Trends and prediction of antimicrobial susceptibility in urinary bacteria isolated in European emergency departments: the EuroUTI 2010-2016 Study
Por:
Quaegebeur, A, Brunard, L, Javaudin, F, Vibet, M, Bemer, P, Le Bastard, Q, Batard, E, Montassier, E, Roman, F, Llorens, P, Salvi, F, Galeazzi, R, Ortega, M, Marco, F, de Zarate MMO, Ceron, R, Trovato, F, Carpinteri, G, Moustafa, F, Romaszko, J, Pedersen, M, Westh, H, Dejaune, P, Fihman, V, Joost, I, Blumel, B, Ruiz, F, Corral, G, Bieler, D, Bergmann, H, Granzer, H, Carron, P, Prod'hom, G, Greub, G, Del Castillo, J, Gonzalez, F, Juvin, M, Occelli, C, Ruimy, R, Claret, P, Lavigne, J, 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, A, Cores-Calvo, O, Van den Brand, C, Van Veen, S, Laribi, S, Lartigue, M and EuroUTI 2010-2016 Study Grp
Publicada:
1 oct 2019
Resumen:
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.
Filiaciones:
Quaegebeur, A:
Lausanne Univ Hosp, Emergency Dept, Lausanne, Switzerland
Brunard, L:
CHU Nantes, Emergency Dept, Nantes, France
Javaudin, F:
CHU Nantes, Emergency Dept, Nantes, France
Univ Nantes, Microbiotas Hosts Antibiot Bacterial Resistances, Nantes, France
Vibet, M:
Univ Nantes, Microbiotas Hosts Antibiot Bacterial Resistances, Nantes, France
CHU Nantes, DRCI Plateforme Methodol & Biostat, Nantes, France
Bemer, P:
Univ Nantes, Microbiotas Hosts Antibiot Bacterial Resistances, Nantes, France
CHU Nantes, Bacteriol & Infect Control, Nantes, France
Le Bastard, Q:
CHU Nantes, Emergency Dept, Nantes, France
Univ Nantes, Microbiotas Hosts Antibiot Bacterial Resistances, Nantes, France
Batard, E:
CHU Nantes, Emergency Dept, Nantes, France
Univ Nantes, Microbiotas Hosts Antibiot Bacterial Resistances, Nantes, France
Montassier, E:
CHU Nantes, Emergency Dept, Nantes, France
Univ Nantes, Microbiotas Hosts Antibiot Bacterial Resistances, Nantes, France
:
Hosp Gen Alicante, Emergency Dept, Alicante, Spain
:
Hosp Gen Alicante, Emergency Dept, Alicante, Spain
Salvi, F:
IRCCS, INRCA, Dept Geriatr & Emergency Care, Ancona, Italy
Galeazzi, R:
IRCCS, INRCA, Chem & Mol Lab, Ancona, Italy
Ortega, M:
Univ Barcelona, Hosp Clin Barcelona, Emergency Dept, Barcelona, Spain
Marco, F:
Univ Barcelona, Hosp Clin Barcelona, Microbiol Dept, Barcelona, Spain
de Zarate MMO:
Hosp Univ Basurto, Emergency Dept, Bilbao, Spain
Ceron, R:
Hosp Univ Basurto, Microbiol Dept, Bilbao, Spain
Trovato, F:
Univ Hosp Vittorio Emanuele, Emergency Dept, Catania, Italy
Carpinteri, G:
Univ Hosp Vittorio Emanuele, Emergency Dept, Catania, Italy
Moustafa, F:
CHU Clermont Ferrand, Clermont Ferrand, France
Romaszko, J:
CHU Clermont Ferrand, Clermont Ferrand, France
Pedersen, M:
Copenhagen Univ Hosp, Dept Clin Microbiol, Hvidovre, Denmark
Westh, H:
Copenhagen Univ Hosp, Dept Clin Microbiol, Hvidovre, Denmark
Dejaune, P:
CHU Henri Mondor, Creteil, France
Fihman, V:
CHU Henri Mondor, Creteil, France
Joost, I:
Univ Med Ctr Freiburg, Div Emergency Med, Freiburg, Germany
Blumel, B:
Univ Med Ctr Freiburg, Inst Med Microbiol & Hyg, Freiburg, Germany
Ruiz, F:
Alta Resoluc Hosp Guadix, Emergency Dept, Granada, Spain
Corral, G:
Alta Resoluc Hosp Guadix, Microbiol Dept, Granada, Spain
Bieler, D:
German Armed Forces Cent Hosp, Dept Trauma Surg & Orthoped, Koblenz, Germany
Bergmann, H:
German Armed Forces Cent Hosp, Dept Anesthesiol Intens Care Med Emergency Med &, Koblenz, Germany
Granzer, H:
German Armed Forces Cent Hosp, Microbiol Dept, Koblenz, Germany
Carron, P:
Univ Hosp Lausanne, Emergency Dept, Lausanne, Switzerland
Prod'hom, G:
Univ Hosp Lausanne, Inst Microbiol, Lausanne, Switzerland
Greub, G:
Univ Hosp Lausanne, Inst Microbiol, Lausanne, Switzerland
Del Castillo, J:
Hosp Clin Univ San Carlos, Emergency Dept, Madrid, Spain
Gonzalez, F:
Hosp Clin Univ San Carlos, Dept Clin Microbiol, Madrid, Spain
Juvin, M:
CHU Nantes, Bacteriol Dept, Nantes, France
Occelli, C:
CHU Nice, Nice, France
Ruimy, R:
CHU Nice, Nice, France
Claret, P:
CHU Nimes, Nimes, France
Lavigne, J:
CHU Nimes, Nimes, France
Hausfater, P:
CHU Pitie Salpetriere, Paris, France
Robert, J:
CHU Pitie Salpetriere, Paris, France
Ramacciati, N:
Santa Maria Misericordia Hosp, Emergency Dept, Perugia, Italy
Mencacci, A:
Santa Maria Misericordia Hosp, Microbiol Unit, Perugia, Italy
Tartaglia, D:
Cisanello Hosp, Emergency Surg Dept, Pisa, Italy
Rossi, L:
Cisanello Hosp, Emergency Surg Dept, Pisa, Italy
Ojetti, V:
Catholic Univ, IRCCS, Fdn Policlin Gemelli, Rome, Italy
Petruzziello, C:
Catholic Univ, IRCCS, Fdn Policlin Gemelli, Rome, Italy
Fiori, B:
Catholic Univ, IRCCS, Fdn Policlin Gemelli, Rome, Italy
Bonenfant, J:
CHU Rennes, Rennes, France
Piau-Couape, C:
CHU Rennes, Rennes, France
Dejoies, L:
CHU Rennes, Rennes, France
Garcia-Garcia, A:
Complejo Asistencial Univ Salamanca, Emergency Dept, Salamanca, Spain
Cores-Calvo, O:
Complejo Asistencial Univ Salamanca, Microbiol & Parasitol Lab, Salamanca, Spain
Van den Brand, C:
Haaglanden Med Ctr, Emergency Dept, The Hague, Netherlands
Van Veen, S:
Haaglanden Med Ctr, Microbiol Dept, The Hague, Netherlands
Laribi, S:
CHU Tours, Tours, France
Lartigue, M:
CHU Tours, Tours, France
Open Access
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