Antibiotic susceptibility of bacterial strains isolated from patients with community-acquired urinary tract infections in France

The aim of this study was to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from adults with community-acquired urinary tract infections (UTI) in France. From December 1996 to March 1997, each of 15 private laboratories in France consecutively collected about 80 non-duplicate strains isolated from adult outpatients with UTI, including patients receiving care at home, and tested their susceptibility by the disk diffusion test. A total of 1160 strains were collected: 1031 gram-negative bacilli, including Escherichia coli (n=865), Proteus mirabilis (n = 68) and Klebsiella spp. (n = 40), and 129 grampositive cocci, including Staphylococus aureus (n = 16), other staphylococci (n = 25), group B streptococci (n = 25) and enterococci (n = 63). In the case of 430 bacterial isolates, the patients had either been hospitalised in the last: 6 months or received antibiotic treatment in the last 3 months. The antibiotic susceptibility rates for Escherichia coli were: amoxicillin (58.7%), amoxicillin-clavulanic acid (63.3%), ticarcillin (61.4%), cephalothin (66.8%) cefuroxime (77.6%), cefixime (83.6%), cefotaxime (99.8%), ceftazidime (99%), nalidixic acid (91.9%), norfloxacin (96.6%), ofloxacin (96.3%), ciprofloxacin (98.3%), cotrimoxazole (78.2%), fosfomycin (99.1%) and gentamicin (98.4%). Of the Enterobacteriaceae, five strains produced an extended-spectrum beta-lactamase. Methicillin resistance was detected in nine Staphylococus aureus isolates. The most important findings were two extended-spectrum, beta-lactamase-producing and three methicillin-resistant Staphylococcus aureus strains isolated from patients who had not been hospitalised in the last 6 months or taken antibiotics in the last 3 months. The findings indicate that these strains can spread within the community; therefore, monitoring antibiotic susceptibility of bacteria isolated in the community appears to be mandatory.