Antimicrobial resistance among uropathogens that cause acute uncomplicated cystitis in women in Hong Kong: a prospective multicenter study in 2006 to 2008

Abstract A prospective multicenter study was conducted to assess the epidemiology of antimicrobial resistance among uropathogens causing uncomplicated cystitis. Adult women with clinical diagnosis of uncomplicated cystitis were enrolled from 54 participating centers distributed all over Hong Kong du...

Full description

Saved in:
Bibliographic Details
Published in:Diagnostic microbiology and infectious disease 2010, Vol.66 (1), p.87-93
Main Authors: Ho, Pak-leung, Yip, King-Sun, Chow, Kin-Hung, Lo, Janice Y.C, Que, Tak-Lun, Yuen, Kwok-yung
Format: Article
Language:English
Subjects:
Adult
Anti-Bacterial Agents - pharmacology
Chi-Square Distribution
Co-trimoxazole
Cystitis - epidemiology
Cystitis - microbiology
Drug Resistance, Bacterial
Enterobacteriaceae
Enterobacteriaceae - drug effects
Enterobacteriaceae - genetics
Enterobacteriaceae Infections - epidemiology
Enterobacteriaceae Infections - metabolism
Epidemiology
Escherichia coli
Escherichia coli - drug effects
Escherichia coli - genetics
Escherichia coli Infections - epidemiology
Escherichia coli Infections - microbiology
Female
Fluoroquinolones
Hong Kong - epidemiology
Humans
Infectious Disease
Internal Medicine
Microbial Sensitivity Tests
Middle Aged
Phylogeny
Prospective Studies
Risk Factors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract A prospective multicenter study was conducted to assess the epidemiology of antimicrobial resistance among uropathogens causing uncomplicated cystitis. Adult women with clinical diagnosis of uncomplicated cystitis were enrolled from 54 participating centers distributed all over Hong Kong during 2006 to 2008. A positive urine culture was found in 59.5% (352/592) patients. The patients had mean age of 44.9 years, and most (89.2%) were otherwise healthy. The most prevalent causative organism was Escherichia coli (77%), followed by other Enterobacteriaceae (14.2%), staphylococci (5.1%), and other Gram-positive bacteria (3.7%). The resistance rates of E. coli to co-trimoxazole and ciprofloxacin were 29.5% and 12.9%, respectively, and 14 isolates (5.2%) were confirmed as extended-spectrum β-lactamase (ESBL) producers. Of the ESBL producers, molecular studies showed CTX-M-14, CTX-M-24, or CTX-M-9. Nitrofurantoin and fosfomycin were active against >90% of the isolates, regardless of resistance phenotypes for other drugs. Pulsed-field gel electrophoresis of representative isolates showed that the antibiotic-resistant strains were genetically diverse. Patients with history of recent antibiotic use were significantly more likely to have infection by E. coli with co-trimoxazole resistance (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.4–5.7; P = 0.003) and ciprofloxacin resistance (OR, 2.5; 95% CI, 1.1–5.8; P = 0.03). Knowledge of the resistance data and risk factors could inform better use of antibiotics for empiric therapy for acute uncomplicated cystitis.
ISSN:0732-8893
1879-0070
DOI:10.1016/j.diagmicrobio.2009.03.027