Universität zu Köln

Rohde, Anna M., Wiese-Posselt, Miriam, Zweigner, Janine, Schwab, Frank, Mischnik, Alexander, Seifert, Harald, Gastmeier, Petra ORCID: 0000-0001-5520-4287 and Kern, Winfried V. (2018). High admission prevalence of fluoroquinolone resistance in third-generation cephalosporin-resistant Enterobacteriaceae in German university hospitals. J. Antimicrob. Chemother., 73 (6). S. 1688 - 1692. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Objectives: Fluoroquinolone resistance (FQR) in third-generation cephalosporin-resistant Enterobacteriaceae 3GCRE) presents serious limitations to antibiotic therapy. The aim of this study was to investigate whether the FQR proportion among 3GCRE differs between community-acquired (CA) and hospital-acquired (HA) isolates. Methods: In a prospective observational study covering 2014 and 2015, we monitored the occurrence of 3GCRE in adult hospitalized patients in six German university hospitals. 3GCRE clinical isolates were subdivided into CA and HA. Multivariable analysis identified factors associated with in vitro non-susceptibility to ciprofloxacin. Results: The dataset included 5721 3GCRE isolates of which 52.9% were HA and 52.7% exhibited FQR. Interestingly, the FQR proportion was higher in CA 3GCRE than in HA 3GCRE (overall, 60.1% versus 46.2%, respectively, P<0.001). Multivariable analysis adjusting for age confirmed community acquisition as a risk factor for FQR [adjusted rate ratio (aRR) 1.33, 95% CI 1.17-1.53]. Escherichia coli and Klebsiella spp. were associated with a much higher FQR proportion than other Enterobacteriaceae species (aRR 8.14, 95% CI 6.86-9.65 and aRR 7.62 with 95% CI 6.74-8.61, respectively). Conclusions: The high FQR proportion observed among CA 3GCRE, particularly in E. coli and Klebsiella spp., indicates that selection pressure in the outpatient setting needs to be addressed with antibiotic stewardship and other interventions in order to limit further spread of MDR.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rohde, Anna M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiese-Posselt, Miriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Zweigner, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwab, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Mischnik, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Gastmeier, Petra UNSPECIFIED orcid.org/0000-0001-5520-4287 UNSPECIFIED Kern, Winfried V. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-183419
DOI:	10.1093/jac/dky040
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	73
Number:	6
Page Range:	S. 1688 - 1692
Date:	2018
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ESCHERICHIA-COLI; PNEUMONIAE; INFECTION; EMERGENCE; IMPACT Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18341