Clinical spectrum of urine cultures positive for ESBL-producing Escherichia coli in hospitalized patients and impact on antibiotic use

Med Mal Infect. 2014 Dec;44(11-12):530-4. doi: 10.1016/j.medmal.2014.09.004. Epub 2014 Oct 11.

Abstract

Objective: We wanted to describe the clinical features associated with urinalysis positive for ESBL-producing Escherichia coli and their impact on antibiotic use.

Methods: We performed a prospective observational study in 13 French hospitals of the Paris area for 3 consecutive months. We included all patients with urine cultures positive for ESBL-producing E. coli.

Results: One hundred and seventeen of the 218 patients (54%) presented with asymptomatic bacteriuria, 31 (14%) with cystitis, and 70 (32%) with a parenchymal infection. Nineteen patients with asymptomatic bacteriuria (16%) received antibiotics. Forty-one with parenchymal infections (59%) received a carbapenem. A carbapenem alternative could have been used in every patient treated with a carbapenem, according to antibiotic susceptibility testing results.

Conclusions: Urinary tract infections accounted for 46% of E. coli ESBL positive urinalysis. Fifty percent of parenchymal infections were treated with a carbapenem.

Keywords: Carbapenem; Carbapénème; ESBL-producing Escherichia coli; Escherichia coli BLSE; Infection urinaire; Urinary tract infection.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Proteins / metabolism
  • Bacteriuria / drug therapy
  • Catheter-Related Infections / epidemiology
  • Catheter-Related Infections / microbiology
  • Child
  • Child, Preschool
  • Cross Infection / drug therapy
  • Escherichia coli / enzymology
  • Escherichia coli / isolation & purification*
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / urine*
  • Female
  • Humans
  • Inappropriate Prescribing / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Paris
  • Prospective Studies
  • Risk Factors
  • Substrate Specificity
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / microbiology
  • Urine / microbiology*
  • Young Adult
  • beta-Lactam Resistance
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • beta-Lactamases