Urinary tract infections (UTI), mainly driven by Gram-negative bacteria (GNB) are a frequent cause of hospitalization and the second cause of antibiotic prescription after lower respiratory tract infections. Integrons play a major role in the dissemination of antibiotic resistance among GNB. In the prospective INVICTUS project, whose ultimate objective is to reduce the use of large broad-spectrum antibiotics, our hypothesis is that, in adult patients with a non-severe UTI (qSOFA\<2) and a former documentation with a 3GC-resistant GNB in the previous 6 months, integrons search could reduce the empirical use of large broad-spectrum antibiotics.
Age ≥ 18 years old; Hospitalized or admitted to the Emergency department;
Diagnosis of non-severe (qSOFA < 2) urinary tract infection coupled with fever ≥ 38°C or < 36°C
Presence of bacteria in the fresh urine sample and/or GNB on the Gram stain
Empirical parenteral antibiotic therapy required; Hospitalization required;
Pregnant and/or breastfeeding
Neutropenia (absolute neutrophil count < 500 / mm3)
Severe UTI with sepsis (qSOFA ≥ 2) or septic shock
Urinary derivation required (ureteral catheter/per-cutaneous nephrostomy) except for simple urinary catheterization