: placing resistance to third-generation cephalosporins and fluoroquinolones in Australia and New Zealand into perspective

Abstract

At least 300 million urinary tract infections (UTIs) occur annually worldwide. Uropathogenic Escherichia coli (UPEC) are the leading cause of UTIs. The discovery of antibiotics has revolutionised modern medicine. Yet, overusing antibiotics has accelerated the emergence of antimicrobial resistance (AMR), with UPEC driving the dissemination of AMR globally. Resistance to broad-spectrum antibiotics like third-generation cephalosporins (3GCs) and fluoroquinolones threatens public health. Extended-spectrum b-lactamase (ESBL)-producing E. coli precipitate resistance, particularly when these antibiotics are used as empirical therapies against UPEC. In response, the Centers for Disease Control and Prevention in the United States have listed ESBL-producing Enterobacterales, such as E. coli as a severe threat. Additionally, the World Health Organization have classified 3GCs and fluoroquinolones as the highest priority (critically important antimicrobials), where these therapies are only recommended following susceptibility testing. The present report demonstrates the distributions of E. coli cases with resistance to 3GC and fluoroquinolones in Australia and New Zealand and contextualises trends with European reports. This investigation emphasises the value of epidemiology and the justification of evidence-based interventions using data as an essential resource for reducing resistance to our 'first-line' antibiotics.

A study of Uropathogenic Escherichia coli from men in regional NSW (Australia) with special emphasis on antibiotic resistance

“…The prevalence of antibiotic resistance among the present isolates, with 42% and 73% of the isolates being resistant to one or more antibiotics, for cystitis and pyelonephritis, respectively, is modest compared to other jurisdictions with much higher rates, albeit limited number of studies and isolates [19].Over the last 15 to 20 years, antibiotic surveillance programs have shown reductions in the use of antibiotic drugs in Australia [20], Slovakia [21], and Sweden [22].Thus, our results probably re ect more conservative antibiotic prescribing and consumption practices in Australia than in many other countries. Unfortunately, similar previous studies describing associations between age group and antimicrobial resistance rates in males, with which to compare the current data, are quite scarce in literature.…”

A study of uropathogenic Escherichia coli from men in regional NSW (Australia) with special emphasis on antibiotic resistance

“…The prevalence of antibiotic resistance among the present isolates, with 42% and 73% of the isolates being resistant to one or more antibiotics, for cystitis and pyelonephritis, respectively, is modest compared to other jurisdictions with much higher rates, albeit limited number of studies and isolates. 19 Over the last 15 to 20 years, antibiotic surveillance programs have shown reductions in the use of antibiotic drugs in Australia, 20 Slovakia, 21 and Sweden. 22 Thus, our results probably reflect more conservative antibiotic prescribing and consumption practices in Australia than in many other countries.…”

Genomic epidemiology reveals geographical clustering of multidrug-resistant Escherichia coli ST131 associated with bacteraemia in Wales

“…Increasing rates of AMR can lead to treatment failures and progression to systemic bacteraemia infections. Additionally, the emergence and dissemination of UPEC strains encoding AMR are causing economic damage to countries and healthcare systems 1 , 2 . Incidences of E. coli- associated bacteraemia are increasing globally.…”