Risk factors for resistance in urinary tract infections in women in general practice: A cross-sectional survey

Rossignol, Louise; Maugat, S.; Blake, Alexandre; Vaux, Sophie; Heym, Béate; Strat, Yann Le; Kernéis, Solen; Blanchon, Thierry; Coignard, B.; Hanslik, Thomas

doi:10.1016/j.jinf.2015.05.012

Cited by 14 publications

(14 citation statements)

References 32 publications

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“…10,12 Por um lado, isto implica que exista escassez de informação. 12,25 Por outro lado, torna admissível que os resultados deste estudo e de outros semelhantes sobrestimem os padrões de resistência locais, devido a um desequilíbrio da amostra, que provavelmente inclui um número de cistites não complicadas inferior ao real. 10,11 Esta situação poderá também enviesar a prevalência de ITU na comunidade, sendo que não podemos concluir que estas sejam mais frequentes em idosos apenas baseado no facto de nesta população a percentagem da amostra ter sido maior.…”

Section: Discussionunclassified

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Perfil de Sensibilidade aos Antibióticos na Infeção Urinária em Ambulatório no Distrito de Coimbra: Um Estudo Transversal

C¹,

Rosendo²,

Santiago³

2019

Acta Med Port

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Introduction: Urinary tract infections in the community setting are quite common. It is necessary to be aware of antibiotic susceptibility patterns in order to provide rational empirical therapy. The aim of this study is to determine the frequency and antimicrobial susceptibility of the strains responsible for urinary tract infections in primary health care, in the district of Coimbra, Portugal.Material and Methods: In this observational and cross-sectional study, we analyzed 7134 positive urine cultures of outpatient laboratories in the district of Coimbra, over one year. In most cases, a positive culture was defined by a threshold of 105 colony-forming units per milliliter and was conducted by the automated system VITEK® 2, by bioMérieux. We used descriptive and inferential statistics to determine the prevalence and antimicrobial susceptibility of bacteria and to ascertain whether there were differences associated with sex and age.Results: From the total of positive cultures, 83.4% pertained to females and 41.0% to individuals over 75 years old. Escherichia coli was the most frequent strain (63.9%), although its prevalence was lower (p < 0.001) in males and individuals over 75 years old. Its susceptibility to fosfomycin and nitrofurantoin was higher than 95% and with ciprofloxacin and trimethoprim/sulfamethoxazole it was lower than 80%. Resistances were more frequent (p < 0.001) in males and in the elderly.Discussion: Escherichia coli was the most frequent strain, revealing less resistance to fosfomycin and nitrofurantoin. Antimicrobial susceptibility was lower in the elderly and in males, populations in whom empirical therapy may be less successful.Conclusion: In order to improve clinical results, we recommend periodic surveillance of antimicrobial susceptibility, which could enable the provision of efficient information to clinicians, namely those who prescribe empirically for such infections, as well as standardization of identification methods of bacterial strains diagnosis and of the antibiotic kits to be tested.

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Section: Discussionunclassified

“…Salienta-se a relevância do uso futuro de métodos de monitorização mais adequados, que tenham em conta o tipo de ITU e outros possíveis fatores de risco para resistência aos antibióticos, como a antibioterapia prévia, a hospitalização recente ou a presença de ITU recorrentes. 23,25,27…”

Section: Discussionunclassified

Perfil de Sensibilidade aos Antibióticos na Infeção Urinária em Ambulatório no Distrito de Coimbra: Um Estudo Transversal

C¹,

Rosendo²,

Santiago³

2019

Acta Med Port

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“…Bacteriological analyses and antimicrobial susceptibility testing were described elsewhere. [13] They were conducted according to the recommendations of the French…”

Section: Bacteriological Analyses and Definitionsmentioning

confidence: 99%

Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study

et al. 2016

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“…Regarding urovirulence, genotypic similarity has been documented previously between E. coli isolates from patients with UTI vs. from food products (Manges et al., ; Rossignol et al., ). Additionally, phylogenetic group D isolates from broiler chickens, broiler chicken meat and community‐dwelling humans have been shown experimentally to infect the urine, bladder and kidneys of mice, which indirectly supports UTI as a potential zoonosis (Jakobsen et al., ).…”

Section: Discussionmentioning

confidence: 65%

Escherichia coli isolates from commercial chicken meat and eggs cause sepsis, meningitis and urinary tract infection in rodent models of human infections

Mellata

Johnson

Curtiss

2017

Zoonoses and Public Health

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The zoonotic potential of Escherichia coli from chicken-source food products is important to define for public health purposes. Previously, genotypic and phenotypic screening of E. coli isolates from commercial chicken meat and shell eggs identified some E. coli strains that by molecular criteria resembled human-source extraintestinal pathogenic E. coli (ExPEC). Here, to clarify the zoonotic risk of such chicken-source E. coli, we compared selected E. coli isolates from chicken meat and eggs, stratified by molecularly defined ExPEC status, to human-source ExPEC and to laboratory E. coli for virulence in rodent models of sepsis, meningitis and UTI, and evaluated whether specific bacterial characteristics predict experimental virulence. Multiple chicken-source E. coli resembled human-source ExPEC in their ability to cause one or multiple different ExPEC-associated infections. Swimming ability corresponded with urovirulence, K1 capsule corresponded with ability to cause neonatal meningitis, and biofilm formation in urine corresponded with ability to cause sepsis. In contrast, molecularly defined ExPEC status and individual genotypic traits were uncorrelated with ability to cause sepsis, and neither complement sensitivity nor growth in human urine corresponded with virulence in any infection model. These findings establish that chicken-derived food products contain E. coli strains that, in rodent models of multiple human-associated ExPEC infections, are able to cause disease comparably to human-source E. coli clinical isolates, which suggests that they may pose a significant food safety threat. Further study is needed to define the level of risk they pose to human health, which if appreciable would justify efforts to monitor for and reduce or eliminate them.

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Risk factors for resistance in urinary tract infections in women in general practice: A cross-sectional survey

Abstract: In the community, antibiotic use and exposure to a person returning from an area with a high risk of drug resistance are associated with UTIs due to MDREB. The potentially protective role of raw meat consumption warrants further study.

Cited by 14 publications

References 32 publications

Perfil de Sensibilidade aos Antibióticos na Infeção Urinária em Ambulatório no Distrito de Coimbra: Um Estudo Transversal

Perfil de Sensibilidade aos Antibióticos na Infeção Urinária em Ambulatório no Distrito de Coimbra: Um Estudo Transversal

Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study

Escherichia coli isolates from commercial chicken meat and eggs cause sepsis, meningitis and urinary tract infection in rodent models of human infections

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