Bacterial epidemiology of male urinary tract infections in France: An expert review - 26/08/26

on behalf on the IUMACA study group 1
Abstract |
Urinary tract infections (UTIs) in men, though less frequent than in women, represent a significant clinical challenge due to their increasing incidence with age and distinct microbiological profiles. This expert review analyzed data of urine cultures in men with community-acquired UTIs, collected from emergency departments of 15 french hospitals, from the private laboratory group Atoutbio (21 sites in Meurthe-et-Moselle and the Vosges French departments, alongside primary care records from the AntibioClic tool and the PRIMO database, to characterize the bacterial epidemiology of community-acquired male UTIs in France. Escherichia coli (39–40%) dominated, followed by Enterococcus faecalis (13–15%), Klebsiella pneumoniae (6–8%), and Proteus mirabilis (5–6%). Resistance rates were as follows amoxicillin (47–53.5%), amoxicillin-clavulanate (24–35.7%), trimethoprim-sulfamethoxazole (25.4–31.5%), and fluoroquinolones (16.3–20.2%). Resistance to third-generation cephalosporins (6.6–9.3%) and mecillinam (6.8–8.9%) was lower, while fosfomycin (1.4–1.5%) and nitrofurantoin (0.4–0.7%) retained high susceptibility. Extended-spectrum β-lactamase (ESBL)-producing E. coli ranged from 2 to 8.4%, with carbapenemase producers remaining rare (0.1%). Resistance was higher in men > 65 years, particularly in nursing homes, where 3GC resistance reached 15–18%. « Emerging uropathogens » ( Aerococcus urinae 1–1.1%, Actinotignum schaalii 0.1–0.4%) were rare. This study highlights the greater microbial diversity in male UTIs compared to women and underscores the need for systematic urine culture, susceptibility testing, and empirical therapy tailored to resistance patterns, age, and risk factors.
Le texte complet de cet article est disponible en PDF.Highlights |
• | E. coli (39–40%), Enterococcus faecalis (13–15%), Klebsiella pneumoniae (6–8%), and Proteus mirabilis (5–6%) are the most common in male community-acquired UTIs. |
• | E. coli shows high resistance to amoxicillin (47–53.5%), amoxicillin-clavulanate (24–35.7%), 3rd-generation, TMP-SMX (25.4–31.5%), and fluoroquinolones (16.3–20.2%). |
• | E. coli remains susceptible to fosfomycin (1.4–1.5%), mecillinam (6.8–8.9%), and nitrofurantoin (0.4–0.7%). |
• | Men over 65, especially in nursing homes, have higher E. coli resistance to 3rd-gen cephalosporins (15–18%). |
Keywords : Epidemiology, Urinary tract infection, Men, Bacterial resistance
Plan
Vol 56 - N° 6S
Article 105317- août 2026 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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