Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae: The Role of Prior Exposure to Fluoroquinolones

Martínez-Casanova, Javier; Gómez-Zorrilla, Sílvia; Prim, Núria; Molin, Agustina Dal; Echeverría-Esnal, Daniel; Gracia-Arnillas, María Pilar; Sendra, Elena; Güerri‐Fernández, Robert; Duran, Xavier; Padilla, Eduardo; Horcajada, Juan Pablo; Grau, Santiago

doi:10.3390/antibiotics10050582

Cited by 11 publications

(4 citation statements)

References 29 publications

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“…This agent is considered an adequate empiric treatment for UTIs in specific patient groups like children, elderly patients, or during pregnancy. Similar to our results were reported by Martínez-Casanova and Gaspari (7,8).…”

Section: Discussionsupporting

confidence: 93%

Etiological spectrum and antimicrobial resistance of the most frequently isolated pathogens, associated with urinary tract infections in ambulatory patients

Snegarova-Toneva

Ermenlieva²,

Niyazi³

et al. 2022

SSM

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INTRODUCTION: Urinary tract infections (UTIs) are among the most common infections both in the community and in the hospital setting. AIM: The aim of this study is to investigate the etiological spectrum and antimicrobial resistance of most frequently isolated pathogens, associated with UTIs in ambulatory patients in Varna city, Bulgaria during a seven-month period (October 2020-April 2021). MATERIALS AND METHODS: A total of 1600 urine samples, collected from patients with suspected UTIs were tested. Screening for bacterial growth was done by HM&L Uroquattro instrument (ALIFAX, Italy). Species identification and antimicrobial susceptibility testing were performed by VITEK 2 Compact System (bioMerieux) and Kirby-Bauer disk diffusion method.RESULTS: E. coli was the most commonly isolated uropathogen regardless of the age group (48%, n=61), followed by Enterococcus faecalis (33%, n=42) and other representatives of order Enterobacterales (13.3%, n=18). The resistance rates in the group of Gram-negative isolates (n=79) in decreasing order were as follows: ampicillin, 64.5% > trimethoprim/sulfamethoxazole, 36% > ciprofloxacin, 29.1% > amoxicillin-clavulanic acid, 27.8% > cefuroxime, levofloxacin, 21.5% > fosfomycin, 13.1% > ceftriaxone, 12.6% > ceftazidime, 10.1% > gentamicin, nitrofurantoin, 6.5% > nitroxoline, 4.9%. The resistance rates among the isolates of E. faecalis (n=42) were as follows: ciprofloxacin, 28.6% > gentamicin, 23.8% > levofloxacin, 19% > nitrofurantoin, 4.7% > amoxicillin, 2.4%. No resistance to meropenem, amikacin, vancomycin, and teicoplanin was found in the studied collection of isolates (n=127). CONCLUSION:The etiological spectrum of UTIs in ambulatory patients was dominated by E. coli, followed by E. faecalis. In the group of Gram-negative uropathogens, high resistance rates to ampicillin, trimethoprim/sulfamethoxazole and quinolones were detected. Third-generation cephalosporins, fosfomycin, nitrofurantoin

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Section: Discussionsupporting

confidence: 93%

Etiological spectrum and antimicrobial resistance of the most frequently isolated pathogens, associated with urinary tract infections in ambulatory patients

Snegarova-Toneva

Ermenlieva²,

Niyazi³

et al. 2022

SSM

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“…Amoxicillin/clavulanic acid is among the ABs commonly used to treat uncomplicated UTI. In this study, we found a high level of resistance (37.3%-47.1%) to amoxicillin/clavulanic acid in Enterobacterales, which could endanger its future empirical use for treatment of UTIs [36] as happened with amoxicillin alone, whose use in uncomplicated UTI is no longer recommended [29].…”

Section: Discussionmentioning

confidence: 99%

Predominance of multidrug-resistant (MDR) bacteria causing urinary tract infections (UTIs) among symptomatic patients in East Africa: a call for action

Maldonado‐Barragán

Mshana

Keenan

et al. 2023

Preprint

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In low- and middle-income countries, antibiotics are often prescribed for patients with symptoms of urinary tract infections (UTIs) without microbiological confirmation. Inappropriate antibiotic use can contribute to antimicrobial resistance (AMR) and the selection of multi-drug resistant (MDR) bacteria. Data on antibiotic susceptibility patterns of cultured bacteria are important in drafting empirical treatment guidelines and monitoring resistance trends, which can prevent the spread of AMR. In East Africa, antibiotic susceptibility data are sparse. To fill the gap, this study reports common microorganisms and their susceptibility patterns isolated from patients with UTI-like symptoms in Kenya, Tanzania, and Uganda in 2019-2020. Microbiologically confirmed UTI was observed in 2,653 (35.0%) of the 7583 patients studied. The predominant bacteria were Escherichia coli (37.0%), Staphylococcus spp. (26.3%), Klebsiella spp. (5.8%) and Enterococcus spp. (5.5%). E. coli contributed 982 of the isolates with an MDR proportion of 52.2%. Staphylococcus spp. contributed 697 of the isolates with an MDR rate of 60.3%. The overall proportion of MDR bacteria (n=1,153) was 50.9%. MDR bacteria are common causes of UTI in patients attending healthcare centres in East African countries, which emphasizes the need for investment in laboratory culture capacities and diagnostic algorithms to improve accuracy of diagnosis that will lead to appropriate antibiotic uses to prevent and control AMR.

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“…Clavulanic acid is a -lactamase inhibitor that can protect amoxicillin from betalactamase hydrolysis reactions (Pratiwi, 2017). However, a study reported that Escherichia coli and Klebsiella pneumoniae were resistant to Amoxicillin-clavulanate (Martínez-Casanova et al, 2021). Drug Utilization (DU 90%) can be interpreted as a list of drugs that are included in the accumulation of 90% of drug use in a location.…”

Section: Quantitative Analysis Of Antibiotic Usementioning

confidence: 99%

Quantitative Evaluation of Antibiotics Use Trend in One Puskesmas in Bengkulu City: ATC/DDD and DU 90% Methods

Muslim,

Amesta,

Susilo

2023

Pharm. : j. farm. Indones.

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Irrational use of antibiotics results in decreased effectiveness of antibiotics due to inappropriate use of therapeutic doses or methods of use. This causes the bacteria to become resistant to antibiotic therapy. Periodic evaluation of antibiotic use is necessary. This study aims to evaluate the use of antibiotics quantitatively in one of the Puskesmas in Bengkulu City in 2021. This type of research is descriptive research. The sample used is an antibiotic prescription in 2021 and is taken by total sampling. This research uses the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) and Drugs Utilization 90% (DU 90%) methods. The results obtained were the number of prescriptions containing antibiotics as many as 1422 prescriptions (18.40%) of the total prescriptions (7730 prescriptions). The antibiotic prescriptions consisted of 1205 prescriptions for oral preparations and 217 prescriptions for topical preparations. There are 9 types of antibiotics used during 2021, namely Amoxicillin, Ciprofloxacin, Cefixime, Chloramphenicol, Gentamicin, Oxytetracycline, Levofloxacin, Tetracycline, and Tiamphenicol. The most widely used antibiotic was Amoxicillin (92.28%) with a DDDs per 1000 inhabitants per day value of 429.27 followed by Ciprofloxacin (5.06%) with a DDD value of 30.47. So it can be concluded that the most use of antibiotics in 2021 in one of the Puskesmas in Bengkulu City is Amoxicillin.

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Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae: The Role of Prior Exposure to Fluoroquinolones

Cited by 11 publications

References 29 publications

Etiological spectrum and antimicrobial resistance of the most frequently isolated pathogens, associated with urinary tract infections in ambulatory patients

Etiological spectrum and antimicrobial resistance of the most frequently isolated pathogens, associated with urinary tract infections in ambulatory patients

Predominance of multidrug-resistant (MDR) bacteria causing urinary tract infections (UTIs) among symptomatic patients in East Africa: a call for action

Quantitative Evaluation of Antibiotics Use Trend in One Puskesmas in Bengkulu City: ATC/DDD and DU 90% Methods

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