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http://hdl.handle.net/1942/27335
Title: | Characteristics of the antibiotic regimen that affect antimicrobial resistance in urinary pathogens | Authors: | Catry, Boudewijn Latour, Katrien BRUYNDONCKX, Robin Diba, Camellia GEERDENS, Candida Coenen, Samuel |
Issue Date: | 2018 | Publisher: | BMC | Source: | ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL, 7 (Art N° 76) | Abstract: | Background: Treatment duration, treatment interval, formulation and type of antimicrobial (antibiotic) are modifiable factors that will influence antimicrobial selection pressure. Currently, the impact of the route of administration on the occurrence of resistance in humans is unclear. Methods: In this retrospective multi-center cohort study, we assessed the impact of different variables on antimicrobial resistance (AMR) in pathogens isolated from the urinary tract in older adults. A generalized estimating equations (GEE) model was constructed using 7397 Escherichia coli (E. coli) isolates. Results: Resistance in E. coli was higher when more antibiotics had been prescribed before isolation of the sample, especially in women (significant interaction p = 0.0016) and up to nine preceding prescriptions it was lower for higher proportions of preceding parenteral prescriptions (significant interactions p = 0.0067). The laboratory identity, dying, and the time between prescription and sampling were important confounders (p < 0.001). Conclusions: Our model describing shows a dose-response relation between antibiotic use and AMR in E. coli isolated from urine samples of older adults, and, for the first time, that higher proportions of preceding parenteral prescriptions are significantly associated with lower probabilities of AMR, provided that the number of preceding prescriptions is not extremely high (>= 10 during the 1.5 year observation period; 93% of 5650 included patients). | Notes: | [Catry, Boudewijn; Latour, Katrien] Sciensano, Healthcare Associated Infect & Antimicrobial Resi, Ruy Juliette Wytsmanstr 14, B-1050 Brussels, Belgium. [Latour, Katrien] Univ Leuven, Dept Publ Hlth & Primary Care, KU Leuven, Leuven, Belgium. [Bruyndonckx, Robin; Diba, Camellia; Geerdens, Candida] Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat, I BIOSTAT, Hasselt, Belgium. [Bruyndonckx, Robin; Coenen, Samuel] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, Lab Med Microbiol, Antwerp, Belgium. | Keywords: | Route of administration; Drug resistance; Uropathogens; Elderly;Route of administration; Drug resistance; Uropathogens; Elderly | Document URI: | http://hdl.handle.net/1942/27335 | ISSN: | 2047-2994 | e-ISSN: | 2047-2994 | DOI: | 10.1186/s13756-018-0368-3 | ISI #: | 000436180100001 | Rights: | © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2019 |
Appears in Collections: | Research publications |
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