Clinical consequences of increased ciprofloxacin and gentamicin resistance in patients with Escherichia coli bacteraemia in the Netherlands

Author： Cranendonk Duncan R.   van der Valk Marc   Langenberg M. L.   van der Meer Jan T. M.  

Publisher： Informa Healthcare

ISSN： 0036-5548

Source： Scandinavian Journal of Infectious Diseases, Vol.44, Iss.5, 2012-05, pp. : 363-368

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

AbstractBackground: Escherichia coli is a common cause of bacteraemia and is increasingly resistant to ciprofloxacin and gentamicin. The primary objective of this study was to investigate how often this leads to inadequate initial antimicrobial treatment. Secondary goals were to determine factors associated with inadequate empirical therapy and to assess its impact on mortality and length of stay. Methods: All patients with an E. coli bacteraemia hospitalized in 2008 were identified retrospectively. Initial antimicrobial therapy and clinical outcomes of all patients with an isolate resistant to gentamicin and/or ciprofloxacin (cases) were compared to those of a group of randomly selected patients in whom a gentamicin and ciprofloxacin susceptible E. coli was isolated (controls). Results: One hundred and thirty-six unique patients had E. coli bacteraemia. Of these, 34 patients were identified as cases and were compared to 34 controls. Among the cases, 97% of the E. coli was resistant to ciprofloxacin and 44% to gentamicin. Resistance to amoxicillin was high in both cases (94%) and controls (65%). In 41% of the cases initial antimicrobial therapy was inadequate, compared to only 3% in the controls. The majority of inadequately treated cases had a biliary focus (64%). Infections in cases were more often healthcare-associated than infections in controls (62% vs 26%). E. coli with the same resistance pattern had been isolated before in adequately treated cases more often than in inadequately treated cases. Mortality did not differ significantly between cases and controls. Conclusions: Neither ciprofloxacin nor amoxicillin should be used as empirical therapy in patients with a presumed E. coli bacteraemia.

Related content

Piperacillin-resistant Escherichia coli bacteraemia: Relation to empiric therapy and clinical outcome

By Andersen Niels Frost   Møller Jens   Peterslund Niels Anker  

Scandinavian Journal of Infectious Diseases, Vol. 37, Iss. 2, 2005-02 ,pp. : 90-95 (6)

Informa Healthcare

Access to resources Recommend Favorite

Genetic Relatedness of Enterococcus Faecalis Isolates with High-level Gentamicin Resistance from Patients with Bacteraemia in the South East of Sweden 1994-2001

By Saeedi Baharak   Hällgren Anita   Isaksson Barbro   Jonasson Jon   Nilsson Lennart E.   Hanberger Håkan  

Scandinavian Journal of Infectious Diseases, Vol. 36, Iss. 6-7, 2004-07 ,pp. : 405-409 (5)

Informa Healthcare

Access to resources Recommend Favorite

Epidemiological and Clinical Characteristics of Bacteraemia Caused by Aeromonas spp. as Compared with Escherichia coli and Pseudomonas aeruginosa

By Llopis Ferran   Grau Imma   Tubau Fe   Cisnal Maria   Pallares Roman  

Scandinavian Journal of Infectious Diseases, Vol. 36, Iss. 5, 2004-05 ,pp. : 335-341 (7)

Informa Healthcare

Access to resources Recommend Favorite

Contribution of Efflux to Cefuroxime Resistance in Clinical Isolates of Escherichia coli

By Källman Owe   Fendukly Faiz   Karlsson Inga   Kronvall Göran  

Scandinavian Journal of Infectious Diseases, Vol. 35, Iss. 8, 2003-08 ,pp. : 464-470 (7)

Informa Healthcare

Access to resources Recommend Favorite

Short-term gentamicin therapy and risk of renal toxicity in patients with bacteraemia

By Spanggaard Marianne H.   Hønge Bo L.   Schønheyder Henrik C.   Nielsen Henrik  

Scandinavian Journal of Infectious Diseases, Vol. 43, Iss. 11-12, 2011-12 ,pp. : 953-956 (4)

Informa Healthcare

Access to resources Recommend Favorite