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
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- dc.contributor.author Martínez-Casanova, Javier
- dc.contributor.author Gómez-Zorrilla, Silvia
- dc.contributor.author Prim, Núria
- dc.contributor.author Molin, Agustina Dal
- dc.contributor.author Echeverría Esnal, Daniel
- dc.contributor.author Gracia Arnillas, María Pilar
- dc.contributor.author Sendra, Elena
- dc.contributor.author Güerri Fernández, Roberto
- dc.contributor.author Duran Jordà, Xavier, 1974-
- dc.contributor.author Padilla, Eduardo
- dc.contributor.author Horcajada Gallego, Juan Pablo
- dc.contributor.author Grau Cerrato, Santiago
- dc.contributor.author PROA-PSMAR Group
- dc.date.accessioned 2021-08-31T06:30:24Z
- dc.date.available 2021-08-31T06:30:24Z
- dc.date.issued 2021
- dc.description.abstract 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.
- dc.format.mimetype application/pdf
- dc.identifier.citation Martínez-Casanova J, Gómez-Zorrilla S, Prim N, Dal Molin A, Echeverría-Esnal D, Gracia-Arnillas MP, Sendra E, Güerri-Fernández R, Durán-Jordà X, Padilla E, Horcajada JP, Grau S, Proa-Psmar Group OBOT. 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. Antibiotics (Basel). 2021;10(5):582. DOI: 10.3390/antibiotics10050582
- dc.identifier.doi http://dx.doi.org/10.3390/antibiotics10050582
- dc.identifier.issn 2079-6382
- dc.identifier.uri http://hdl.handle.net/10230/48347
- dc.language.iso eng
- dc.publisher MDPI
- dc.relation.ispartof Antibiotics (Basel). 2021;10(5):582
- dc.rights © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Enterobacterales
- dc.subject.keyword Amoxicillin/clavulanate
- dc.subject.keyword Antimicrobial resistance
- dc.subject.keyword Emergency department
- dc.subject.keyword Fluoroquinolones
- dc.subject.keyword Urinary tract infection (UTI)
- dc.title 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
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion