In vitro susceptibility to mecillinam of Escherichia coli strains isolated from the urine of pregnant women.
OBJECTIVE
Pivmecillinam is a safe beta-lactam for use in pregnancy. It has been widely used for the treatment of lower urinary tract infections (UTIs) in the Nordic countries where its efficacy, minor impact on the microbiota, and low level of resistance among the Escherichia coli strains have been proven. However, susceptibility data related to E. coli involved in asymptomatic bacteriuria and lower UTIs in pregnant women is lacking. We aimed to support the 2015 recommendations issued by the French Infectious Diseases Society (SPILF) on gestational UTI, with a particular focus on pivmecillinam.


METHODS
Antimicrobial susceptibility testing was performed by 12 hospitals with a maternity department on 235 E. coli strains isolated from the urine of pregnant women. Susceptibility to mecillinam was tested by disk diffusion method using the 2015 recommendations of the antibiogram committee of the French microbiology society (CA-SFM).


RESULTS
Global susceptibility to mecillinam was 86.4%. Susceptibility to mecillinam was 96.5% for strains susceptible to amoxicillin-clavulanic acid and 38.7% for resistant strains. All six extended-spectrum beta-lactamase-producing E. coli strains were susceptible to mecillinam.


CONCLUSIONS
Given the efficacy and safety of pivmecillinam during pregnancy, it may be used for the documented treatment of asymptomatic bacteriuria and acute cystitis in pregnant women. It also represents an alternative for the treatment of multidrug-resistant bacterial infections.
Centre hospitalier universitaire, institut de microbiologie, 59037 Lille cedex, France. Electronic address: claire.duployez@gmail.com.
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Duployez
Centre hospitalier universitaire, institut de microbiologie, 59037 Lille cedex, France. Electronic address: caroline.loiez@chru-lille.fr.
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Loiez
Centre hospitalier de Valenciennes, laboratoire de microbiologie, 59322 Valenciennes cedex, France. Electronic address: cattoen-c@ch-valenciennes.fr.
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Cattoen
Centre hospitalier de Béthune, laboratoire de biologie, 62408 Béthune cedex, France. Electronic address: ddescamps@ch-bethune.fr.
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Descamps
Centre hospitalier universitaire, institut de microbiologie, 59037 Lille cedex, France. Electronic address: frederic.wallet@chru-lille.fr.
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Wallet
Centre hospitalier de Roubaix, laboratoire de biologie, 59100 Roubaix, France. Electronic address: anne.vachee@ch-roubaix.fr.
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Vachée
Réseau de microbiologistes du Nord-Pas-de-Calais, Nord-Pas-de-Calais, France.
D000328:Adult; D000560:Amdinocillin / Q000494:pharmacology*; D000561:Amdinocillin Pivoxil / Q000493:pharmacokinetics / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D058070:Asymptomatic Diseases; D001426:Bacterial Proteins / Q000032:analysis; D001437:Bacteriuria / Q000382:microbiology / Q000652:urine; D052978:Disk Diffusion Antimicrobial Tests; D004352:Drug Resistance, Microbial; D004927:Escherichia coli Infections / Q000382:microbiology* / Q000652:urine; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology* / Q000652:urine; D011355:Prodrugs / Q000493:pharmacokinetics / Q000627:therapeutic use; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000382:microbiology* / Q000652:urine; D014556:Urine / Q000382:microbiology*; D056689:Uropathogenic Escherichia coli / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D001618:beta-Lactamases / Q000032:analysis
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D011355:Prodrugs; D000561:Amdinocillin Pivoxil; D001618:beta-Lactamases; D000560:Amdinocillin
Escherichia coli; Grossesse; Infections urinaires; Mecillinam; Mécillinam; Pregnancy; Urinary tract infections