Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-24T19:10:20.262Z Has data issue: false hasContentIssue false
  • English
  • Français

Antimicrobial resistance patterns in urinary E. coli isolates after a change in a single center’s guidelines for uncomplicated cystitis in ambulatory settings

Published online by Cambridge University Press:  21 March 2019

Patrick P. Ryan Open the ORCID record for Patrick P. Ryan [Opens in a new window] ,
Bryan C. Knepper ,
Rachel M. Everhart  and
Connie S. Price
Patrick P. Ryan*
Affiliation:
Department of General Internal Medicine, Denver Health and Hospital Authority, Denver, Colorado Ambulatory Care Services, Community Health Services, Denver Health and Hospital Authority, Denver, Colorado University of Colorado School of Medicine, Aurora, Colorado
Bryan C. Knepper
Affiliation:
Department of Patient Safety and Quality, Denver Health and Hospital Authority, Denver, Colorado
Rachel M. Everhart
Affiliation:
Ambulatory Care Services, Community Health Services, Denver Health and Hospital Authority, Denver, Colorado
Connie S. Price
Affiliation:
University of Colorado School of Medicine, Aurora, Colorado Division of Infectious Diseases, Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado
*
Author for correspondence: Patrick Ryan, Email: patrick.ryan@dhha.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Recommending nitrofurantoin to treat uncomplicated cystitis was associated with increased nitrofurantoin use from 3.53 to 4.01 prescriptions per 1,000 outpatient visits, but nitrofurantoin resistance in E. coli isolates remained stable at 2%. Concomitant levofloxacin resistance was a significant risk for nitrofurantoin resistance in E. coli isolates (odds ratio [OR], 2.72; 95% confidence interval [CI], 1.04–7.17).

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 5 , May 2019 , pp. 600 - 602
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Previous Presentation: This work was previously presented in a poster at IDWeek 2016 on October 28, 2016, in New Orleans, Louisiana.

References

Schappert, SR, Rechtsteiner, EA. Ambulatory medical care utilization estimates for 2007. Vital Health Stat 2011;169:1–38.Google Scholar
Etienne, M, Lefebvre, E, Frebourg, N, Hamel, H, Pestel-Caron, M, Caron, F. Antibiotic treatment of acute uncomplicated cystitis based on rapid urine test and local epidemiology: lessons from a primary care series. BMC Infect Dis 2014;14:137.CrossRefGoogle ScholarPubMed
Davey, P, Marwick, CA, Scott, CL, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2017;2:CD003543.Google ScholarPubMed
Zhanel, GG, Hisanaga, TL, Laing, NM, et al. Antibiotic resistance in Escherichia coli outpatient urinary isolates: final results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA). Int J Antimicrob Agent 2006;27:468–475.CrossRefGoogle Scholar
Burman, WJ, Breese, PE, Murray, BE, et al. Conventional and molecular epidemiology of trimethoprimsulfamethoxazole resistance among urinary Escherichia coli isolates. Am J Med 2003;115:358–364.CrossRefGoogle Scholar
Johnson, L, Sabel, A, Burman, WJ, et al. Emergence of fluoroquinolone resistance in outpatient urinary Escherichia coli isolates. Am J Med 2008;121:876–884.CrossRefGoogle ScholarPubMed
Gupta, K, Hooton, TM, Naber, KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis 2011;52:e103–e120.CrossRefGoogle Scholar
Webber, MA,Piddock, LJV. The importance of efflux pumps in bacterial antibiotic resistance. J Antimicrob Chemother 2003;51:9–11.CrossRefGoogle ScholarPubMed
Sulavik, MC, Houseweart, C, Cramer, C, et al. Antibiotic susceptibility profiles of Escherichia coli strains lacking multidrug efflux pump genes. Antimicrob Agents Chemother 2001;45:1126–1136.CrossRefGoogle ScholarPubMed
Paterson, DL. “Collateral damage” from cephalosporin or quinolone antibiotic therapy. Clin Infect Dis 2004;38 Suppl 4:S341–S345.CrossRefGoogle ScholarPubMed