Antimicrobial-resistant invasive Escherichia coli, Spain

Abstract

Surveillance System. A network of 32 Spanish hospitals, serving approximately 9.6 million persons, submitted antimicrobial-susceptibility data on 7,098 invasive Escherichia coli species (2001-2003). Resistance to ampicillin, cotrimoxazole, ciprofloxacin, gentamicin, and tobramycin was found at rates of 59.9%, 32.6%, 19.3%, 6.8%, and 5.3%, respectively. Resistance to multiple drugs increased from 13.8% in 2001 to 20.6% in 2003 (p <0.0001). Antimicrobial consumption data were obtained from the Spanish National Health System. In spite of decreased cephalosporin and beta-lactam use, overall extended-spectrum beta-lactamase production increased from 1.6% (2001) to 4.1% (2003) (p <0.0001), mainly due to the rising prevalence of cefotaximases. Resistance to ciprofloxacin significantly increased, mostly in community-onset infections, which coincided with a rise in community quinolone use. Cotrimoxazole resistance remained stable at approximately 30%, even though its use was dramatically reduced.

Figure 1

Annual evolution of antimicrobial resistance in invasive Escherichia coli isolated by Spanish laboratories participating in European Antimicrobial Resistance Surveillance System, 2001–2003.

Figure 2

Evolution of community quinolone consumption and prevalence of resistance to ciprofloxacin in invasive community-acquired Escherichia coli infections (European Antimicrobial Resistance Surveillance System–Spain 2001–2003). DDD, defined daily doses. 1, January–June; 2, July–December.

Figure 3

Annual evolution of community cotrimoxazole consumption and prevalence of resistance to cotrimoxazole in invasive community-acquired Escherichia coli infections, European Antimicrobial Resistance Surveillance System, Spain, 2001–2003. DDD, defined daily dose.