authors.affiliation: Service d'Urologie, Centre Hospitalier René Dubos, 95300 Pontoise, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Coloby
authors.affiliation: Laboratoire de Bactériologie, Centre Hospitalier René Dubos, 95300 Pontoise, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Thibault
authors.affiliation: Service d'Urologie, Groupe Hospitalier Diaconesses Croix St Simon, 75020 Paris, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Cariou
authors.affiliation: Laboratoire de Bactériologie, Groupe Hospitalier Diaconesses Croix St Simon, 75020 Paris, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Desplaces
authors.affiliation: Service d'Urologie, Groupe Hospitalo-Universitaire de Carémeau, 30029 Nîmes Cedex 9, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Costa
authors.affiliation: INSERM, U1047, Université Montpellier, UFR de Médecine, 30908 Nîmes Cedex 2, France.|Service des Maladies Infectieuses et Tropicales, Groupe Hospitalo-Universitaire de Carémeau, 30029 Nîmes Cedex 9, France.
authors.forename: Albert
authors.initials: A
authors.lastname: Sotto
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology*; D005602:France / Q000453:epidemiology; D006801:Humans; D015999:Multivariate Analysis; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D056689:Uropathogenic Escherichia coli / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents