Antibiotic resistance of Escherichia coli urinary tract infections at a North Carolina community hospital: Comparison of rural and urban community type
| Autor: | Alexandra S.F. Miller, Peter Ahiawodzi, Dorothea K. Thompson, Adriana G. Muradyan |
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| Rok vydání: | 2021 |
| Předmět: |
Rural Population
medicine.medical_specialty Epidemiology Hospitals Community Microbial Sensitivity Tests Antibiotic resistance Levofloxacin Internal medicine Ampicillin Drug Resistance Bacterial medicine Escherichia coli North Carolina Antimicrobial stewardship Humans Escherichia coli Infections business.industry Health Policy Public Health Environmental and Occupational Health Drug Resistance Microbial Odds ratio Community hospital Anti-Bacterial Agents Ciprofloxacin Infectious Diseases Cross-Sectional Studies Nitrofurantoin Urinary Tract Infections business medicine.drug |
| Zdroj: | American journal of infection control. 50(1) |
| ISSN: | 1527-3296 |
| Popis: | We aimed to identify differences in urinary E. coli resistance rates based on community type of patient residence (rural and urban).This cross-sectional study examined antibiotic resistance of E. coli isolates from 12,604 urine specimens at a North Carolina hospital between 2016 and 2018. Using multivariable logistic regression modeling, we investigated the association between resistance and community type, adjusting for patient age, gender, season, and setting of infection onset. Analyses were performed using SAS Version 9.3 (SAS Institute, Cary, NC) at alpha = 0.05.Prevalence of resistance was highest for ampicillin (42.2%), ampicillin-sulbactam (24.7%), ciprofloxacin (21.8%), trimethoprim-sulfamethoxazole (SXT) (21.6%), and levofloxacin (21.4%). Rural compared to urban community type was significantly associated with resistance of E. coli urinary isolates to ciprofloxacin (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] = 1.16-1.43, P.0001), levofloxacin (aOR = 1.28, 95% CI = 1.15-1.42, P.0001), SXT (aOR = 1.15, 95% CI = 1.04-1.27, P = .01), and nitrofurantoin (aOR = 1.57, 95% CI = 1.13-2.17, P = .01).Rural community type may influence urinary E. coli resistance to fluoroquinolones, SXT, and nitrofurantoin, indicating the need for antimicrobial stewardship interventions in medically underserved populations. |
| Databáze: | OpenAIRE |
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