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1.
Int J Antimicrob Agents ; 55(5): 105909, 2020 May.
Article in English | MEDLINE | ID: mdl-31991220

ABSTRACT

OBJECTIVES: Since the early 2000s, Escherichia coli resistance to third-generation cephalosporins (3GCs) has been increasing in all European countries, mainly due to the spread of extended spectrum ß-lactamases (ESBLs). Here we present a retrospective study that combines resistance of E. coli to 3GCs and quinolones with data on antibiotic use in the community in a region of Northeastern France. METHODS: Since 2012, an observational surveillance of antimicrobial resistance and antibiotic use in the community was conducted: data on antimicrobial resistance in E. coli isolates were collected from 11 private laboratories, and consumption data were collected from the three main healthcare insurances. RESULTS: A significant decrease in the prevalence of resistance to 3GCs (from 5.6% to 4.2%; P < 0.001), nalidixic acid (from 16.7% to 14.8%; P = 0.004) and ciprofloxacin (from 10.9% to 8.1%; P < 0.001) was reported between 2015 and 2017. Although total antibiotic consumption did not vary significantly between 2012 and 2017, a decrease in the consumption of 3GCs (-32.%; P < 0.001) and quinolones (-25.5%; P < 0.001) was observed. CONCLUSION: Here we report a decrease in the prevalence of E. coli isolates resistant to 3GCs and quinolones in outpatients in the context of significant decreasing consumption of these two antibiotic classes.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Cephalosporins/therapeutic use , Ciprofloxacin/therapeutic use , Drug Resistance, Bacterial/genetics , Escherichia coli/drug effects , Nalidixic Acid/therapeutic use , Escherichia coli/genetics , Escherichia coli/isolation & purification , Escherichia coli Infections/drug therapy , Escherichia coli Infections/epidemiology , France/epidemiology , Humans , Microbial Sensitivity Tests , Outpatients/statistics & numerical data , Prevalence , Retrospective Studies , beta-Lactamases/genetics
2.
Int J Antimicrob Agents ; 52(1): 100-103, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29580930

ABSTRACT

In this study, the activity of 18 non-carbapenem antibiotics was evaluated against 100 extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli (ESBL-Ec) and 50 ESBL-producing Klebsiella pneumoniae (ESBL-Kp) isolated from urinary tract infections and bacteraemia in 2016. Minimum inhibitory concentrations (MICs) were determined using reference methods and the susceptibility profiles were defined according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2017 recommendations. All of the ESBL-Ec isolates were susceptible to ceftazidime/avibactam and a great majority of them were susceptible to fosfomycin (98%), piperacillin/tazobactam (97%), amikacin (97%) and nitrofurantoin (96%). Mecillinam, cefoxitin and ceftolozane/tazobactam remained active against 92%, 83% and 78% of the ESBL-Ec isolates, respectively. Moreover, 100%, 94% and 90% of the ESBL-Kp tested were susceptible to ceftazidime/avibactam, amikacin and mecillinam, respectively. This study showed that there are non-carbapenem options (including orally administrable drugs) for the treatment of all of the situations of ESBL-Ec or ESBL-Kp infections, with ceftazidime/avibactam being the most efficient alternative.


Subject(s)
Anti-Bacterial Agents/pharmacology , Enterobacteriaceae/drug effects , beta-Lactamases/metabolism , Azabicyclo Compounds/pharmacology , Carbapenems/pharmacology , Ceftazidime/pharmacology , Cephalosporins/pharmacology , Drug Combinations , Enterobacteriaceae/isolation & purification , Enterobacteriaceae/metabolism , Enterobacteriaceae Infections/microbiology , Escherichia coli/drug effects , Humans , Klebsiella pneumoniae/drug effects , Microbial Sensitivity Tests , Penicillanic Acid/analogs & derivatives , Penicillanic Acid/pharmacology , Tazobactam , Urinary Tract Infections/microbiology
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