Increased fluoroquinolone resistance with time in Escherichia coli from >17,000 patients at a large county hospital as a function of culture site, age, sex, and location.
Increased fluoroquinolone resistance with time in Escherichia coli from >17,000 patients at a large county hospital as a function of culture site, age, sex, and location.
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DOI：
10.1186/1471-2334-8-4
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发表时间：
2008-01-15
影响因子：
3.7
通讯作者：
Zechiedrich L
中科院分区：
文献类型：
--
作者：
Boyd LB;Atmar RL;Randall GL;Hamill RJ;Steffen D;Zechiedrich L
大肠杆菌感染很常见，通常用氟喹诺酮类药物治疗。氟喹诺酮类药物耐药性在全球范围内具有重要意义，并受到国家和国际监测网络的监测。在这项研究中，我们分析了时间，培养地点，患者的年龄，性别和地点对氟喹诺酮耐药的影响。大肠杆菌临床分离株。为了了解患者因素和时间如何影响氟喹诺酮耐药性，并确定来自监测网络的数据如何预测德克萨斯州休斯顿Ben Taub综合医院的趋势，我们使用Perl解析并使用MySQL存储来自E.使用卡方检验、Bonferroni和多元线性回归方法在1999年至2004年间分离出大肠杆菌。氟喹诺酮类药物耐药性（i）随时间增加;（ii）超过全国平均水平2- 4倍;（iii）男性高于女性，主要是因为男性门诊患者的尿液分离株;（iv）随患者年龄增加;（v）在儿科患者中为3%;（vi）住院患者高于门诊患者;（vii）无论患者位置如何，痰液样本（特别是住院患者的痰液样本）的阳性率高于所有其他培养地点（包括血液和尿液）;（viii）生殖器分离株的阳性率低于所有其他培养地点。此外，数据表明，关于Dade Behring MicroScan系统的敏感性或耐药性，单一氟喹诺酮足以作为所有检测氟喹诺酮的“替代标记物”。大型监测项目通常不能预测E。大肠杆菌氟喹诺酮类耐药趋势在一个大的，城市医院，主要是贫困，种族多样化的患者人群或其附属社区诊所。
Escherichia coli infections are common and often treated with fluoroquinolones. Fluoroquinolone resistance is of worldwide importance and is monitored by national and international surveillance networks. In this study, we analyzed the effects of time, culture site, and patient age, sex, and location on fluoroquinolone resistance in E. coli clinical isolates. To understand how patient factors and time influenced fluoroquinolone resistance and to determine how well data from surveillance networks predict trends at Ben Taub General Hospital in Houston, TX, we used Perl to parse and MySQL to house data from antibiograms (n ≅ 21,000) for E. coli isolated between 1999 to 2004 using Chi Square, Bonferroni, and Multiple Linear Regression methods. Fluoroquinolone resistance (i) increased with time; (ii) exceeded national averages by 2- to 4-fold; (iii) was higher in males than females, largely because of urinary isolates from male outpatients; (iv) increased with patient age; (v) was 3% in pediatric patients; (vi) was higher in hospitalized patients than outpatients; (vii) was higher in sputum samples, particularly from inpatients, than all other culture sites, including blood and urine, regardless of patient location; and (viii) was lowest in genital isolates than all other culture sites. Additionally, the data suggest that, with regard to susceptibility or resistance by the Dade Behring MicroScan system, a single fluoroquinolone suffices as a "surrogate marker" for all of the fluoroquinolone tested. Large surveillance programs often did not predict E. coli fluoroquinolone resistance trends at a large, urban hospital with a largely indigent, ethnically diverse patient population or its affiliated community clinics.