INterest of the Negative Predictive Value of Integrons in the reduCtion of Large Broad-spectrum anTibiotics Consumption for Urinary Tract infectionS

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\

Inclusion Criteria: * 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; * Former documentation of a 3GC-resistant GNB on a microbiological sample in the previous six months * Informed consent of the patient or their representative Exclusion Criteria: * 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 * Known allergy to β-lactams * Patients with a former documentation with carbapenemase-producing Enterobacterales in the last 6 months * Ongoing antibiotic treatment with 3GC, piperacillin-tazobactam or carbapenem * Not affiliated to Social Security