Title

Incidence of Single-Drug-, Multidrug-, and Extensively Drug-Antimicrobial Resistance of Escheria Coli Urinary Tract Infections: An Australian Laboratory-Based Retrospective Study

Author Faculty (Discipline)

Nursing

Document Type

Article

Publication Date

11-6-2018

Publication Details

This article was originally published as:

Fasugba, O., Das, A., Mnatzaganian, G., Mitchell, B., Collignon, P., & Gardner, A. (2019). Incidence of single-drug-, multidrug-, and extensively drug-antimicrobial resistance of Escherichia coli urinary tract infections: An Australian laboratory-based retrospective study. Journal of Global Antimicrobial Resistance, 16(1), 254-259. doi:10.1016/j.jgar.2018.10.026

ISSN: 2213-7165

ANZSRC / FoR Code

060502 Infectious Agents| 111099 Nursing not elsewhere classified| 111706 Epidemiology

Avondale Research Centre

Lifestyle Research Centre

Reportable Items

C1

Abstract

Objectives

To evaluate incidence of single-drug resistant, multidrug-resistant, extensively drug-resistant and pandrug-resistant E. coli urinary tract infections (UTI) in a sample of Australian Capital Territory (ACT) residents.

Methods

We utilised laboratory-based retrospective data from all ACT residents whose urine samples were processed from January 2009 to December 2013. Multivariate logistic regression models were constructed to determine the associations of age, sex, urine sample source and socioeconomic status with risk of resistant infections.

Results

A total of 146,915 urine samples from 57,837 ACT residents were identified over five years. Mean age of people in the sample was 48 years (standard deviation = 26 years) and 64.4% were females. Five-year incidence of single-drug resistant E. coli UTI was high for ampicillin, trimethoprim and cefazolin (6.8%, 3.5% and 1.9% respectively). No pandrug-resistant E. coli UTI was detected. Five-year incidences of multidrug- and extensively drug-resistant E. coli UTI were 1.9% and 0.2% respectively, which is low in comparison to international rates. Female sex and age over 38 years were significantly associated with single- and multidrug-resistance. Compared to hospitals, office-hours general practices, community and specialist health services, risk of single-drug resistance was significantly higher in samples from after-hours general practices (adjusted-odds ratio (OR) and 95% confidence intervals (CI) 2.6 (2.2–3.1)).

Conclusions

Our findings have significant implications for antimicrobial prescribing given identified risk factors for the detection of resistance, especially in patients attending after-hours general practices.

Comments

© 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

This article may be accessed from the publisher here.

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