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Older patient age and prior antimicrobial use strongly predict antimicrobial resistance in Escherichia coli isolates recovered from urinary tract infections among female outpatients

Author

Listed:
  • Fanny S Mitrani-Gold
  • Keith S Kaye
  • Vikas Gupta
  • Aruni Mulgirigama
  • Barbara W Trautner
  • Nicole E Scangarella-Oman
  • Kalvin C Yu
  • Gang Ye
  • Ashish V Joshi

Abstract

Background: Increasing prevalence of antimicrobial resistance (AMR), including multidrug resistance (MDR), among Escherichia coli (E. coli) makes treatment of uncomplicated urinary tract infection (uUTI) difficult. We assessed risk factors for fluoroquinolone (FQ)-not-susceptible (NS) and MDR E. coli among US female outpatients. Methods: This retrospective cohort study utilized data from female outpatients aged ≥ 12 years with E. coli positive urine culture and oral antimicrobial prescription ± 1 day from index. We assessed patient-level factors within 90 and 91–360 days prior to index as predictors of FQ NS (intermediate/resistant) and MDR (NS to ≥ 1 drug across ≥ 3 classes) E. coli: age, prior oral antimicrobial dispensing, prior AMR phenotypes, prior urine culture, and prior hospitalization. Results: Among 1,858 outpatients with urine-isolated E. coli, 369 (19.9%) had FQ NS and 59 (3.2%) had MDR isolates. After multivariable adjustment, independent risk factors (p

Suggested Citation

  • Fanny S Mitrani-Gold & Keith S Kaye & Vikas Gupta & Aruni Mulgirigama & Barbara W Trautner & Nicole E Scangarella-Oman & Kalvin C Yu & Gang Ye & Ashish V Joshi, 2023. "Older patient age and prior antimicrobial use strongly predict antimicrobial resistance in Escherichia coli isolates recovered from urinary tract infections among female outpatients," PLOS ONE, Public Library of Science, vol. 18(5), pages 1-11, May.
    • Handle: RePEc:plo:pone00:0285427
    DOI: 10.1371/journal.pone.0285427
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