[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]
Trends and prediction of antimicrobial susceptibility in urinary bacteria isolated in European emergency departments: the EuroUTI 2010-2016 Study
Alice Quaegebeur, Loïc Brunard, François Javaudin, Marie-Anne Vibet, Pascale Bemer, Quentin Le Bastard, Eric Batard, Emmanuel Montassier, EuroUTI 2010-2016 Study Group
Journal of Antimicrobial Chemotherapy, dkz274, https://doi.org/10.1093/jac/dkz274
Published: 30 June 2019
To assess recent trends in susceptibility to antibiotics among urinary isolates isolated in European emergency departments (EDs) and to identify isolates with a high (90% or more) predicted probability of susceptibility to fluoroquinolones or third-generation cephalosporins (3GCs).
In this cross-sectional study, we included urine cultures obtained from adult patients between 2010 and 2016 in 24 European EDs. Temporal trends were assessed using time-series analysis and multivariate logistic models. Multivariate logistic models were also used to predict susceptibility to fluoroquinolones or 3GCs from patient age and sex, year, month and ED.
We included 88 242 isolates. Time-series analysis found a significant increase in susceptibility to fluoroquinolones and no significant trend for susceptibility to 3GCs. Adjusting for patient age and sex, ED and organism, multivariate models showed that susceptibility to 3GCs decreased from 2014 to 2016, while susceptibility to fluoroquinolones increased in 2015 and 2016. Among isolates from 2016, multivariate models predicted high probability of susceptibility to fluoroquinolones in 11% of isolates (positive predictive value 91%) and a high probability of susceptibility to 3GCs in 35% of isolates (positive predictive value 94%).
Susceptibility of ED urinary isolates to fluoroquinolones increased from 2014, while susceptibility to 3GCs decreased from 2015. Predictive models identified isolates with a high probability of susceptibility to fluoroquinolones or 3GCs. The ability of such models to guide the empirical treatment of pyelonephritis in the ED remains to be determined.
Topic: antibiotics – cephalosporins – adult – emergency service, hospital – fluoroquinolones – pyelonephritis – urinary tract – bacteria – urine culture – antimicrobial susceptibility
Issue Section: ORIGINAL RESEARCH
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Keywords: Antibiotics; Drugs Resistance; Fluoroquinolones; Cephalosporins; UTI; European Region.