Rossignol Louise, Vaux Sophie, Maugat Sylvie, Blake Alexandre, Barlier Roxane, Heym Beate, Le Strat Yann, Blanchon Thierry, Hanslik Thomas, Coignard Bruno
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.
Infection. 2017 Feb;45(1):33-40. doi: 10.1007/s15010-016-0910-2. Epub 2016 May 27.
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).
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.
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.
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.
2012年至2013年，对因尿路感染（UTI）就诊于全科医生的女性进行了一项横断面调查，以估计耐抗生素大肠杆菌（E. coli）所致UTI的年发病率。
所有分析均考虑了抽样设计（分层、阶段和抽样权重）。对每位女性进行尿液分析，并集中在一个实验室进行。
在纳入的538名女性中，尿培养确诊UTI的病例占75.2%。大肠杆菌占菌种的82.8%。在大肠杆菌中，对阿莫西林的耐药率[38%（95%置信区间31.1 - 44.5）]和对甲氧苄啶/磺胺甲恶唑的耐药率[18.1%（12.0 - 24.1）]最为常见。对环丙沙星和头孢噻肟的耐药率较低[两种情况均为1.9%，（0.3 - 3.5）]，呋喃妥因[0.4（0 - 1.0）]和磷霉素（0）的耐药率也较低。超广谱β-内酰胺酶（ESBL）占大肠杆菌的1.6%（0.2 - 2.9）。确诊UTI的年发病率估计为每10万名女性2400例（1800 - 3000）。耐氟喹诺酮大肠杆菌和产ESBL大肠杆菌所致UTI的发病率估计分别为每10万名女性102例（75 - 129）和32例（24 - 41）。
在社区人群中发现了ESBL，尽管比例较低，但这是一个警示，证实了监测工作应继续进行。
