Factors associated with ciprofloxacin- and cefotaxime-resistant Escherichia coli in women with acute pyelonephritis in the emergency department

Title
Factors associated with ciprofloxacin- and cefotaxime-resistant Escherichia coli in women with acute pyelonephritis in the emergency department
Author(s)
허지안박경화[박경화]오원섭[오원섭]김의석[김의석]박상원[박상원]김영근[김영근]문치숙[문치숙]이재훈[이재훈]이창섭[이창섭]김백남[김백남]
Keywords
URINARY-TRACT-INFECTION; SPECTRUM BETA-LACTAMASE; ONSET ACUTE PYELONEPHRITIS; RISK-FACTORS; ANTIMICROBIAL SUSCEPTIBILITY; FLUOROQUINOLONE RESISTANCE; NONHOSPITALIZED PATIENTS; UNITED-STATES; COMMUNITY; STRAINS
Issue Date
201406
Publisher
ELSEVIER SCI LTD
Citation
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, v.23, pp.8 - 13
Abstract
Background: High rates of antimicrobial resistance in Escherichia coli isolated from patients with urinary tract infections have been reported worldwide. The aim of this study was to identify risk factors for resistance to ciprofloxacin (CIP) and cefotaxime (CTX) in E. coli isolated from patients with acute pyelonephritis (APN). Methods: We prospectively identified women over 18 y of age who visited the emergency department of one of 10 hospitals with APN and whose urine culture grew E. coli. The study was conducted from April 16 to June 10, 2012. Results: Of the 229 patients identified, 173 (75.5%) had community-associated (CA) infections and 56 (24.5%) had healthcare-associated (HCA) infections. Sixty-seven isolates (29.3%) were resistant to CIP, 45 (19.7%) to CTX, and 29 (12.7%) to both CIP and CTX. Multivariate analyses revealed that hematologic disease, chronic kidney disease, a bed-ridden state, indwelling urinary catheter, antibiotic treatment in the preceding 3 months, and isolation of CIP-resistant E. coli in the urine within the preceding 3 months, were significantly associated with resistance to both CIP and CTX. Conclusions: Chronic conditions and healthcare-associated factors were related to resistance to both fluoroquinolones and third-generation cephalosporins in women with APN. Continued and vigilant surveillance is necessary to monitor the dissemination of antimicrobial resistance in uropathogens. (C) 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
URI
http://hdl.handle.net/YU.REPOSITORY/31904http://dx.doi.org/10.1016/j.ijid.2013.12.021
ISSN
1201-9712
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의과대학 > 내과학교실 > Articles
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