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Temporal changes in the prevalence of community-acquired antimicrobial-resistant urinary tract infection affected by Escherichia coli clonal group composition.
Clin Infect Dis. 2008 Mar 01; 46(5):689-95.CI

Abstract

BACKGROUND

The changing prevalence of drug-resistant community-acquired urinary tract infection (UTI) is often attributed to local antimicrobial drug use or prescribing practices. However, recent molecular epidemiologic studies of community-acquired UTI suggest that other factors may play a greater role.

METHODS

We conducted a multiyear, cross-sectional study to characterize temporal changes in the prevalence of drug-resistant community-acquired UTI at a university community in California. During four 3.5-month sampling periods, urine samples from patients consecutively presenting to the university health service with symptoms of UTI were cultured for Escherichia coli. Antimicrobial susceptibility and genotyping tests of the E. coli isolates were performed.

RESULTS

We recovered 780 E. coli isolates from 1667 patients with UTI. The prevalence of trimethoprim-sulfamethoxazole, ciprofloxacin, and nitrofurantoin resistance showed no trend over the 4 periods. The prevalence of ampicillin resistance decreased significantly over the last 2 study periods. A single clonal group accounted for 75% of this decrease. Enterobacterial repetitive intergenic consensus 2 PCR-based genotyping revealed that only 4 large clonal groups accounted for 52% of the UTIs resistant to trimethoprim-sulfamethoxazole, ciprofloxacin, or nitrofurantoin. No initially pansusceptible clonal groups gained resistance over time.

CONCLUSIONS

This study revealed no obvious trend in the prevalence of drug-resistant community-acquired UTI in a single community. Prevalence at any time was influenced by a small number of E. coli clonal groups. This observation suggests that the introduction of strains that are drug resistant into a community plays a greater role in changing the prevalence of drug-resistant UTI than does the drug use or prescribing habits in that community.

Authors+Show Affiliations

School of Public Health, University of California, Berkeley, CA 94720, USA. lwriley@berkeley.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18230040

Citation

Smith, Sherry P., et al. "Temporal Changes in the Prevalence of Community-acquired Antimicrobial-resistant Urinary Tract Infection Affected By Escherichia Coli Clonal Group Composition." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 46, no. 5, 2008, pp. 689-95.
Smith SP, Manges AR, Riley LW. Temporal changes in the prevalence of community-acquired antimicrobial-resistant urinary tract infection affected by Escherichia coli clonal group composition. Clin Infect Dis. 2008;46(5):689-95.
Smith, S. P., Manges, A. R., & Riley, L. W. (2008). Temporal changes in the prevalence of community-acquired antimicrobial-resistant urinary tract infection affected by Escherichia coli clonal group composition. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 46(5), 689-95. https://doi.org/10.1086/527386
Smith SP, Manges AR, Riley LW. Temporal Changes in the Prevalence of Community-acquired Antimicrobial-resistant Urinary Tract Infection Affected By Escherichia Coli Clonal Group Composition. Clin Infect Dis. 2008 Mar 1;46(5):689-95. PubMed PMID: 18230040.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Temporal changes in the prevalence of community-acquired antimicrobial-resistant urinary tract infection affected by Escherichia coli clonal group composition. AU - Smith,Sherry P, AU - Manges,Amee R, AU - Riley,Lee W, PY - 2008/1/31/pubmed PY - 2008/3/1/medline PY - 2008/1/31/entrez SP - 689 EP - 95 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 46 IS - 5 N2 - BACKGROUND: The changing prevalence of drug-resistant community-acquired urinary tract infection (UTI) is often attributed to local antimicrobial drug use or prescribing practices. However, recent molecular epidemiologic studies of community-acquired UTI suggest that other factors may play a greater role. METHODS: We conducted a multiyear, cross-sectional study to characterize temporal changes in the prevalence of drug-resistant community-acquired UTI at a university community in California. During four 3.5-month sampling periods, urine samples from patients consecutively presenting to the university health service with symptoms of UTI were cultured for Escherichia coli. Antimicrobial susceptibility and genotyping tests of the E. coli isolates were performed. RESULTS: We recovered 780 E. coli isolates from 1667 patients with UTI. The prevalence of trimethoprim-sulfamethoxazole, ciprofloxacin, and nitrofurantoin resistance showed no trend over the 4 periods. The prevalence of ampicillin resistance decreased significantly over the last 2 study periods. A single clonal group accounted for 75% of this decrease. Enterobacterial repetitive intergenic consensus 2 PCR-based genotyping revealed that only 4 large clonal groups accounted for 52% of the UTIs resistant to trimethoprim-sulfamethoxazole, ciprofloxacin, or nitrofurantoin. No initially pansusceptible clonal groups gained resistance over time. CONCLUSIONS: This study revealed no obvious trend in the prevalence of drug-resistant community-acquired UTI in a single community. Prevalence at any time was influenced by a small number of E. coli clonal groups. This observation suggests that the introduction of strains that are drug resistant into a community plays a greater role in changing the prevalence of drug-resistant UTI than does the drug use or prescribing habits in that community. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/18230040/Temporal_changes_in_the_prevalence_of_community_acquired_antimicrobial_resistant_urinary_tract_infection_affected_by_Escherichia_coli_clonal_group_composition_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/527386 DB - PRIME DP - Unbound Medicine ER -