{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T03:23:20Z","timestamp":1782185000857,"version":"3.54.5"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T00:00:00Z","timestamp":1636329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Regional Health Authorities of Ile-de-France"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hospital-based surveillance of antimicrobial resistance may be irrelevant as a guide to antimicrobial use for urinary tract infections (UTIs) in primary care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To highlight the value of online computerized decision support systems (CDSS) in providing information on the surveillance of antimicrobial resistance in community-acquired UTIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We collected the susceptibility profile for key antibiotics by type of UTI involving Escherichia coli from 2017 to 2020, using queries for UTI (Q-UTI) submitted to a French CDSS. We compared these results with those from the MedQual French surveillance system for community-acquired UTI and the European Antimicrobial Resistance Surveillance Network (EARS-NET) for invasive infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We collected 43\u200a591 Q-UTI, of which 10\u200a192 (23%) involved E. coli: 40% cystitis, 32% male-UTI, and 27% pyelonephritis. Resistance was 41.3% (95% CI, 40.3%\u201342.2%) for amoxicillin, 16.6% (95% CI, 15.9%\u201317.3%) for fluoroquinolones, 6.6% (95% CI, 6.1%\u20137.0%) for third-generation cephalosporins (3GC), and 5.7% (95% CI, 5.2%\u20136.1%) for aminoglycosides. Resistance to amoxicillin was lower than that reported in MedQual (42.7%, P value\u200a=\u200a0.004), and in EARS-NET (55.2%, P value\u200a&amp;lt;\u200a0.001). For fluoroquinolones, resistance was higher than in MedQual (12.0%, P value\u200a&amp;lt;\u200a0.001) and EARS-NET (15.8%, P value\u200a=\u200a0.041). In complicated pyelonephritis and male UTI, fluoroquinolone resistance peaked at \u223c20%. For 3GC, all UTI had higher resistance than in MedQual (3.5%, P value\u200a&amp;lt;\u200a0.001), but lower than in EARS-NET (9.5%, P value\u200a&amp;lt;\u200a0.001). Aminoglycoside resistance was not reported by MedQual, and was lower than in EARS-NET (7.1%, P value\u200a&amp;lt;\u200a0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>CDSS can inform prescribers in real-time about the ecology and surveillance of E. coli resistance in community-acquired UTI. In complicated upper UTIs, they can underline the risk of empirical use of fluoroquinolones and suggest preferential use of 3GC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkab392","type":"journal-article","created":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T11:21:42Z","timestamp":1633778502000},"page":"524-530","source":"Crossref","is-referenced-by-count":10,"title":["Computerized decision support system (CDSS) use for surveillance of antimicrobial resistance in urinary tract infections in primary care"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0165-8934","authenticated-orcid":false,"given":"Tristan","family":"Delory","sequence":"first","affiliation":[{"name":"Antibioclic Steering Committee, Paris, France"},{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019\u00c9pid\u00e9miologie et de Sant\u00e9 Publique, IPLESP, F-75012 Paris, France"},{"name":"Annecy-Genevois Hospital (CHANGE), DRCI, F-74370 Epagny-Metz-Tessy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josselin","family":"Le Bel","sequence":"additional","affiliation":[{"name":"Antibioclic Steering Committee, Paris, France"},{"name":"Department of General Practice, Universit\u00e9 de Paris, F-75018 Paris, France"},{"name":"UMR 1137, INSERM, IAME, F-75018 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Lariven","sequence":"additional","affiliation":[{"name":"Antibioclic Steering Committee, Paris, France"},{"name":"Department of Infectious and Tropical Diseases, AP-HP, Bichat Hospital, F-75018 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Peiffer-Smadja","sequence":"additional","affiliation":[{"name":"Antibioclic Steering Committee, Paris, France"},{"name":"UMR 1137, INSERM, IAME, F-75018 Paris, France"},{"name":"Department of Infectious and Tropical Diseases, AP-HP, Bichat Hospital, F-75018 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois-Xavier","family":"Lescure","sequence":"additional","affiliation":[{"name":"Antibioclic Steering Committee, Paris, France"},{"name":"UMR 1137, INSERM, IAME, F-75018 Paris, France"},{"name":"Department of Infectious and Tropical Diseases, AP-HP, Bichat Hospital, F-75018 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Bouvet","sequence":"additional","affiliation":[{"name":"Antibioclic Steering Committee, Paris, France"},{"name":"French National Authority for Health (HAS), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Jeanmougin","sequence":"additional","affiliation":[{"name":"Antibioclic Steering Committee, Paris, France"},{"name":"Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Tubach","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019\u00c9pid\u00e9miologie et de Sant\u00e9 Publique, IPLESP, F-75012 Paris, France"},{"name":"D\u00e9partement de Sant\u00e9 Publique, Centre de Pharmaco\u00e9pid\u00e9miologie (Cephepi), CIC-1901, AP-HP, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, F-75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Yves","family":"Bo\u00eblle","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019\u00c9pid\u00e9miologie et de Sant\u00e9 Publique, IPLESP, F-75012 Paris, France"},{"name":"Public Health Unit, AP-HP, Saint Antoine Hospital, F-75012, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,8]]},"reference":[{"key":"2022021008035637000_dkab392-B1","article-title":"Antimicrobial resistance and primary care","author":"World Health Organization","year":"2018"},{"key":"2022021008035637000_dkab392-B2","doi-asserted-by":"crossref","first-page":"2723","DOI":"10.1093\/jac\/dkw223","article-title":"Antimicrobial resistance surveillance in urinary tract infections in primary care","volume":"71","author":"Chin","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"2022021008035637000_dkab392-B3","doi-asserted-by":"crossref","first-page":"873","DOI":"10.3201\/eid1106.041160","article-title":"Integrating Escherichia coli Antimicrobial Susceptibility Data from Multiple Surveillance Programs","volume":"11","author":"Stelling","year":"2005","journal-title":"Emerg Infect 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Global action plan on antimicrobial resistance","year":"2016"},{"key":"2022021008035637000_dkab392-B6","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1093\/cid\/ciq257","article-title":"International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the infectious diseases society of America and the European society for microbiology and infectious diseases","volume":"52","author":"Gupta","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2022021008035637000_dkab392-B7","article-title":"Antimicrobial resistance in the EU\/EEA (EARS-Net) - Annual Epidemiological Report 2019","author":"European Centre for Disease Prevention and Control","year":"2020"},{"key":"2022021008035637000_dkab392-B8","author":"Observatoire National de l\u2019Epid\u00e9miologie de la R\u00e9sistance Bact\u00e9rienne aux Antibiotiques (ONERBA)","year":"2018"},{"key":"2022021008035637000_dkab392-B9","article-title":"Surveillance de la r\u00e9sistance bact\u00e9rienne aux antibiotiques en soins de ville et en \u00e9tablissements pour personnes \u00e2g\u00e9es d\u00e9pendantes. R\u00e9seau Primo: r\u00e9sultats 2018","author":"Mission Primo","year":"2019"},{"key":"2022021008035637000_dkab392-B10","author":"Mission Primo","year":"2021"},{"key":"2022021008035637000_dkab392-B11","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1093\/jac\/dkz543","article-title":"Can evidence-based decision support tools transform antibiotic management? A systematic review and meta-analyses","volume":"75","author":"Laka","year":"2020","journal-title":"J Antimicrob Chemother"},{"key":"2022021008035637000_dkab392-B12","first-page":"2353","article-title":"A computerized decision support system (CDSS) for antibiotic prescription in primary care-Antibioclic: implementation, adoption and sustainable use in the era of extended antimicrobial resistance","volume":"75","author":"Delory","year":"2020","journal-title":"J Antimicrob Chemother"},{"key":"2022021008035637000_dkab392-B13","author":"European Association of Urology. EAU Guidelines: Urological Infections","year":"2020"},{"key":"2022021008035637000_dkab392-B14","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.medmal.2018.03.005","article-title":"Practice guidelines for the management of adult community-acquired urinary tract infections","volume":"48","author":"Caron","year":"2018","journal-title":"Med Mal Infect"},{"key":"2022021008035637000_dkab392-B15","article-title":"Comit\u00e9 de l\u2019antibiogramme de la Soci\u00e9t\u00e9 Fran\u00e7aise de Microbiologie","author":"CASFM\/EUCAST","year":"2020"},{"key":"2022021008035637000_dkab392-B16","volume-title":"External Quality Assessment of Laboratory Performance - European Antimicrobial Resistance Surveillance Network (EARS-Net), 2019","author":"European Centre for Disease Prevention and Control","year":"2020"},{"key":"2022021008035637000_dkab392-B17","author":"French Ministry of Health. 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