Increased rates of extended-spectrum beta-lactamase isolates in patients hospitalized with culture-positive urinary Enterobacterales in the United States: 2011 - 2020.

Autor: Aronin SI; Iterum Therapeutics, Old Saybrook, CT, USA. Electronic address: saronin@iterumtx.com., Dunne MW; Iterum Therapeutics, Old Saybrook, CT, USA; Bill & Melinda Gates Medical Research Institute, Cambridge, MA, USA., Yu KC; Becton, Dickinson and Company, Franklin Lakes, NJ, USA., Watts JA; Becton, Dickinson and Company, Franklin Lakes, NJ, USA., Gupta V; Becton, Dickinson and Company, Franklin Lakes, NJ, USA.
Jazyk: angličtina
Zdroj: Diagnostic microbiology and infectious disease [Diagn Microbiol Infect Dis] 2022 Aug; Vol. 103 (4), pp. 115717. Date of Electronic Publication: 2022 Apr 29.
DOI: 10.1016/j.diagmicrobio.2022.115717
Abstrakt: Antimicrobial resistance in Enterobacterales has made empiric therapy for hospitalized patients with urinary tract infections (UTIs) more challenging. We analyzed the antibiotic susceptibility of nonduplicate Enterobacterales isolates from urine cultures tested at US hospitals in the BD Insights Research Database (2011-2020). Multivariable generalized estimating equation models were used to assess resistance trends over time. A total of 322 US hospitals provided data on 876,507 urinary Enterobacterales isolates (62.4% Escherichia coli). Enterobacterales antibiotic resistance rates were 64.6%, 29.3%, 27.6%, and 26.3% for beta-lactams, fluoroquinolones, nitrofurantoin, and trimethoprim/sulfamethoxazole, respectively, and 12.4% had an extended-spectrum beta-lactamase (ESBL) phenotype. In multivariable models, rates of ESBL isolates and isolates resistant to ≥3 drug classes increased significantly between 2011 and 2020, while other categories of resistance generally decreased. We conclude that antimicrobial resistance is common in urinary Enterobacterales isolates. Management of UTIs should be guided by urine culture data and may benefit from new therapies.
Competing Interests: Declaration of competing interest SIA is an employee of Iterum Therapeutics and MWD was previously employed by Iterum Therapeutics. KCY, JAW, and VG are employees of Becton, Dickinson & Company, which was contracted by Iterum Therapeutics to conduct the study. KCY and VG also own stock in Becton, Dickinson & Company.
(Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: