Trends and prediction of antimicrobial susceptibility in urinary bacteria isolated in European emergency departments: the EuroUTI 2010-2016 Study
Author:
Quaegebeur Alice1, Brunard Loïc2, Javaudin François23, Vibet Marie-Anne34, Bemer Pascale35, Le Bastard Quentin23, Batard Eric23, Montassier Emmanuel23, Roman F, Llorens P, Salvi F, Galeazzi R, Ortega M, Marco F, Martinez Ortiz de Zarate M, Figueroa Ceron R, Trovato F M, Carpinteri G, Moustafa F, Romaszko J P, Pedersen M, Westh H, Dejaune P, Fihman V, Joost I, Blumel B, Parrilla Ruiz F M, Alvarez Corral G, Bieler D, Bergmann H, Granzer H, Carron P N, Prod’hom G, Greub G, Gonzalez Del Castillo J M, Candel Gonzalez F J, Juvin M E, Occelli C, Ruimy R, Claret P G, Lavigne J P, Hausfater P, Robert J, Ramacciati N, Mencacci A, Tartaglia D, Rossi L, Ojetti V, Petruzziello C, Fiori B, Bonenfant J, Piau-Couape C, Dejoies L, Garcia-Garcia Á, Cores-Calvo O, Van Den Brand C L, van Veen S Q, Laribi S, Lartigue M F,
Affiliation:
1. Lausanne University Hospital, Emergency Department, Lausanne, Switzerland 2. CHU Nantes, Emergency Department, Nantes, France 3. Université de Nantes, Microbiotas Hosts Antibiotics Bacterial Resistances (MiHAR), Nantes, France 4. CHU Nantes, DRCI, Plateforme de Méthodologie et de Biostatistique, Nantes, France 5. CHU Nantes, Bacteriology and Infection Control, Nantes, France
Abstract
Abstract
Objectives
To assess recent trends in susceptibility to antibiotics among urinary isolates isolated in European emergency departments (EDs) and to identify isolates with a high (90% or more) predicted probability of susceptibility to fluoroquinolones or third-generation cephalosporins (3GCs).
Methods
In this cross-sectional study, we included urine cultures obtained from adult patients between 2010 and 2016 in 24 European EDs. Temporal trends were assessed using time-series analysis and multivariate logistic models. Multivariate logistic models were also used to predict susceptibility to fluoroquinolones or 3GCs from patient age and sex, year, month and ED.
Results
We included 88242 isolates. Time-series analysis found a significant increase in susceptibility to fluoroquinolones and no significant trend for susceptibility to 3GCs. Adjusting for patient age and sex, ED and organism, multivariate models showed that susceptibility to 3GCs decreased from 2014 to 2016, while susceptibility to fluoroquinolones increased in 2015 and 2016. Among isolates from 2016, multivariate models predicted high probability of susceptibility to fluoroquinolones in 11% of isolates (positive predictive value 91%) and a high probability of susceptibility to 3GCs in 35% of isolates (positive predictive value 94%).
Conclusions
Susceptibility of ED urinary isolates to fluoroquinolones increased from 2014, while susceptibility to 3GCs decreased from 2015. Predictive models identified isolates with a high probability of susceptibility to fluoroquinolones or 3GCs. The ability of such models to guide the empirical treatment of pyelonephritis in the ED remains to be determined.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology,Microbiology (medical)
Cited by
9 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|