Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae

Background: High rates of amoxicillin-clavulanate (AMC) resistance among Enterobacterales isolated from urinary tract infections (UTIs) were observed in our area. The aim of this study was to identify risk factors associated with AMC resistance in patients with community-onset UTI in emergency depar...

Descripción completa

Detalles Bibliográficos
Autores: Martínez-Casanova, Javier, Gómez-Zorrilla, Silvia|||0000-0002-5987-068X, Prim, Núria|||0000-0002-5283-0917, Dal Molin, Agustina|||0000-0002-2282-4436, Echeverría-Esnal, Daniel|||0000-0003-4975-8798, Gracia-Arnillas, María Pilar, Sendra, Elena|||0000-0002-4374-2173, Güerri-Fernández, Robert|||0000-0002-9794-9161, Duran-Jordà, Xavier|||0000-0001-8517-9254, Padilla León, Eduardo, Horcajada, Juan Pablo|||0000-0001-9873-5459, Grau, Santiago|||0000-0002-8428-1836
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:255649
Acceso en línea:https://ddd.uab.cat/record/255649
https://dx.doi.org/urn:doi:10.3390/antibiotics10050582
Access Level:acceso abierto
Palabra clave:Amoxicillin/clavulanate
Urinary tract infection (UTI)
Enterobacterales
Antimicrobial resistance
Fluoroquinolones
Emergency department
id ES_930d025baab91dc940dffd5074fc70c8
oai_identifier_str oai:ddd.uab.cat:255649
network_acronym_str ES
network_name_str España
repository_id_str
spelling Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniaeThe Role of Prior Exposure to FluoroquinolonesMartínez-Casanova, JavierGómez-Zorrilla, Silvia|||0000-0002-5987-068XPrim, Núria|||0000-0002-5283-0917Dal Molin, Agustina|||0000-0002-2282-4436Echeverría-Esnal, Daniel|||0000-0003-4975-8798Gracia-Arnillas, María PilarSendra, Elena|||0000-0002-4374-2173Güerri-Fernández, Robert|||0000-0002-9794-9161Duran-Jordà, Xavier|||0000-0001-8517-9254Padilla León, EduardoHorcajada, Juan Pablo|||0000-0001-9873-5459Grau, Santiago|||0000-0002-8428-1836Amoxicillin/clavulanateUrinary tract infection (UTI)EnterobacteralesAntimicrobial resistanceFluoroquinolonesEmergency departmentBackground: High rates of amoxicillin-clavulanate (AMC) resistance among Enterobacterales isolated from urinary tract infections (UTIs) were observed in our area. The aim of this study was to identify risk factors associated with AMC resistance in patients with community-onset UTI in emergency departments (EDs). Methods: A retrospective study was performed of all ED patients with positive urine cultures for Escherichia coli or Klebsiella pneumoniae in a Spanish tertiary-care hospital. Results: 330 urine cultures in all were included: 261 (79.1%) for E. coli and 69 (20.90%) for K. pneumonia. Rates of AMC resistance were 14.94% and 34.78%, respectively. UTI was clinically confirmed in 212 (64.24%) cases. Previous antimicrobial exposure was independently associated with AMC resistance development in E. coli and K. pneumoniae urinary isolates (OR = 2.94, 95% CI = 1.55-5.58). Analyses of infected patients revealed that previous exposure to fluoroquinolones (OR = 3.33, 95% CI = 1.10-10.12, p = 0.034) and to AMC (OR = 5.68, 95% CI = 1.97-16.44, p = 0.001) was significantly associated with isolation of AMC-resistant strains. Conclusions: Prior antibiotic exposure, particularly to AMC or fluoroquinolones, was the only independent risk factor associated with development of AMC resistance in E. coli and K. pneumoniae urinary isolates from patients attending the ED.Universitat Autònoma de Barcelona 22021-01-0120212021-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/255649https://dx.doi.org/urn:doi:10.3390/antibiotics10050582reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2556492026-06-06T12:50:31Z
dc.title.none.fl_str_mv 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
title Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae
spellingShingle Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae
Martínez-Casanova, Javier
Amoxicillin/clavulanate
Urinary tract infection (UTI)
Enterobacterales
Antimicrobial resistance
Fluoroquinolones
Emergency department
title_short Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae
title_full Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae
title_fullStr Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae
title_full_unstemmed Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae
title_sort Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae
dc.creator.none.fl_str_mv Martínez-Casanova, Javier
Gómez-Zorrilla, Silvia|||0000-0002-5987-068X
Prim, Núria|||0000-0002-5283-0917
Dal Molin, Agustina|||0000-0002-2282-4436
Echeverría-Esnal, Daniel|||0000-0003-4975-8798
Gracia-Arnillas, María Pilar
Sendra, Elena|||0000-0002-4374-2173
Güerri-Fernández, Robert|||0000-0002-9794-9161
Duran-Jordà, Xavier|||0000-0001-8517-9254
Padilla León, Eduardo
Horcajada, Juan Pablo|||0000-0001-9873-5459
Grau, Santiago|||0000-0002-8428-1836
author Martínez-Casanova, Javier
author_facet Martínez-Casanova, Javier
Gómez-Zorrilla, Silvia|||0000-0002-5987-068X
Prim, Núria|||0000-0002-5283-0917
Dal Molin, Agustina|||0000-0002-2282-4436
Echeverría-Esnal, Daniel|||0000-0003-4975-8798
Gracia-Arnillas, María Pilar
Sendra, Elena|||0000-0002-4374-2173
Güerri-Fernández, Robert|||0000-0002-9794-9161
Duran-Jordà, Xavier|||0000-0001-8517-9254
Padilla León, Eduardo
Horcajada, Juan Pablo|||0000-0001-9873-5459
Grau, Santiago|||0000-0002-8428-1836
author_role author
author2 Gómez-Zorrilla, Silvia|||0000-0002-5987-068X
Prim, Núria|||0000-0002-5283-0917
Dal Molin, Agustina|||0000-0002-2282-4436
Echeverría-Esnal, Daniel|||0000-0003-4975-8798
Gracia-Arnillas, María Pilar
Sendra, Elena|||0000-0002-4374-2173
Güerri-Fernández, Robert|||0000-0002-9794-9161
Duran-Jordà, Xavier|||0000-0001-8517-9254
Padilla León, Eduardo
Horcajada, Juan Pablo|||0000-0001-9873-5459
Grau, Santiago|||0000-0002-8428-1836
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Amoxicillin/clavulanate
Urinary tract infection (UTI)
Enterobacterales
Antimicrobial resistance
Fluoroquinolones
Emergency department
topic Amoxicillin/clavulanate
Urinary tract infection (UTI)
Enterobacterales
Antimicrobial resistance
Fluoroquinolones
Emergency department
description Background: High rates of amoxicillin-clavulanate (AMC) resistance among Enterobacterales isolated from urinary tract infections (UTIs) were observed in our area. The aim of this study was to identify risk factors associated with AMC resistance in patients with community-onset UTI in emergency departments (EDs). Methods: A retrospective study was performed of all ED patients with positive urine cultures for Escherichia coli or Klebsiella pneumoniae in a Spanish tertiary-care hospital. Results: 330 urine cultures in all were included: 261 (79.1%) for E. coli and 69 (20.90%) for K. pneumonia. Rates of AMC resistance were 14.94% and 34.78%, respectively. UTI was clinically confirmed in 212 (64.24%) cases. Previous antimicrobial exposure was independently associated with AMC resistance development in E. coli and K. pneumoniae urinary isolates (OR = 2.94, 95% CI = 1.55-5.58). Analyses of infected patients revealed that previous exposure to fluoroquinolones (OR = 3.33, 95% CI = 1.10-10.12, p = 0.034) and to AMC (OR = 5.68, 95% CI = 1.97-16.44, p = 0.001) was significantly associated with isolation of AMC-resistant strains. Conclusions: Prior antibiotic exposure, particularly to AMC or fluoroquinolones, was the only independent risk factor associated with development of AMC resistance in E. coli and K. pneumoniae urinary isolates from patients attending the ED.
publishDate 2021
dc.date.none.fl_str_mv 2
2021-01-01
2021
2021-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/255649
https://dx.doi.org/urn:doi:10.3390/antibiotics10050582
url https://ddd.uab.cat/record/255649
https://dx.doi.org/urn:doi:10.3390/antibiotics10050582
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869413534975131648
score 15,301603

Similares en LA Referencia