National surveillance of antibiotic resistance in community and healthcare settings is conducted by the Primo initiative under the auspices of Santé publique France. This surveillance relies on the MedQual-Ville e-tool, which enables the prospective collection of data on antibiotic resistance in Enterobacteriaceae strains isolated within a broad network of community clinical laboratories. In 2018, a total of 421,353 antibiotic susceptibility tests performed on Enterobacteriaceae strains (90.4% Escherichia coli and 6.1% Klebsiella pneumoniae) from urine samples were provided by the 742 LBMs in 11 regions of mainland France participating in the Primo network. Within this population, 3.2% of E. coli strains isolated from home-bound patients were resistant to third-generation cephalosporins, of which 2.8% were due to extended-spectrum beta-lactamase (ESBL) production, compared to 7.7% of those isolated from residents of long-term care facilities (LTCFs) not affiliated with a healthcare facility. The annual proportions of ESBL-producing E. coli in LTCFs or in the community increased from 2012 to 2015 and then declined. Regarding fluoroquinolone resistance in E. coli, it affected 11% of strains isolated from home-bound patients and 18.7% of those isolated from nursing home residents. The annual proportions of fluoroquinolone resistance remained stable in the community, while they decreased from 2015 to 2018 in nursing homes. For K. pneumoniae, ESBL production was observed in 7.2% of strains isolated from outpatients and 18.8% of those isolated from nursing home residents; the proportion of fluoroquinolone-resistant strains was 10.8% and 24.3%, respectively. The Primo surveillance system provides insights into the bacterial ecology in urban and medical-social sectors, where 93% of antibiotics are consumed. These data suggest a reversal of the upward trends in antibiotic resistance observed to date and call for expanded efforts to control antibiotic resistance in these two sectors.