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Clinical Trial
. 1999 Nov;43(11):2736-41.
doi: 10.1128/AAC.43.11.2736.

Emergence and dissemination of quinolone-resistant Escherichia coli in the community

J Garau  1 , M Xercavins, M Rodríguez-Carballeira, J R Gómez-Vera, I Coll, D Vidal, T Llovet, A Ruíz-Bremón
Affiliations
Free PMC article
Clinical Trial

Emergence and dissemination of quinolone-resistant Escherichia coli in the community

J Garau et al. Antimicrob Agents Chemother. 1999 Nov.
Free PMC article

Abstract

We studied the evolution of resistance to quinolones in Escherichia coli from 1992 to 1997 in Barcelona, Spain. An increasing proportion of quinolone-resistant E. coli (QREC) infections was observed. QREC strains were more common in patients with nosocomial infections but also increased in patients with community-acquired infections (9% in 1992 to 17% in 1996). Seventy (12%) of 572 episodes of E. coli bacteremia were due to QREC. Factors significantly associated with QREC bacteremia were the presence of underlying disease, recent exposure to antibiotics, and bacteremia of unknown origin. In the multivariate analysis, only prior exposure to antimicrobial agents (P < 0.001; odds ratio [OR] = 2), specifically, to quinolones (P < 0. 001; OR = 14), and the presence of a urinary catheter (P < 0.001; OR = 2) were significantly associated with QREC bacteremia. Among 16 QREC isolates from cultures of blood of community origin selected at random, 13 different pulsed-field gel electrophoresis patterns were recognized, showing the genetic diversity of these isolates and in turn indicating the independent emergence of QREC in the community. The prevalence of QREC in the feces of healthy people was unexpectedly high (24% in adults and 26% in children). A survey of the prevalence of QREC of avian and porcine origin revealed a very high proportion of QREC in animal feces (up to 90% of chickens harbored QREC). The high prevalence of QREC in the stools of healthy humans in our area could be linked to the high prevalence of resistant isolates in poultry and pork.

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Figures

FIG. 1
FIG. 1
Ciprofloxacin-resistant E. coli evolution (1992 to 1997). ⧫, isolates from blood (n = 564); ░⃞, nosocomially acquired isolates (n = 3,349); ▴, community-acquired isolates (n = 10,690). Numbers in squares indicate percentages of resistant isolates recovered each year.
FIG. 2
FIG. 2
Consumption of quinolones in the province of Barcelona. ⧫, metric tons; ■, DDDs/1,000 inhabitants.
See this image and copyright information in PMC

References

    1. Aguiar J M, Chacon J, Canton R, Baquero F. The emergence of highly fluoroquinolone-resistant E. coliin community-acquired urinary tract infections. J Antimicrob Chemother. 1992;29:349–350. - PubMed
    1. Ball P. Is resistant Escherichia coli bacteremia an inevitable outcome for neutropenic patients receiving a fluoroquinolone as prophylaxis? Clin Infect Dis. 1995;20:561–563. . (Editorial response.)
    1. Baquero F the Task Force of the General Direction for Health Planning of the Spanish Ministry of Health. Antibiotic resistance in Spain: what can be done? Clin Infect Dis. 1996;23:819–823. - PubMed
    1. Blanco J E, Blanco M, Mora A, Blanco J. Prevalence of bacterial resistance to quinolones and other antimicrobials among avian Escherichia colistrains isolated from septicemic and healthy chickens in Spain. J Clin Microbiol. 1997;35:2184–2185. - PMC - PubMed
    1. Campillo B, Dupeyron C, Richardet J P, Mangeney N, Leluan G. Epidemiology of severe hospital-acquired infections in patients with liver cirrhosis: effect of long-term administration of norfloxacin. Clin Infect Dis. 1998;26:1066–1070. - PubMed

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