Major discrepancy between factual antibiotic resistance and consumption in South of France: analysis of 539,037 bacterial strains

Ousmane Oumou Diallo (1, 2) , Sophie Alexandra Baron (2, 1) , Gregory Dubourg (1, 2) , Herve Chaudet (2, 3) , Philippe Halfon (4) , Sabine Camiade (4) , Beatrice Comte , Stephanie Joubert , Arnaud François (5) , Philippe Seyral (6) , Francois Parisot (7) , Jean-Paul Casalta (2) , Raymond Ruimy (8) , Christophe Maruejouls , Jean-Christophe Achiardy , Sophie Burignat , Joseph Carvajal , Edouard Delaunay , Sandra Meyer , Pierre-Yves Levy (9) , Patricia Roussellier , Patrick Brunet , Claude Bosi , Philippe Stolidi , Jean-Pierre Arzouni , Gisele Gay , Pierre Hance , Philippe Colson (1, 2) , Didier Raoult (1, 2) , Jean-Marc Rolain (1, 2)

1 MEPHI - Microbes évolution phylogénie et infections
2 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
3 VITROME - Vecteurs - Infections tropicales et méditerranéennes
4 ALPHABIO - Laboratoire de biologie médicale
5 LBM Bioesterel - Laboratoire de Biologie Médiciale Bioesterel
6 Eurofins Labazur
7 EUMETSAT - European Organisation for the Exploitation of Meteorological Satellites
8 CHU Nice - Centre Hospitalier Universitaire de Nice
9 TIMONE - Hôpital de la Timone [CHU - APHM]

The burden of antibiotic resistance is currently estimated by mathematical modeling, without real count of resistance to key antibiotics. Here we report the real rate of resistance to key antibiotics in bacteria isolated from humans during a 5 years period in a large area in southeast in France. We conducted a retrospective study on antibiotic susceptibility of 539,107 clinical strains isolated from hospital and private laboratories in south of France area from January 2014 to January 2019. The resistance rate to key antibiotics as well as the proportion of bacteria classified as Difficult-to-Treat (DTR) were determined and compared with the Mann-Whitney U test, the chi(2) test or the Fisher's exact test. Among 539,037 isolates, we did not observe any significant increase or decrease in resistance to key antibiotics for 5 years, (oxacillin resistance in Staphylococcus aureus, carbapenem resistance in enterobacteria and Pseudomonas aeruginosa and 3rd generation cephalosporin resistance in Escherichia coli and Klebsiella pneumoniae). However, we observed a significant decrease in imipenem resistance for Acinetobacter baumannii from 2014 to 2018 (24.19-12.27%; p = 0.005) and a significant increase of ceftriaxone resistance in Klebsiella pneumoniae (9.9-24.03%; p = 0.001) and Enterobacter cloacae (24.05-42.05%; p = 0.004). Of these 539,037 isolates, 1604 (0.3%) had a DTR phenotype. Over a 5-year period, we did not observe a burden of AR in our region despite a high rate of antibiotic consumption in our country. These results highlight the need for implementation of real-time AR surveillance systems which use factual data.

Mots clés: Antimicrobials; Bacteria

Domaines: Sciences du Vivant [q-bio]

Ousmane Oumou Diallo, Sophie Alexandra Baron, Gregory Dubourg, Herve Chaudet, Philippe Halfon, et al.. Major discrepancy between factual antibiotic resistance and consumption in South of France: analysis of 539,037 bacterial strains. Scientific Reports, 2020, 10 (1), ⟨10.1038/s41598-020-75158-7⟩. ⟨hal-03149270⟩