ArticleInfection control and hospital epidemiology2009
Gastrointestinal tract colonization with fluoroquinolone-resistant Escherichia coli in hospitalized patients: changes over time in risk factors for resistance.
Article in Infection control and hospital epidemiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Risk factors for quinolone-resistantAntimicrobial resistance and infection control · 2020Pooled it
- Epidemiology and characteristics of Escherichia coli sequence type 131 (ST131) from long-term care facility residents colonized intestinally with fluoroquinolone-resistant Escherichia coli.Diagnostic microbiology and infectious disease · 2017Article
- Clinical and molecular epidemiology of Escherichia coli sequence type 131 among hospitalized patients colonized intestinally with fluoroquinolone-resistant E. coli.Antimicrobial agents and chemotherapy · 2014Article
- Risk factors for the development of gastrointestinal colonization with fluoroquinolone-resistant Escherichia coli in residents of long-term care facilities.The Journal of infectious diseases · 2014Article
- Impact of antibiotic use during hospitalization on the development of gastrointestinal colonization with Escherichia coli with reduced fluoroquinolone susceptibility.Infection control and hospital epidemiology · 2013Article
- Temporal changes in resistance mechanisms in colonizing Escherichia coli isolates with reduced susceptibility to fluoroquinolones.Diagnostic microbiology and infectious disease · 2013Article
- Risk factors for efflux pump overexpression in fluoroquinolone-resistant Escherichia coli.The Journal of infectious diseases · 2012Article
- Risk factors for infection or colonization with CTX-M extended-spectrum-β-lactamase-positive Escherichia coli.Antimicrobial agents and chemotherapy · 2012Article
- Global fluoroquinolone resistance epidemiology and implictions for clinical use.Interdisciplinary perspectives on infectious diseases · 2012Article
- Treatment with fluoroquinolones or with beta-lactam-beta-lactamase inhibitor combinations is a risk factor for isolation of extended-spectrum-beta-lactamase-producing Klebsiella species in hospitalized patients.Antimicrobial agents and chemotherapy · 2010Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThe prevalence of fluoroquinolone (FQ) resistance in Escherichia coli has increased markedly in recent years. Despite the important role of gastrointestinal tract colonization with FQ-resistant E. coli (FQREC), the prevalence of and risk factors for FQREC colonization among the general hospitalized patient population have not been described, to our knowledge. The objective of this study was to identify the prevalence of and risk factors for FQREC colonization among hospitalized patients.
designThree-year case-control study. Case patients (ie, all subjects with FQREC colonization) were compared with control patients (ie, all subjects without FQREC colonization).
settingTwo large medical centers within an academic health system.
participantsAll patients hospitalized at the 2 study hospitals.
main outcome measureThree annual fecal surveillance surveys were conducted. All patients colonized with FQREC (levofloxacin minimum inhibitory concentration, >or=8 microg/mL) were identified.
resultsOf the 774 subjects, 89 (11.5%) were colonized with FQREC. Although there was a significant association between prior FQ use and FQREC colonization on bivariable analysis (odds ratio [OR], 2.02 [95% confidence interval {CI}, 1.14-3.46]; P=.01), there was statistically significant effect modification by year of study (P=.005). In multivariable analyses, after controlling for the hospital and for the duration of hospitalization prior to sampling, the association between FQ use and FQREC colonization was as follows: adjusted OR (aOR), 0.97 (95% CI, 0.29-3.23) in 2002; aOR, 1.41 (95% CI, 0.57-3.50) in 2003; and aOR, 9.87 (95% CI, 3.67-26.55) in 2004.
conclusionsThe association between prior FQ use and FQREC colonization varied significantly by study year, suggesting that the clinical epidemiology of resistant organisms may change over time. Furthermore, in the context of recent work showing significant changes in FQREC prevalence as well as changes in FQ resistance mechanisms (specifically, efflux overexpression) over the same time period, these results suggest a previously unrecognized complexity in the relationship between the clinical and molecular epidemiology of FQ resistance.
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