Temporal Changes in the Prevalence of Community-Acquired Antimicrobial-Resistant Urinary Tract Infection Affected by Escherichia coli Clonal Group Composition

Smith, Sherry P.; Manges, Amee R.; Riley, Lee W.

doi:10.1086/527386

Cited by 52 publications

(45 citation statements)

References 23 publications

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“…This increase in resistance among E coli in the community has been reported in numerous studies 3,4,[39][40][41] and may be due to several factors, including increasing reliance on outpatient medical management, increasing antimicrobial use in the outpatient setting, transmission of drug-resistant strains from the hospital into the community, or expansion of drug-resistant clones within the community. 3,14,18,42 Because resistance to fluoroquinolone and fluoroquinolone plus trimethoprim-sulfamethoxazole increased more markedly than resistance to other antibiotics among our E coli isolates from 2005 through 2009, we hypothesize that there has been expansion of drug-resistant clones within Olmsted County. In the United States, more than half of E coli with resistance to fluoroquinolones or fluoroquinolones plus trimethoprim-sulfamethoxazole are sequence type 131, 1 a highly drug-resistant and globally disseminated clonal group first reported in 2008.…”

Section: Discussionmentioning

confidence: 99%

“…2,6 In addition, extended-spectrum ␤-lactamase and carbapenemase-producing E coli strains, such as were historically associated with nosocomial or health care-associated (HA) infections, are now prevalent in the community. 2,6,[12][13][14] Most studies that have examined antibiotic resistance among E coli isolates have included convenience samples, 1,2,4,5,[15][16][17][18][19] and only 2 have been population based. 20,21 Thus, it is unclear whether the increase in antibiotic-resistant E coli infections is disproportionately affecting specific patient groups.…”

Section: -11mentioning

confidence: 99%

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Incidence of Antibiotic-Resistant Escherichia coli Bacteriuria According to Age and Location of Onset: A Population-Based Study From Olmsted County, Minnesota

Swami

Liesinger

Shah

et al. 2012

Mayo Clinic Proceedings

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Objective: To better understand the epidemiology of drug-resistant Escherichia coli across health care and community settings. Patients and Methods:We conducted a population-based cohort study of the incidence of antibiotic-resistant E coli bacteriuria among different patient groups. All urine cultures with monomicrobial growth of E coli obtained from Olmsted County, Minnesota, residents from January 1, 2005, through December 31, 2009, were identified. The initial isolate per patient per year was included. Analyses were stratified by patient age and location of infection onset (ie, nosocomial, health care associated, and community associated). Results: We evaluated 5619 E coli isolates and the associated patients. During the study period, the incidence of drug-resistant bacteriuria did not change among children but increased significantly among adults of all ages, most markedly among elderly patients older than 80 years. In elderly patients, the incidence of bacteriuria with isolates resistant to fluoroquinolones increased from 464 to 1116 per 100,000 person-years (PϽ.001), and the incidence of bacteriuria with isolates resistant to fluoroquinolones plus trimethoprim-sulfamethoxazole increased from 274 to 512 per 100,000 person-years (PϽ.05). When analyzed by location of infection onset, incidence of bacteriuria with isolates resistant to trimethoprim-sulfamethoxazole, fluoroquinolones, trimethoprim-sulfamethoxazole plus fluoroquinolones, extended-spectrum cephalosporins, and more than 3 drug classes increased significantly among communityassociated but not among nosocomial or health care-associated cases. Conclusion: In this population-based study, the incidence of antibiotic-resistant E coli bacteriuria nearly doubled during the 5-year study period among elderly patients and those with community-associated isolates. These patient groups should be targets of interventions to slow the emergence and spread of antibiotic-resistant E coli.

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Section: Discussionmentioning

confidence: 99%

Section: -11mentioning

confidence: 99%

Incidence of Antibiotic-Resistant Escherichia coli Bacteriuria According to Age and Location of Onset: A Population-Based Study From Olmsted County, Minnesota

Swami

Liesinger

Shah

et al. 2012

Mayo Clinic Proceedings

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“…Some authors have therefore emphasized that the introduction of drug-resistant E. coli clonal strains into a community plays a greater role in changing the prevalence of drug-resistant UTIs than does the drug usage or the prescribing habits in that community (36).…”

Section: Discussionmentioning

confidence: 99%

European Emergence of Ciprofloxacin-Resistant Escherichia coli Clonal Groups O25:H4-ST 131 and O15:K52:H1 Causing Community-Acquired Uncomplicated Cystitis

et al. 2008

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A total of 148 E. coli strains displaying reduced susceptibility to ciprofloxacin (MIC > 2 g/ml) and causing uncomplicated urinary tract infections in eight European countries during 2003 to 2006 were studied. Their phylogenetic groups, biochemical profiles, and antibiotic susceptibilities were determined. Determination of the O:H serotype, pulsed-field gel electrophoresis (PFGE), randomly amplified polymorphic DNA (RAPD) PCR, and multilocus sequence typing provided additional discrimination. The majority (82.4%) of the microorganisms (122/148) carried resistance to two or more additional drugs, with the pattern ciprofloxacin-trimethoprim-sufamethoxazole-tetracycline-ampicillin being the most represented (73 strains out of 148; 49.3%). Extended-spectrum beta-lactamase production was detected in 12/148 strains (8.1%), with CTX-M-15 being the most-common enzyme. Six strains out of the whole collection studied (4.0%) contained a qnrB-like gene. Overall, 55 different PFGE or RAPD PCR profiles could be distinguished, indicating a substantial heterogeneity. However, about one-third (51/148) of the strains belonged to two clonal groups: O15:K52:H1 (phylogenetic group B2, lactose-nonfermenting variant, ciprofloxacin MIC of 16 g/ml) and O25:H4 sequence type 131 (ST-131) (phylogenetic group D, ciprofloxacin MIC of >32 g/ml). With the exception of Poland, strains of these two groups were isolated in samples from all participating countries but more frequently in samples from Spain and Italy. In some representative strains of the two main clonal groups, alterations in GyrA and ParC were the basic mechanism of fluoroquinolone resistance. In some members of the O25:H4 ST-131 group, displaying a ciprofloxacin MIC of >32 g/ml, additional OmpF loss or pump efflux overexpression was found. In the Mediterranean area, strains belonging to these two clonal groups played a major role in determining the high rate of fluoroquinolone-resistant E. coli strains observed in the community.Uncomplicated urinary tract infections (UTIs) are among the most prevalent infectious diseases mainly affecting women. Between one-quarter and one-half of all women experience a UTI at some time (27).The overall etiology has not changed in recent years, and Escherichia coli remains by far the most-common uropathogen, accounting for Ͼ80% of all positive cultures (19). However, the management of these infections is becoming complicated due to the emergence of resistance to several first-line antimicrobial agents in this primary pathogen (13).In fact, in E. coli bacteria, ampicillin and sulfamethoxazoletrimethoprim resistance rates have reached 20% to 50% worldwide. In Europe, increasing percentages of ciprofloxacinresistant mutants have been observed in the community in Spain, Portugal, and Italy (10,18).The results of a recent surveillance survey, the ARESC (Antimicrobial Resistance Epidemiological Survey on Cystitis) study, have shown high rates (Ͼ10%) of ciprofloxacin-resistant E. coli in Spain, Italy, and Russia and the emergence of this problem in all c...

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“…Otros trabajos demuestran que no siempre se puede establecer una clara correlación entre consumo y resistencia a quinolonas en E. coli 35 . En ese sentido, se ha demostrado la diseminación de grupos clonales de cepas de E. coli resistentes a FQ 36,37 , los cuales podrían tener un reservorio en animales y/o alimentos 38 .…”

Section: Artículo Originalunclassified

Factores asociados al desarrollo de infección urinaria de origen comunitario causada por Escherichia coli resistente a fluoroquinolonas

Seija

Fratchez

Ventura

et al. 2014

Rev. chil. infectol.

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Temporal Changes in the Prevalence of Community-Acquired Antimicrobial-Resistant Urinary Tract Infection Affected by Escherichia coli Clonal Group Composition

Cited by 52 publications

References 23 publications

Incidence of Antibiotic-Resistant Escherichia coli Bacteriuria According to Age and Location of Onset: A Population-Based Study From Olmsted County, Minnesota

Incidence of Antibiotic-Resistant Escherichia coli Bacteriuria According to Age and Location of Onset: A Population-Based Study From Olmsted County, Minnesota

European Emergence of Ciprofloxacin-Resistant Escherichia coli Clonal Groups O25:H4-ST 131 and O15:K52:H1 Causing Community-Acquired Uncomplicated Cystitis

Factores asociados al desarrollo de infección urinaria de origen comunitario causada por Escherichia coli resistente a fluoroquinolonas

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