title: Cefoxitin: An alternative to carbapenems in urinary tract infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae.
abstract: OBJECTIVE
  Infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) have become a major public health issue worldwide. Cefoxitin is a second-generation cephalosporin and is associated with a strong in vitro activity against ESBL.
  
  
  METHODS
  We conducted a prospective monocentric cohort study from 2012 to 2015 to evaluate the clinical efficacy and safety of cefoxitin in 15 patients treated for urinary tract infection (UTI) caused by ESBL-E, without any severity criteria.
  
  
  RESULTS
  We included 15 patients; 11 were male patients with defined risk factors for ESBL-E. Ten patients presented with male UTI, three with pyelonephritis, and two with cystitis. Escherichia coli was the predominant pathogen. All patients had a positive outcome with a good tolerance (a skin rash without any sign of severity was observed in one patient). Microbiological cure was obtained in 9 patients out of 10 at the end of treatment.
  
  
  CONCLUSIONS
  Cefoxitin is an alternative treatment to carbapenems for urinary tract infections caused by ESBL-producing Enterobacteriaceae.
authors.affiliation: CHU de Lille, Maladies Infectieuses, 59000 Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Mambie
authors.affiliation: CHU de Lille, Maladies Infectieuses, 59000 Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Vuotto
authors.affiliation: CHU de Lille, Maladies Infectieuses, 59000 Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Poitrenaud
authors.affiliation: CHU de Lille, Maladies Infectieuses, 59000 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Weyrich
authors.affiliation: CHU de Lille, Maladies Infectieuses, 59000 Lille, France.
authors.forename: O
authors.initials: O
authors.lastname: Cannesson
authors.affiliation: CHU de Lille, Bactériologie-Hygiène, 59045 Lille, France.
authors.forename: R
authors.initials: R
authors.lastname: Dessein
authors.affiliation: CHU de Lille, Maladies Infectieuses, 59000 Lille, France; Université de Lille, EA 7366, Recherche translationnelle, relations hôte-pathogènes, 59000 Lille, France.
authors.forename: K
authors.initials: K
authors.lastname: Faure
authors.affiliation: CHU de Lille, Maladies Infectieuses, 59000 Lille, France; Université de Lille, EA 7366, Recherche translationnelle, relations hôte-pathogènes, 59000 Lille, France.
authors.forename: B
authors.initials: B
authors.lastname: Guery
authors.affiliation: CHU de Lille, Maladies Infectieuses, 59000 Lille, France. Electronic address: tatgalp@yahoo.com.
authors.forename: T
authors.initials: T
authors.lastname: Galpérine
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000378:metabolism; D002440:Cefoxitin / Q000009:adverse effects / Q000627:therapeutic use*; D003875:Drug Eruptions / Q000209:etiology; D004927:Escherichia coli Infections / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy*; D056689:Uropathogenic Escherichia coli / Q000187:drug effects / Q000201:enzymology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D002440:Cefoxitin; D001618:beta-Lactamases
keywords: Bêta-lactamases à spectre élargi; Carbapenems; Carbapénèmes; Cefoxitin; Céfoxitine; Enterobacteriaceae; Entérobactérie; Extended-spectrum beta-lactamases; Infection urinaire; Urinary tract infection