Clinical Risk Factors and Multi-Antimicrobial Resistance Pattern in Community-Acquired Outpatient Urinary Tract Isolates of Escherichia Coli

Objective: To evaluate multi-antimicrobial resistance pattern of Escherichia coli (E. coli) urinary isolates and the risk factors associated with commonly prescribed antibiotics in emergency department and primary care clinics. Method This is a cross-sectional study of patients 18 to 65 years of age reported to have E. coli positive urinary tract infections (UTIs) whose medical and laboratory records were systematically reviewed. Results: Overall, 37.7% E. coli urinary isolates were resistant to ampicillin, 18.3% to trimethoprim/sulfamethoxazole (TMP/SMX), and 7.8% to ciprofloxacin. About 21% isolates were resistant to two or more antibiotics. Ciprofloxacin-resistant E. coli isolates from outpatient urine sample were frequently resistant to ampicillin (81.5%), and TMP/SMX (58.2%). The concurrent resistance rate of ciprofloxacin was about 8 times more frequent (24.8% vs. 3.1%) than nitrofurantoin among TMP/SMX-resistant E. coli urinary isolates. Patients with histories of genitourinary abnormalities were 1.59 times (CI 1.27-1.98) more likely have E. coli isolates resistant to TMP/SMX, and 2.35 times more likely (CI 1.79-3.09) to ciprofloxacin. Diabetic patients were at increased risk for resistance to TMP/SMX (OR 1.37,CI 1.14-1.65) and ciprofloxacin (OR 2.51,CI 2.00-3.16). Obesity is significantly associated with ciprofloxacin resistance (OR 1.68,CI 1.34-2.09). TMP/SMX and ciprofloxacin resistance rate increased gradually with the number of previous UTIs, hospitalizations, and antibiotic prescriptions. Conclusions: Ciprofloxacin resistant isolates of E. coli from urine were frequently multi-drug resistant and TMP/SMX can induce ciprofloxacin resistant. In addition to demographic factors, history of genitourinary abnormalities, diabetes, obesity, number of hospitalizations, previous diagnosis of UTIs, antibiotic prescriptions in previous 6 months are risk factors for antimicrobial resistance.

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Antimicrobial Resistance Pattern of Escherichia Coli From Urinary Tract Infections in Relation to ESBL and pap gene Production and Fosfomycin Sensitivity

Indian Journal of Public Health Research & Development ◽

10.37506/ijphrd.v11i11.11353 ◽

2020 ◽

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Antimicrobial Resistance ◽

Urinary Tract Infections ◽

Resistance Pattern ◽

Tract Infections

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Identifying clinical risk factors for antibiotic resistances in urinary tract infections and optimizing empirical treatment: a retrospective study.

10.26226/morressier.572768e4d462b8029237f4ab ◽

2016 ◽

Author(s):

Sebastian Bischoff

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Empirical Treatment ◽

Clinical Risk Factors ◽

Clinical Risk ◽

Tract Infections

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Non-Escherichia coli Versus Escherichia coli Community-Acquired Urinary Tract Infections in Children Hospitalized in a Tertiary Center: Relative Frequency, Risk Factors, Antimicrobial Resistance and Outcome

Yearbook of Pediatrics ◽

10.1016/s0084-3954(08)70102-7 ◽

2007 ◽

Vol 2007 ◽

pp. 181-182

Author(s):

J.A. Stockman

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Urinary Tract ◽

Antimicrobial Resistance ◽

Urinary Tract Infections ◽

Relative Frequency ◽

Tertiary Center ◽

Tract Infections

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PP-004 Antimicrobial resistance and risk factors for urinary tract infection due to ciprofloxacin-resistant Escherichia coli in Rwanda

International Journal of Infectious Diseases ◽

10.1016/s1201-9712(11)60157-4 ◽

2011 ◽

Vol 15 ◽

pp. S46-S47

Author(s):

C. Muvunyi ◽

F. Masaisa ◽

C. Bayingana ◽

L. Mutesa ◽

A. Musemakweri ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Antimicrobial Resistance ◽

Tract Infection

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Isolation and Antimicrobial Susceptibility Pattern of Escherichia coli Causing Urinary Tract Infection in Enam Medical College Hospital

Journal of Enam Medical College ◽

10.3329/jemc.v1i2.11463 ◽

2012 ◽

Vol 1 (2) ◽

pp. 60-62 ◽

Cited By ~ 1

Author(s):

Mejbah Uddin Ahmed ◽

Md Khairuzzaman ◽

Afroza Begum ◽

Iftikhar Ahmed

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Antimicrobial Resistance ◽

Tract Infection ◽

Resistance Pattern ◽

Susceptibility Pattern ◽

College Hospital ◽

Medical College ◽

Antimicrobial Susceptibility Pattern

Background: Since antibiotic resistance of uropathogens has gradually been rising, knowledge of antimicrobial resistance pattern of Escherichia coli (Esch. coli), the predominant pathogen of urinary tract infection (UTI), is important in selecting empirical antimicrobial therapy.Objectives: To find out the common organisms causing UTI with their antimicrobial susceptibility pattern in Enam Medical College Hospital.Materials and Methods: This study was carried out in the department of Microbiology, Enam Medical College Hospital, Savar, Dhaka between January 2010 to June 2011 to see the antimicrobial resistance pattern of Esch. coli in urine sample. A total of 512 urine samples were studied from clinically suspected UTI cases irrespective of age and sex. Esch. coli were isolated and antibiogram of the isolates were done.Results: The results of antibiogram revealed the resistance pattern of the isolated Esch. coli to ampicillin (93.94%), cefradine (70.71%), trimethoprim-sulfamethoxazole (48.49%), azithromycin (41.42%), ciprofloxacin (39.40%), ceftazidime (35.56%), nitrofurantoin (29.30%), ceftriaxone (10.11%), gentamicin (7.08%) and imipenem (3.04%).Conclusion: It can be inferred that our findings will render useful information to clinicians in determining the appropriately directed antimicrobial regimen when given empirically. DOI: http://dx.doi.org/10.3329/jemc.v1i2.11463 J Enam Med Col 2011; 1(2): 60-62

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Antimicrobial Resistance Pattern in Escherichia coli Causing Urinary Tract Infection among Inpatients - A Retrospective Study

International Journal of Current Microbiology and Applied Sciences ◽

10.20546/ijcmas.2019.807.267 ◽

2019 ◽

Vol 8 (07) ◽

pp. 2198-2206

Author(s):

G. Sasikala ◽

Usha Rani Ramavath ◽

Qader Ahmed Jalily

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Retrospective Study ◽

Urinary Tract ◽

Antimicrobial Resistance ◽

Tract Infection ◽

Resistance Pattern

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Antimicrobial Resistance of Uropathogenic Escherichia coli from Elderly Patients at a General Hospital, Argentina

The Open Infectious Diseases Journal ◽

10.2174/1874279301810010079 ◽

2018 ◽

Vol 10 (1) ◽

pp. 79-87 ◽

Cited By ~ 1

Author(s):

Gastón Delpech ◽

Natalia García Allende ◽

Sabina Lissarrague ◽

Mónica Sparo

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Urinary Tract ◽

Antimicrobial Resistance ◽

Elderly Patients ◽

Nalidixic Acid ◽

Urinary Tract Infections ◽

E Coli ◽

Amoxicillin Clavulanate ◽

Tract Infections

Background:Urinary Tract Infection (UTI) is a common cause of morbidity and mortality in older adults.Objective:To investigate antimicrobial resistance of uropathogenicEscherichia colifrom elderly patients in a General Hospital, Argentina.Method:During the period July 2011-July 2015, patients over 70 years old with urinary tract infections, without urinary catheters and with no antimicrobial therapy the previous week before sampling, were included. Phenotypic characterization was carried out.In vitroqualitative and quantitative antimicrobial resistances were investigated. Antimicrobials assayed: ampicillin, amoxicillin-clavulanate, cefazolin, cefuroxime, cefoxitin, cefotaxime, ceftazidime, cefepime, imipenem, ertapenem, gentamicin, nalidixic acid, ciprofloxacin, trimethoprim-sulfamethoxazole (TMS) and nitrofurantoin. Patients’ medical records were produced, and risk factors were analyzed by multivariate analysis.Results:768 bacterial isolates were identified asE. coli. Resistances to ampicillin (80.5%), nalidixic acid (61.7%), ciprofloxacin (42.8%), TMS (37.6%), amoxicillin-clavulanate (28.6%), cefazolin (21.6%), cefuroxime (20.7%), gentamicin (13.8%), cefotaxime (9.7%), ceftazidime (9.7%), cefepime (8.4%), cefoxitin (3.1%) and nitrofurantoin (2.3%) were observed. Resistance to carbapenems was not expressed. Production of extended spectrum β-lactamases was detected (7.6%) in community acquired (96%) and healthcare associated (4%) isolates. The independent risk factors for urinary infections produced by multi-resistantE. coliwere: diabetes mellitus, recurrent infections, hospitalization during the last year and exposure to β-lactams in the last 3 months.Conclusion:A high prevalence of resistance to β-lactams and to other antimicrobials was observed. Detection of antimicrobial multi-resistant isolates highlights the need of antimicrobial resistance surveillance in elderly patients with urinary tract infections.

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