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

Kyung Hwa Park, Won Sup Oh, Eu Suk Kim, Sang Won Park, Ji An Hur, YoungKeun Kim, Chisook Moon, Jae Hoon Lee, Chang Seop Lee, Baek Nam Kim

Research output: Contribution to journalArticle

18 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)8-13
Number of pages6
JournalInternational Journal of Infectious Diseases
Volume23
DOIs
Publication statusPublished - 2014 Jan 1

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Cefotaxime
Pyelonephritis
Ciprofloxacin
Hospital Emergency Service
Escherichia coli
Urine
Urinary Catheters
Indwelling Catheters
Hematologic Diseases
Fluoroquinolones
Cephalosporins
Cross Infection
Chronic Renal Insufficiency
Urinary Tract Infections
Multivariate Analysis
Anti-Bacterial Agents
Delivery of Health Care
Infection

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Park, Kyung Hwa ; Oh, Won Sup ; Kim, Eu Suk ; Park, Sang Won ; Hur, Ji An ; Kim, YoungKeun ; Moon, Chisook ; Lee, Jae Hoon ; Lee, Chang Seop ; Kim, Baek Nam. / Factors associated with ciprofloxacin- and cefotaxime-resistant Escherichia coli in women with acute pyelonephritis in the emergency department. In: International Journal of Infectious Diseases. 2014 ; Vol. 23. pp. 8-13.
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title = "Factors associated with ciprofloxacin- and cefotaxime-resistant Escherichia coli in women with acute pyelonephritis in the emergency department",
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.",
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Factors associated with ciprofloxacin- and cefotaxime-resistant Escherichia coli in women with acute pyelonephritis in the emergency department. / Park, Kyung Hwa; Oh, Won Sup; Kim, Eu Suk; Park, Sang Won; Hur, Ji An; Kim, YoungKeun; Moon, Chisook; Lee, Jae Hoon; Lee, Chang Seop; Kim, Baek Nam.

In: International Journal of Infectious Diseases, Vol. 23, 01.01.2014, p. 8-13.

Research output: Contribution to journalArticle

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T1 - Factors associated with ciprofloxacin- and cefotaxime-resistant Escherichia coli in women with acute pyelonephritis in the emergency department

AU - Park, Kyung Hwa

AU - Oh, Won Sup

AU - Kim, Eu Suk

AU - Park, Sang Won

AU - Hur, Ji An

AU - Kim, YoungKeun

AU - Moon, Chisook

AU - Lee, Jae Hoon

AU - Lee, Chang Seop

AU - Kim, Baek Nam

PY - 2014/1/1

Y1 - 2014/1/1

N2 - 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.

AB - 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.

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