Regional Differences in Antibiotic-resistant Enterobacterales Urine Isolates in the United States: 2018-2020.

Autor:	Aronin SI; Iterum Therapeutics, Old Saybrook, Connecticut, United States., Gupta V; Becton, Dickinson and Company, Franklin Lakes, New Jersey, United States., Dunne MW; Iterum Therapeutics, Old Saybrook, Connecticut, United States; Bill & Melinda Gates Medical Research Institute, Cambridge, Massachusetts, United States., Watts JA; Becton, Dickinson and Company, Franklin Lakes, New Jersey, United States., Yu KC; Becton, Dickinson and Company, Franklin Lakes, New Jersey, United States. Electronic address: Kalvin.Yu@bd.com.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2022 Jun; Vol. 119, pp. 142-145. Date of Electronic Publication: 2022 Mar 30.
DOI:	10.1016/j.ijid.2022.03.052
Abstrakt:	Antimicrobial resistance (AMR) can complicate effective management of urinary tract infections. We conducted a retrospective study of AMR in Enterobacterales urine isolates from ambulatory and hospitalized adult patients from 2018-2020 (BD Insights Research Database) to evaluate regional differences in isolates with an extended-spectrum beta-lactamase-producing phenotype and those not susceptible to beta-lactams, fluoroquinolone (FQ), nitrofurantoin (NFT), trimethoprim/sulfamethoxazole (TMP/SMX), or multiple antibiotic classes (≥ 2 or ≥ 3). Our analyses included 349,741 Enterobacterales urine isolates from 321 inpatient facilities and 980,354 isolates from 338 ambulatory care facilities. In multivariable analyses, the highest rate of resistance was to beta-lactams (60.8% and 55.8% for inpatient and ambulatory settings, respectively), followed by FQ (27.5%), NFT (27.0%), and TMP/SMX (25.4%) for inpatients and by TMP/SMX (22.4%), FQ (21.6%), and NFT (21.6%) for ambulatory patients. Isolates with an extended-spectrum beta-lactamase-producing phenotype (13.2% and 8.6% for inpatient and ambulatory settings, respectively) and multidrug resistance (inpatient and ambulatory rates of 23.4% and 17.7% for ≥ 2 drugs; 9.9% and 6.4% for ≥ 3 drugs) were also prevalent. Statistically significant differences by geographic region (P ≤ 0.005) were observed for AMR classes in both inpatient and ambulatory settings, but the rates remained above the thresholds recommended for empiric urinary tract infection therapy across most regions. (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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