title: Temporal trends and risks factors for antimicrobial resistant Enterobacteriaceae urinary isolates from outpatients in Guadeloupe.
abstract: Urinary tract infections are bacterial infections most commonly encountered in the community. The resistance rate of uropathogens to commonly prescribed antibiotics has increased worldwide but there are no published data concerning the resistance of strains isolated from community-acquired UTI in Guadeloupe. To assess the susceptibility patterns of Enterobacteriaceae strains isolated from outpatients in Guadeloupe we conducted a prospective study from December 2012 to May 2014 among outpatients consulting at private and public laboratories for urine analysis. Risk factors for E. coli resistance to amoxicillin, third-generation cephalosporin, and ciprofloxacin were also determined. To study the trends of E. coli resistance rates over the past 10 years, data on the susceptibility patterns of E. coli from 2003 to 2014 were also collected from three major laboratories for a retrospective study.
  
  
  
  During the prospective study, we isolated 1293 bacterial strains from the urine of outpatients presenting for urine analysis. The most commonly isolated bacteria were E. coli (57 %) and Klebsiella pneumoniae (15.5 %). Thirty seven per cent of the E. coli strains were resistant to amoxicillin. Resistance rates to third generation cephalosporin were low for E. coli and other Enterobacteriaceae (3.1 and 12.2 % respectively) and mostly due to the presence of an Extended Spectrum Beta-lactamase. Resistance to cotrimoxazole and ciprofloxacin was moderate (17.8 and 15.6 % respectively). However, the resistance rate of E. coli to ciprofloxacin has significantly increased during the last 10 years. Risk factors were consistent with previously reported data, especially for the increasing ciprofloxacin resistance with age.
  
  
  
  General practitioners in Guadeloupe need to be better informed to favor the prescription of fosfomycin-trometamol to reduce the risk of resistance to fluoroquinolones.
authors.affiliation: Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France. sguyomard@pasteur-guadeloupe.fr.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Guyomard-Rabenirina
authors.affiliation: Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.
authors.forename: Joyce
authors.initials: J
authors.lastname: Malespine
authors.affiliation: Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.
authors.forename: Célia
authors.initials: C
authors.lastname: Ducat
authors.affiliation: Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.
authors.forename: Syndia
authors.initials: S
authors.lastname: Sadikalay
authors.affiliation: Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Falord
authors.affiliation: Laboratoire de Biologie Clinique, Centre Hospitalier de Basse-Terre, Basse-Terre, Guadeloupe, France.
authors.forename: Dorothée
authors.initials: D
authors.lastname: Harrois
authors.affiliation: Institut Pasteur de Nouvelle-Calédonie, Nouméa, Nouvelle-Calédonie, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Richard
authors.affiliation: Institut Armand Frappier, Laval, Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Dozois
authors.affiliation: Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.|Faculté de Médecine, Université des Antilles, Pointe-à-Pitre, Guadeloupe, France.|Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalo-Universitaire de Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Breurec
authors.affiliation: Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Talarmin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D005260:Female; D019430:Guadeloupe; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010045:Outpatients; D014552:Urinary Tract Infections / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic resistance; Enterobacteriaceae; Urinary tract infections