Emergence and dissemination of quinolone-resistant Escherichia coli in the community

被引:232
作者
Garau, J
Xercavins, M
Rodríguez-Carballeira, M
Gómez-Vera, JR
Coll, I
Vidal, D
Llovet, T
Ruíz-Bremón, A
机构
[1] Univ Autonoma Barcelona, Dept Med, Hosp Mutua Terrassa, Serv Internal Med, Barcelona 08221, Spain
[2] Univ Autonoma Barcelona, Dept Med, Hosp Mutua Terrassa, Microbiol Serv, Barcelona 08221, Spain
[3] Univ Autonoma Barcelona, Dept Pathol, Fac Vet, Hosp St Pau, E-08193 Barcelona, Spain
[4] Univ Autonoma Barcelona, Dept Microbiol, Fac Med, Hosp St Pau, E-08193 Barcelona, Spain
[5] Inst Salud Carlos III, Ctr Nacl Epidemiol, Madrid, Spain
关键词
D O I
10.1128/AAC.43.11.2736
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
We studied the evolution of resistance to quinolones in Escherichia coli from 1992 to 1997 in Barcelona, Spain. An increasing proportion of quinolone-resistant E, coli (QREC) infections was observed. QREC strains were more common in patients with nosocomial infections but also increased in patients with community-acquired infections (9% in 1992 to 17% in 1996), Seventy (12%) of 572 episodes of E, coli bacteremia were due to QREC, Factors significantly associated with QREC bacteremia were the presence of underlying disease, recent exposure to antibiotics, and bacteremia of unknown origin. In the multivariate analysis, only prior exposure to antimicrobial agents (P < 0.001; odds ratio [OR] = 2), specifically, to quinolones (P < 0.001; OR = 14), and the presence of a urinary catheter (P < 0.001; OR = 2) were significantly associated with QREC bacteremia, Among 16 QREC isolates from cultures of blood of community origin selected at random, 13 different pulsed-field gel electrophoresis patterns were recognized, showing the genetic diversity of these isolates and in turn indicating the independent emergence of QREC in the community. The prevalence of QREC in the feces of healthy people was unexpectedly high (24% in adults and 26% in children), A survey of the prevalence of QREC of avian and porcine origin revealed a very high proportion of QREC in animal feces (up to 90% of chickens harbored QREC), The high prevalence of QREC in the stools of healthy humans in our area could be linked to the high prevalence of resistant isolates in poultry and pork.
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页码:2736 / 2741
页数:6
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