title: Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study.
abstract: OBJECTIVE
  In 2012-2013, a cross-sectional survey was conducted in women visiting a general practitioner for urinary tract infection (UTI), to estimate the annual incidence of UTIs due to antibiotic-resistant Escherichia coli (E. coli).
  
  
  METHODS
  A sampling design (stratification, stages and sampling weights) was taken into account in all analyses. Urine analyses were performed for each woman and centralised in one laboratory.
  
  
  RESULTS
  Among 538 included women, urine culture confirmed UTI in 75.2 % of cases. E. coli represented 82.8 % of species. Among E. coli, resistance (I + R) was most common to amoxicillin [38 % (95 % confidence interval 31.1-44.5)] and to trimethoprim/sulfamethoxazole [18.1 % (12.0-24.1)]. Resistance to ciprofloxacin and cefotaxime was lower [1.9 % in both cases, (0.3-3.5)], as it was for nitrofurantoin [0.4 (0-1.0)] and fosfomycin (0). Extended-spectrum β-lactamase (ESBL) represented 1.6 % of E. coli (0.2-2.9). Annual incidence rate of confirmed UTI was estimated at 2400 per 100,000 women (1800-3000). Incidence rates of UTI due to fluoroquinolone-resistant and ESBL-producing E. coli were estimated at 102 per 100,000 women (75-129) and at 32 (24-41), respectively.
  
  
  CONCLUSIONS
  ESBL had been found in a community population, and even though the rate was low, it represents a warning and confirms that surveillance should continue.
authors.affiliation: Département de Médecine Générale, UPMC Univ Paris 06, 27 Rue Chaligny, 75012, Paris, France. louise.rossignol@iplesp.upmc.fr.|Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France. louise.rossignol@iplesp.upmc.fr.|INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France. louise.rossignol@iplesp.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.
authors.forename: Sophie
authors.initials: S
authors.lastname: Vaux
authors.affiliation: Institut de Veille Sanitaire, 12, Rue du Val d'Osne, 94415, Saint-Maurice Cedex, France.
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.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Blake
authors.affiliation: Département de Médecine Générale, UPMC Univ Paris 06, 27 Rue Chaligny, 75012, Paris, France.|Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France.|INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France.
authors.forename: Roxane
authors.initials: R
authors.lastname: Barlier
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.
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.
authors.forename: Yann
authors.initials: Y
authors.lastname: Le Strat
authors.affiliation: Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France.|INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Blanchon
authors.affiliation: INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, Boulevard Vincent Auriol, 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.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hanslik
authors.affiliation: Institut de Veille Sanitaire, 12, Rue du Val d'Osne, 94415, Saint-Maurice Cedex, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Coignard
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic resistance; Escherichia coli; General population; General practitioner; Incidence; Urinary tract infection