Antibiotic resistance patterns of more than 120 000 clinical Escherichia coli isolates in Southeast Austria, 1998–2013

Abstract

Antibiotic resistance patterns of more than 120 000 clinical Escherichia coli isolates were retrospectively analysed. Isolates originated from both hospitalized patients and outpatients from the region of southeast Austria from 1998 to 2013. Except for amoxicillin/clavulanic acid, nitrofurantoin and piperacillin/tazobactam, all of the antibiotics analysed showed increasing proportions of resistant isolates over time, which were most prominent for ampicillin (from 25.4% in 1998 to 40% in 2013), cefotaxime (0.1% to 6.7%), ceftazidime (0.3% to 14.2%), ciprofloxacin (4.3% to 16.7%) and trimethoprim/sulfamethoxazole (14.6% to 24.8%). There was a marked increase in extended-spectrum β-lactamase-positive isolates (0.1% to 6.3%) starting in 2005, with male patients and hospital-related patients showing a higher increase than female patients and outpatients. Proportions of resistant isolates for most antibiotics were generally higher for male patients and hospital-related patients. Amikacin, nitrofurantoin and trimethoprim/sulfamethoxazole showed a marked increase in resistance proportions among male subjects aged 10 to 19 years which were absent for female subjects, indicating a strong modulation potential of host characteristics.

Susceptibility of Austrian Clinical Klebsiella and Enterobacter Isolates Linked to Patient-Related Data

“…The highest resistance percentages for the majority of antibiotics analyzed can be shown for both pathogen groups originating from blood infections. This is in accordance with previous statistical analyses on the association of the infection site and Escherichia coli susceptibility profiles ( Miguel Sahuquillo-Arce et al, 2011 ; Badura et al, 2015 ). As reported for Escherichia coli , Klebsiella sp.…”

“…isolates were included in the present analysis. The study design of this retrospective observational study (data origin, laboratory methods, and statistical analysis) is largely similar to our previous report on E. coli ( Badura et al, 2015 ). Data were retrieved from the Laboratory of Medical Bacteriology and Mycology of the Medical University of Graz, Austria from January 1998 to March 2014.…”

“…All isolates had been tested for antibiotic susceptibilities in the routine microbiology laboratory in the same way as reported in a previous study using the disk diffusion method or a VITEK 2 system (bioMérieux, Marcy l’Etoile France) ( Badura et al, 2015 ). From January 1st, 1998 to May 31st, 2011 results were interpreted using the criteria recommended by the Clinical and Laboratory Standards Institute (CLSI), formerly known as National Committee for Clinical Laboratory Standards (NCCLS) ( CLSI, 2012 ).…”

“…Multivariate statistical analysis further allows studying possible relationships between antimicrobial resistance data and patient-related factors; however, there are only a limited number of studies up to now on that issue mainly dealing with Escherichia coli . The main findings of these studies are that susceptibilities to several antimicrobial agents are strongly depending on infection site as well as patient location (hospital/community), gender and age ( Livermore et al, 2003 ; Miguel Sahuquillo-Arce et al, 2011 ; Badura et al, 2015 ). Under the hypothesis that the same is true for Klebsiella sp.…”

The Rise of Antimicrobial Resistance in Mass Gatherings

“…The proportion of AMR E. coli at Hajj is greater than the global average. Globally, the proportion of E. coli that are resistant to imipenem is 1% (Badura et al 2015;Lien et al 2017), to piperacillin/tazobactam is 0.02-0.8% (Badura et al 2015;Gonzalez and Cortes 2014), and to ampicillin is 40-82.1% (Badura et al 2015;Randrianirina et al 2014).…”