Escherichia coli: epidemiology and analysis of risk factors for infections caused by resistant strains.

This study analyzes the epidemiology of hospital and community-acquired infections caused by Escherichia coli. The antimicrobial resistance pattern was used to characterize the isolates, and a prospective observational study was performed to assess the relationship between antimicrobial use and bacterial resistance. The study was conducted during a 3-month period in a 1,200-bed tertiary care hospital in Nantes, France. An E. coli infection was diagnosed in 3.8% of the patients (507 of 13,384) admitted to the hospital between 1 January and 31 March 1996. Of the 507 isolates, 205 (40.4%) were resistant to at least one antimicrobial; 40% were resistant to amoxicillin, 30% to amoxicillin/clavulanate, 38% to ticarcillin, and 16% to trimethoprim-sulfamethoxazole, while resistance to other antimicrobials was low. Prior receipt of antimicrobial and/or immunosuppressive therapy was significantly associated with infection caused by a resistant organism.

[1]  S. Natsch,et al.  Use of amoxicillin-clavulanate and resistance in Escherichia coli over a 4-year period. , 1998 .

[2]  M. Kresken,et al.  Development of resistance in the past decade in central Europe. , 1986, The Journal of antimicrobial chemotherapy.

[3]  P. Allouch,et al.  Sensibilité aux bétalactamines de souches d'E. coli isolées en 1989 et 1993 dans 9 hôpitaux généraux* , 1994 .

[4]  M. Wagener,et al.  Association with prior fluoroquinolone therapy of widespread ciprofloxacin resistance among gram-negative isolates in a Veterans Affairs medical center , 1991, Antimicrobial Agents and Chemotherapy.

[5]  H. Richet,et al.  Fluoroquinolone use and fluoroquinolone resistance: is there an association? , 1994, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[6]  W. Jarvis.  Preventing the Emergence of Multidrug-Resistant Microorganisms Through Antimicrobial Use Controls: The Complexity of the Problem , 1996, Infection Control & Hospital Epidemiology.

[7]  N. Datta,et al.  R Factors in Escherichia coli in faeces after oral chemotherapy in general practice. , 1971, Lancet.

[8]  J M Hughes,et al.  CDC definitions for nosocomial infections, 1988. , 1988, American journal of infection control.

[9]  J. Mcgowan.  Is antimicrobial resistance in hospital microorganisms related to antibiotic use? , 1987, Bulletin of the New York Academy of Medicine.

[10]  M. Finland.  Emergence of antibiotic resistance in hospitals, 1935-1975. , 1979, Reviews of infectious diseases.

[11]  R A Weinstein,et al.  Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in Hospitals. A challenge to hospital leadership. , 1996, JAMA.

[12]  Surveillance of Nosocomial Infections: A Fundamental Ingredient for Quality , 1997 .

[13]  J. Ariza,et al.  Relationship between quinolone use and emergence of ciprofloxacin-resistant Escherichia coli in bloodstream infections , 1995, Antimicrobial agents and chemotherapy.

[14]  J. Mcgowan,et al.  Do Intensive Hospital Antibiotic Control Programs Prevent the Spread of Antibiotic Resistance? , 1994, Infection Control & Hospital Epidemiology.

[15]  B. Yangco,et al.  CDC definitions for nosocomial infections. , 1989, American journal of infection control.

[16]  P. Pina,et al.  Observatoires hospitaliers de la sensibilité de E. coli et de Klebsiella à l'association amoxicilline-acide clavulanique en 1994 , 1995 .

[17]  V. Lorian,et al.  Antimicrobial agent susceptibility patterns of bacteria in hospitals from 1971 to 1982 , 1984, Journal of clinical microbiology.

[18]  J. Morris,et al.  Enterococci Resistant to Multiple Antimicrobial Agents, Including Vancomycin: Establishment of Endemicity in a University Medical Center , 1995, Annals of Internal Medicine.

[19]  S. Solomon,et al.  Health and economic impacts of antimicrobial resistance. , 1987, Reviews of infectious diseases.

[20]  A. MacGowan,et al.  An eight-year survey of the antimicrobial susceptibility patterns of 85,971 bacteria isolated from patients in a district general hospital and the local community. , 1993, The Journal of antimicrobial chemotherapy.

[21]  W J Martone,et al.  Methicillin-resistant Staphylococcus aureus in U.S. hospitals, 1975-1991. , 1992, Infection control and hospital epidemiology.

[22]  J. Duval,et al.  Resistance aux antibiotiques chez Escherichia coli , 1988 .

[23]  R. Haley.  Measuring the costs of nosocomial infections: methods for estimating economic burden on the hospital. , 1991, The American journal of medicine.

[24]  D. Sirot,et al.  Etude de la sensibilité à l'Augmentin® de 998 souches de Escherichia coli isolées en 1992 dans quatre centres hospitaliers français (Etude COLICERIB I) , 1994 .

[25]  A. Dublanchet,et al.  Escherichia coli dans un hôpital général de 1982 à 1993 , 1994 .

[26]  H. Dupont,et al.  Emergence of high-level trimethoprim resistance in fecal Escherichia coli during oral administration of trimethoprim or trimethoprim-sulfamethoxazole. , 1982 .

[27]  M. Kresken,et al.  Development of resistance to nalidixic acid and the fluoroquinolones after the introduction of norfloxacin and ofloxacin , 1988, Antimicrobial Agents and Chemotherapy.