| Autor: |
Nkontcho Djamkeba F; Pharmacy Department, Cayenne General Hospital, French Guiana., Sainte-Rose V; Laboratory of Microbiology, Cayenne General Hospital, French Guiana., Lontsi Ngoulla GR; Intensive Care Unit, Cayenne General Hospital, French Guiana., Roujansky A; Intensive Care Unit, Cayenne General Hospital, French Guiana., Abboud P; Tropical and Infectious Diseases Department, Cayenne General Hospital, French Guiana., Walter G; Tropical and Infectious Diseases Department, Cayenne General Hospital, French Guiana., Houcke S; Intensive Care Unit, Cayenne General Hospital, French Guiana., Demar M; Laboratory of Microbiology, Cayenne General Hospital, French Guiana.; Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana., Kallel H; Intensive Care Unit, Cayenne General Hospital, French Guiana.; Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana., Pujo JM; Emergency Department, Cayenne General Hospital, French Guiana., Djossou F; Tropical and Infectious Diseases Department, Cayenne General Hospital, French Guiana.; Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana. |
| Abstrakt: |
Antimicrobial resistance (AMR) in the community is increasing worldwide. We aimed to assess AMR trends in Escherichia coli from the community urine isolates in French Amazonia. We conducted a retrospective study from January 2016 to December 2022 in the Cayenne General Hospital microbiology laboratory (French Guiana). It included all urine samples positive for E. coli collected from adult outpatients. During the study period, 3,443 urinalyses positive for E. coli were studied. In 46% of cases, patients were women. In 64.4% of cases, E. coli were β-lactamase producers. The most frequently diagnosed resistance mechanisms were penicillinase production and sparing third-generation cephalosporins. Isolated E. coli were extended-spectrum β-lactamase (ESBL) producers in 6.1% of cases. Overall, E. coli was susceptible to amoxicillin in 35.9% [95% CI: 34.3-37.5], to amoxicillin/clavulanic acid in 62.2% [95% CI: 60.6-63.9], to cefotaxime in 94% [95% CI: 93.1-94.7], to gentamicin in 92.1% [95% CI: 89.1-92.6], to ofloxacin in 76.8% [95% CI: 75.3-78.2], to trimethoprim/sulfamethoxazole (SXT) in 58.8% [95% CI: 57.1-60.5], to fosfomycin in 99.1% [95% CI: 98.6-99.4], and to nitrofurantoin in 99% of cases [95% CI: 98.6-99.3]. We have observed a gradual decline in the susceptibility profile of E. coli for amoxicillin/clavulanic acid (P <0.001), piperacillin/tazobactam (P = 0.003), and temocillin (P = 0.006). However, susceptibility to ciprofloxacin was increasing (P = 0.001). In contrast, the susceptibility trends for amoxicillin, third-generation cephalosporins, gentamicin, SXT, nitrofurantoin, and fosfomycin remained stable over the 28 quarters of the study. In conclusion, isolated E. coli from outpatient urinalyses showed increased resistance profiles involving penicillinase and ESBL production. Close monitoring and strategies to decrease antibiotic consumption in the community are needed. |
