Resistance to third-generation cephalosporins in Escherichia coli in the French community: The times they are a-changin'?

Int J Antimicrob Agents. 2020 May;55(5):105909. doi: 10.1016/j.ijantimicag.2020.105909. Epub 2020 Jan 25.

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 β-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.

Keywords: Escherichia coli; Outpatients; Quinolones; Resistance; Third-generation cephalosporins.

Publication types

  • Observational Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Cephalosporins / therapeutic use*
  • Ciprofloxacin / therapeutic use*
  • Drug Resistance, Bacterial / genetics*
  • Escherichia coli / drug effects*
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / epidemiology
  • France / epidemiology
  • Humans
  • Microbial Sensitivity Tests
  • Nalidixic Acid / therapeutic use*
  • Outpatients / statistics & numerical data
  • Prevalence
  • Retrospective Studies
  • beta-Lactamases / genetics

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Nalidixic Acid
  • Ciprofloxacin
  • beta-Lactamases