Prevalence of extended-spectrum beta-lactamase producing Escherichia coli in community-onset urinary tract infections in France in 2013.

OBJECTIVES: We sought to assess the importance of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae in urinary tract infections in outpatients in France. METHODS: Retrospective laboratory based survey analysing susceptibility patterns of Escherichia coli and Klebsiella pneumoniae isolates providing from urines collected from outpatients during three months in 2013. RESULTS: Four hundred and ninety-nine laboratories collected data on 51,643 E. coli and 3495 K. pneumoniae isolates. The overall proportion of ESBL-producing E. coli was 3.3%. The proportion was higher for males (4.8%) than for females (3.0%) and increased with age: 2% for patients <20 years to 5.4% for those aged >80 years. More than 95% of isolates we susceptible to cefixime, fosfomycin, and nitrofurantoin. In nursing homes, the ESBL-producing E. coli proportion was 12.1%. For K. pneumoniae, the proportion of ESBL-positive isolates was 6.6%, and this proportion increased with age. Data from 2010 collected from a subset of the network showed that the ESBL-producing E. coli proportion was 2.0%. CONCLUSION: ESBL-producing isolates were rather frequent in urines in French outpatients in 2013. Males and persons residing in nursing homes were at higher risk of ESBL-positive infection. Despite the increase in ESBL-positive isolates, the susceptibility to antibiotics used to treat cystitis remains high.

[Evolution of antibiotic resistance of Streptococcus pneumoniae: results of Alsace observatory in 2005]. / Evolution de la sensibilité de Streptococcus pneumoniae aux antibiotiques: résultats de l'observatoire du pneumocoque Alsace (année 2005).

OBJECTIVES: Between 1st January 2005 and 31st December 2005, 232 strains of Streptococcus pneumoniae were collected in the Alsace county from participating laboratories (one from university hospital, 7 from general hospitals and 12 private laboratories) to assess their susceptibility to penicillin and evaluated serogroups of strains. METHOD: The coordinating centre performed MICs by the reference agar dilution test, interpreted according to CA-SFM breakpoints. Others antibiotics (erythromycin, cotrimoxazole, tetracycline...) were tested by agar diffusion, ATB-PNEUMO gallery or VITEK gallery (BioMérieux, France) by each participating laboratory. Data were processed, using 4th dimension software. RESULTS: Strains were collected from 151 blood samples, 38 ear pus, 11 cerebrospinal fluids, 8 pleural liquids and 24 representative pulmonary samples. The prevalence of pneumococci with decreased susceptibility to penicillin G (PDSP) is 35.1% (pulmonary samples excluded). The rate of PNSP decreases for all types of samples compared with other years of surveillance 2003 (44.0%). The rate of blood samples decreases for first time between the creation of Pneumococcal Observatory. The high-level resistance tend to decrease and began low. The PDSP are rather resistant to erythromycin, cotrimoxazole and fosfomycin. Among the PDSP, the most prevalent serotypes were 14, 19, 6 and 9. CONCLUSION: Among pneumococcal strains, the rate of PDSP tend however to decrease in 2005 compared with 2003. The rate stays inferior to the observed rates in other French counties where the same decreasing is described.

[Comparison of five usual techniques for detection of methicillin-resistant Staphylococcus aureus]. / Détection de la résistance à l'oxacilline chez Staphylococcus aureus: comparaison de cinq techniques utilisables en routine.

The detection of methicillin-resistant Staphylococcus aureus in an usual and daily test in a microbiology laboratory. But its interpretation isn't easy because the resistance expression in vitro is so variable. The authors compare five methods about 100 clinical isolated strains. The results are: disk diffusion method using oxacillin 5 microg, on a NaCl 5% Mueller Hinton agar, 100 ml presentation (biorad): specificity 91%; disk diffusion method using oxacillin 5 microg, on a NaCl 5% Mueller Hinton agar, ready to use plate (AES): specificity 95%; the Oxascreen agar (BD): specificity 96%; the oxacillin cupule of ATB STAPH strip (ATB expression bioMerieux system) NaCl 2% semi solid Mueller Hinton agar medium: specificity 100% and disk diffusion method using cefoxitin 30 microg, on a Mueller Hinton agar plate (bioMerieux): specificity 100%. Therefore the cefoxitin disk diffusion method is very interesting to make better the difference between methicillin-resistant and methicillin-sensible S. aureus, in association with the ATB STAPH strip.