Trimethoprim and ciprofloxacin resistance and prescribing in urinary tract infection associated with Escherichia coli: a multilevel model

Vellinga, Akke; Tansey, Sana; Hanahoe, Belinda; Bennett, Kathleen; Murphy, Andrew W.; Cormican, Martin

doi:10.1093/jac/dks222

Cited by 48 publications

(38 citation statements)

References 30 publications

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“…The isolates which are ESBL producers are usually known to be multidrug resistant organisms. They show less susceptibility to the quinolones also [9]. In our present study, we found this correlation.…”

Section: Referencessupporting

confidence: 86%

The Antibiotic Susceptibility Patterns of Uropathogenic Escherichia Coli , With Special Reference to the Fluoroquinolones

M²,

Yadav³

2013

JCDR

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Context: The emergence of drug resistance to trimethoprimsulfamethoxazole, the penicillins, cephalosporins, and fluoroquinolones by Uropathogenic Escherichia coli (UPEC) has limited the options for selecting the appropriate antibiotic for the treatment of urinary tract infections. Aims:The The E. coli isolates, which were obtained from the culture of urine samples,were studied for their antibiotic resistance patterns, with special reference to the antimicrobial activity of the fluoroquinolones and the production of the extended spectrum ß-lactamases. (ESBL), Settings and Design: This was a hospital based, prospective study which was done for a period of eighteen months. Material and Methods:This study was done by using the standard culture techniques for urine samples, the modified Kirby-Bauer disk diffusion method for the antibiotic susceptibility testing and the disk diffusion method to confirm the ESBL production by the clinical isolates of E. coli in urine. The sensitivity pattern was correlated with the clinical condition and the presence of the risk factors.The statistical analysis which was used: The statistical analysis was done by using the proportions of sensitive, resistant and intermediates. Descriptive statistics like the total, mean and percentage were done by using the Statistical Package for the Social Sciences (SPSS), version 15.0. Results:The hospital isolates showed high degrees of resistance to the penicillins, cephalosporins, nalidixic acid and the fluoroquinolones, with 59% of the isolates being ESBL producers. Conclusions:The incidence of the multidrug resistant strains of Escherichia coli has been steadily increasing over the past few years. The knowledge on the resistance pattern of the bacterial strains in a geographical area will help in guiding the appropriate and the judicious use of antibiotics. Also, the formulation of an appropriate hospital antibiotic policy will go a long way in controlling these infections.Abdul RAhAmAn ShARiff V A, SuchitRA Shenoy m, tARunA yAdAV, RAdhAKRiShnA m

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Section: Referencessupporting

confidence: 86%

The Antibiotic Susceptibility Patterns of Uropathogenic Escherichia Coli , With Special Reference to the Fluoroquinolones

M²,

Yadav³

2013

JCDR

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“…17 There have been only a few studies combining both levels of information for investigating antibiotic resistance. 18,24,30 In contrast to these studies, we chose to use more detailed information in our statistical models, which included multiple antibiotics and interaction with previous susceptible culture and calculated ward-level use for each patient-day in the hospital. Our results showed some important ward-level associations.…”

Section: Discussionmentioning

confidence: 99%

A New Approach to the Analysis of Antibiotic Resistance Data from Hospitals

Aşçıoğlu

Samore

Lipsitch

2014

Microbial Drug Resistance

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We aimed to develop a new approach to the analysis of antimicrobial resistance data from the hospitals, which allows simultaneous analysis of both individual- and population-level determinants of bacterial resistance. This was a retrospective cohort study that included adult patients who stayed in the hospital >2 days. We analyzed data using shared frailty Cox models and tested our approach using a priori hypotheses based on biology and epidemiology of antibiotic resistance. For gram-negative bacteria, the use of the major selecting antibiotic by an individual was the main risk factor for acquiring resistant species. Hazard ratios (HRs) were strikingly high for ceftazidime-resistant Enterobacter species (HR=11.17; 95% confidence interval [CI]: 5.67-22.02), ciprofloxacin-resistant Pseudomonas aeruginosa (HR=4.41; 95% CI: 2.14-9.08), and imipenem-resistant P. aeruginosa (HR=7.92; 95% CI: 4.35-14.43). Ward-level use was significant for vancomycin-resistant enterococci (VRE) (HR=1.40; 95% CI: 1.07-1.83) and for imipenem-resistant P. aeruginosa (HR=1.40; 95% CI: 1.08-1.83). Previous incidence of infection in the same ward increased the risk of acquiring methicillin-resistant Staphylococcus aureus (HR=1.22; 95% CI: 1.15-1.30) and VRE (HR=1.53; 95% CI: 1.38-1.70). Our results were consistent with our hypotheses and showed that combining population- and individual-level data is crucial for the exploration of antimicrobial resistance development.

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“…We based the power calculation on conservative estimates, according to active identification of patients by the general practitioners, similar to previous studies. 5 Given the passive consent approach, we decided to adhere to the timelines set out in the protocol, which resulted in a larger sample size than planned. Note: FTE = full-time equivalent, GP = general practitioner, SD = standard deviation, UTI = urinary tract infection.…”

Section: Deviations From Protocolmentioning

confidence: 99%

Intervention to improve the quality of antimicrobial prescribing for urinary tract infection: a cluster randomized trial

Vellinga¹,

Galvin²,

Duane³

et al. 2015

CMAJ

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Trimethoprim and ciprofloxacin resistance and prescribing in urinary tract infection associated with Escherichia coli: a multilevel model

Cited by 48 publications

References 30 publications

The Antibiotic Susceptibility Patterns of Uropathogenic Escherichia Coli , With Special Reference to the Fluoroquinolones

The Antibiotic Susceptibility Patterns of Uropathogenic Escherichia Coli , With Special Reference to the Fluoroquinolones

A New Approach to the Analysis of Antibiotic Resistance Data from Hospitals

Intervention to improve the quality of antimicrobial prescribing for urinary tract infection: a cluster randomized trial

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