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Title: | Time trend of prevalence and susceptibility to nitrofurantoin of urinary MDR Escherichia coli from outpatients | Authors: | BRUYNDONCKX, Robin Latour, Katrien Atud, Glory Abong Dubovy, Patrick JASPERS, Stijn HENS, Niel Catry, Boudewijn Goossens, Herman COENEN, Stefan |
Issue Date: | 2019 | Publisher: | OXFORD UNIV PRESS | Source: | The journal of antimicrobial chemotherapy (Print), 74 (11) , p. 3264 -3267 | Abstract: | Objectives: To assess the time trend of the prevalence of urinary MDR Escherichia coli in Belgian outpatients (2005 versus 2011-12), the antibiotic susceptibility of urinary MDR E. coli, and the time trend of non-susceptibility to nitrofurantoin, i.e. first-line treatment for uncomplicated urinary tract infections (UTIs), of urinary MDR E. coli (2005 versus 2011-12). Methods: In this secondary analysis of a multicentre study, which collected a convenience sample of voluntary participating laboratories (15 and 8 in 2005 and 2011-12, respectively), we analysed antimicrobial susceptibilities (ampicillin, amoxicillin/clavulanate, cefalotin, ciprofloxacin, nitrofurantoin and trimethoprim/sulfamethoxazole) of urinary E. coli. MDR was defined as resistance to three or more of these agents. The prevalence of MDR E. coli and its non-susceptibility to nitrofurantoin was compared between 2005 and 2011-12 using a generalized estimating equation model. Results: MDR status could be determined for 9704 and 12512 urinary E. coli isolates from 7911 and 9441 patients in 2005 and 2011-12, respectively, with most patients being women (79% in both study periods). The prevalence of MDR increased from 28.4% (2758/9704) in 2005 to 34.3% (4286/12512) in 2011-12 (adjusted OR 1.305; 95% CI 1.220-1.397). Within the MDR isolates, the prevalence of nitrofurantoin non-susceptibility decreased from 23.2% (623/2684) in 2005 to 10.7% (455/4253) in 2011-12 (adjusted OR 0.424; 95% CI 0.363-0.494). Conclusions: Despite a high prevalence of MDR E. coli in urinary samples from Belgian outpatients, nitrofurantoin could still be recommended as first-line empirical treatment in uncomplicated UTIs. | Notes: | Bruyndonckx, R (reprint author), Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat I BIOST, Hasselt, Belgium.; Bruyndonckx, R (reprint author), Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, Lab Med Microbiol, Antwerp, Belgium. robin.bruyndonckx@uhasselt.be |
Keywords: | Tract-Infections;Antibiotic-Resistance;Epidemiology;Therapy | Document URI: | http://hdl.handle.net/1942/31428 | ISSN: | 0305-7453 | e-ISSN: | 1460-2091 | DOI: | 10.1093/jac/dkz323 | ISI #: | WOS:000498167700020 | Rights: | The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2020 |
Appears in Collections: | Research publications |
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