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Trends in the Prevalence of Antimicrobial Resistance in Escherichia coli Isolated from Outpatient Urine Cultures in French Amazonia
Flaubert Nkontcho Djamkeba
Flaubert Nkontcho Djamkeba
Pharmacy Department, Cayenne General Hospital, French Guiana;
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Vincent Sainte-Rose
Vincent Sainte-Rose
Laboratory of Microbiology, Cayenne General Hospital, French Guiana;
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Guy Roger Lontsi Ngoulla
Guy Roger Lontsi Ngoulla
Intensive Care Unit, Cayenne General Hospital, French Guiana;
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Ariane Roujansky
Ariane Roujansky
Intensive Care Unit, Cayenne General Hospital, French Guiana;
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Philippe Abboud
Philippe Abboud
Tropical and Infectious Diseases Department, Cayenne General Hospital, French Guiana;
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Gaelle Walter
Gaelle Walter
Tropical and Infectious Diseases Department, Cayenne General Hospital, French Guiana;
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Stephanie Houcke
Stephanie Houcke
Intensive Care Unit, Cayenne General Hospital, French Guiana;
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Magalie Demar
Magalie Demar
Laboratory of Microbiology, Cayenne General Hospital, French Guiana;
Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana;
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Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana;
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Hatem Kallel
Hatem Kallel
Intensive Care Unit, Cayenne General Hospital, French Guiana;
Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana;
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Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana;
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Jean Marc Pujo
Jean Marc Pujo
Emergency Department, Cayenne General Hospital, French Guiana
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Felix Djossou
Felix Djossou
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;
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Tropical Biome and immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana;
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ABSTRACT.
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.
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Author Notes
Current contact information: Flaubert Nkontcho, Pharmacy Department, Cayenne General Hospital, French Guiana, E-mail: nkontcho@hotmail.com. Vincent Sainte-Rose and Magalie Demar, Laboratory of Microbiology, Cayenne General Hospital, French Guiana, E-mails: Vincent.sainte-rose@ch-cayenne.fr and magalie.demar@ch-cayenne.fr. Guy Roger Lontsi Ngoulla, Ariane Roujansky, and Stephanie Houcke, Intensive Care Unit, Cayenne General Hospital, French Guiana, E-mails: guylon6@orange.fr, Ariane.roujansky@ch-cayenne.fr, and stephanie.houcke@ch-cayenne.fr. Philippe Abboud, Gaelle Walter, and Felix Djossou, Tropical and Infectious Diseases Department, Cayenne General Hospital, French Guiana, E-mails: philippe.abboud@ch-cayenne.fr, gaelle.walter@ch-cayenne.fr, and felix.djossou@ch-cayenne.fr. Hatem Kallel, Intensive Care Unit, Cayenne General Hospital, French Guiana, and Tropical Biome and Immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, French Guiana, E-mail: kallelhat@yahoo.fr. Jean Marc Pujo, Emergency Department, Cayenne General Hospital, French Guiana, E-mail: jean.pujo@ch-cayenne.fr.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
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