<i>Escherichia coli</i>
            antimicrobial susceptibility profile and cumulative antibiogram to guide empirical treatment of uncomplicated urinary tract infections in women in the province of Québec, 2010–15

Delisle, Gaelle A; Quach, Caroline; Domingo, Marc-Christian; Boudreault, Alexandre A.; Gourdeau, Marie; Bernatchez, Harold; Lavallée, Christian

doi:10.1093/jac/dkw302

Cited by 14 publications

(14 citation statements)

References 15 publications

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“…1 ) and 1,513 remained after removal of duplicates. After a review of titles and abstracts, 333 articles were selected for review of the full text, and during this process, 2 other articles were identified from bibliographies ( 24 , 25 ). Following examination of the full text, there were 40 articles reporting data from 38 studies that met the eligibility criteria (results of 1 study were published in 2 different journals, and a subgroup analysis of 1 study was published separately from the primary findings).…”

Section: Resultsmentioning

confidence: 99%

“…Six articles concerned studies conducted in North America ( 2 , 25 , 35 – 38 ), and one in particular from Canada allows an insight into changing resistance to ciprofloxacin in this region. In the report by Delisle et al of data from the same primary care, emergency department, and outpatient settings tracked ciprofloxacin resistance from 2010 to 2014 and showed only a slight increase in resistance from 7.9% to 9.7% (although the authors stated that this was a statistically significant change) ( 25 ). In emergency department data from Canada in 2008, resistance to ciprofloxacin was reported in 8.9% of E. coli isolates tested ( 36 ), compared with 2.8% in a separate US outpatient study (2005 to 2007) ( 35 ).…”

Section: Resultsmentioning

confidence: 99%

“…Resistance to fluoroquinolones was most common in Asia (particularly China and Korea) where data from separate studies show a substantial increase in resistance to ciprofloxacin between 2008 and 2014 ( 3 , 23 , 39 – 45 ). A few articles from studies using similar methodologies provided evidence of how rates of resistance to fluoroquinolones have changed over time in Europe ( 4 , 24 , 27 – 34 ) and North America ( 2 , 25 , 35 – 38 ), and they report clear differences from those in Asia with respect to absolute percentages of resistant isolates and also the magnitude of change over time.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Escherichia coli Resistance to Fluoroquinolones in Community-Acquired Uncomplicated Urinary Tract Infection in Women: a Systematic Review

Stapleton

Wagenlehner

Mulgirigama³

et al. 2020

Antimicrob Agents Chemother

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Antibiotic resistance represents a threat to public health, and uncomplicated urinary tract infections (uUTIs) are an example of this concern. This systematic review (PROSPERO ID: CRD42020156674) is the first to determine the prevalence of E. coli resistance to fluoroquinolones in women with community-acquired uUTI. PubMed and Embase searches were conducted, 38 studies fulfilled eligibility criteria and were included in the systematic review. Within Europe, ciprofloxacin resistance in E. coli isolates varied between countries, and increased in some between 2006–8 and 2014–16, specifically in the UK (0.5% to 15.3%), Germany (8.7% to 15.1%), and Spain (22.9% to 30.8%), although methodologies and settings were often not comparable. In Asia there was a substantial increase in ciprofloxacin resistance during 2008–14 from 25% to more than 40%. In North America, resistance to ciprofloxacin also increased between 2008–2017, from 4% to 12%. Data exploring different age groups did not show a consistent relationship with resistance, whereas two studies found that fluoroquinolone resistance was higher in postmenopausal women than premenopausal women. One study indicated a link between fluoroquinolone resistance and uUTI recurrence. These findings may have implications for empirical treatment of uUTI with fluoroquinolones globally, but more data are needed to fully understand regional situations and impact on patient management.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Escherichia coli Resistance to Fluoroquinolones in Community-Acquired Uncomplicated Urinary Tract Infection in Women: a Systematic Review

Stapleton

Wagenlehner

Mulgirigama³

et al. 2020

Antimicrob Agents Chemother

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“…12 The simplicity of using geographic location as the main demarcation to generate a combined antibiogram can allow referral laboratories or state-based healthcare-associated infection antibiotic resistance prevention programs to produce simple regional nursing home antibiograms to inform nursing home antibiotic stewardship programs. [16][17][18][19] This study has several limitations. First, our study was not intended to provide individual providers with prescribing recommendations.…”

Section: Discussionmentioning

confidence: 99%

Creating reasonable antibiograms for antibiotic stewardship programs in nursing homes: Analysis of 260 facilities in a large geographic region, 2016–2017

Fridkin

Pack²,

Licitra

et al. 2019

Infect. Control Hosp. Epidemiol.

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Objective:To determine the best nursing home facility characteristics for aggregating antibiotic susceptibility testing results across nursing homes to produce a useful annual antibiogram that nursing homes can use in their antimicrobial stewardship programs.Design:Derivation cohort study.Setting:Center for Medicare and Medicaid Services (CMS) certified skilled nursing facilities in Georgia (N = 231).Participants:All residents of eligible facilities submitting urine culture specimens for microbiologic testing at a regional referral laboratory.Methods:Crude and adjusted metrics of antibiotic resistance prevalence (percent of isolates testing susceptible) for 5 bacterial species commonly recovered from urine specimens were calculated using mixed linear models to determine which facility characteristics were predictive of testing antibiotic susceptibility.Results:In a single year, most facilities had an insufficient number of isolates tested to create facility-specific antibiograms: 49% of facilities had sufficient Escherichia coli isolates tested, but only about 1 in 10 had sufficient isolates of Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, or Pseudomonas aeruginosa. After accounting for antibiotic tested and age of the patient, facility characteristics predictive of susceptibility were: E. coli, region, year, average length of stay; K. pneumoniae, region, bed size; P. mirabilis, region; and for E. faecalis or P. aerginosa no facility parameter remained in the model.Conclusions:Nursing homes often have insufficient data to create facility-specific antibiograms; aggregating data across nursing homes in a region is a statistically sound approach to overcoming data shortages in nursing home stewardship programs.

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“…4 Previous studies have compiled “geographically focused” antibiograms including data from both tertiary-care and community hospitals. Unfortunately, the results of such efforts typically involve more isolates from tertiary-care centers, skewing susceptibility patterns toward facilities with more intensive care unit (ICU) beds and higher local prevalence of antimicrobial-resistant pathogens.…”

mentioning

confidence: 99%

Feasibility and Value of Developing a Regional Antibiogram for Community Hospitals

Hostler

Moehring

Ashley

et al. 2018

Infect. Control Hosp. Epidemiol.

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OBJECTIVETo determine the feasibility and value of developing a regional antibiogram for community hospitals.DESIGNMulticenter retrospective analysis of antibiograms.SETTING AND PARTICIPANTSA total of 20 community hospitals in central and eastern North Carolina and south central Virginia participated in this study.METHODSWe combined antibiogram data from participating hospitals for 13 clinically relevant gram-negative pathogen-antibiotic combinations. From this combined antibiogram, we developed a regional antibiogram based on the mean susceptibilities of the combined data.RESULTSWe combined a total of 69,778 bacterial isolates across 13 clinically relevant gram-negative pathogen-antibiotic combinations (median for each combination, 1100; range, 174-27,428). Across all pathogen-antibiotic combinations, 69% of local susceptibility rates fell within 1 SD of the regional mean susceptibility rate, and 97% of local susceptibilities fell within 2 SD of the regional mean susceptibility rate. No individual hospital had >1 pathogen-antibiotic combination with a local susceptibility rate >2 SD of the regional mean susceptibility rate. All hospitals' local susceptibility rates were within 2 SD of the regional mean susceptibility rate for low-prevalence pathogens (<500 isolates cumulative for the region).CONCLUSIONSSmall community hospitals frequently cannot develop an accurate antibiogram due to a paucity of local data. A regional antibiogram is likely to provide clinically useful information to community hospitals for low-prevalence pathogens.Infect Control Hosp Epidemiol 2018;39:718-722.

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Escherichia coli antimicrobial susceptibility profile and cumulative antibiogram to guide empirical treatment of uncomplicated urinary tract infections in women in the province of Québec, 2010–15

Cited by 14 publications

References 15 publications

Escherichia coli Resistance to Fluoroquinolones in Community-Acquired Uncomplicated Urinary Tract Infection in Women: a Systematic Review

Escherichia coli Resistance to Fluoroquinolones in Community-Acquired Uncomplicated Urinary Tract Infection in Women: a Systematic Review

Creating reasonable antibiograms for antibiotic stewardship programs in nursing homes: Analysis of 260 facilities in a large geographic region, 2016–2017

Feasibility and Value of Developing a Regional Antibiogram for Community Hospitals

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